IDENTIFYING THE CONTENT AREA FOR THE 51-ITEM NATIONAL-EYE-INSTITUTE VISUAL FUNCTION QUESTIONNAIRE - RESULTS FROM FOCUS GROUPS WITH VISUALLY-IMPAIRED PERSONS

Objective: To identify the content area for a questionnaire designed t o measure vision-targeted health-related quality of life and to determ ine whether problems with vision-related functioning are qualitatively similar across different common eye diseases. Design: Twenty-six cond ition-specific focus groups were conducted with 246 patients from 5 ge ographic regions to identify the content area for a questionnaire for use among persons with diabetic retinopathy, glaucoma, macular degener ation, cytomegalovirus retinitis, and cataract. A standard protocol wa s used to structure each focus group discussion. Sessions were audiota ped, transcribed, and coded in preparation for a content analysis. Set tings: Five university-based ophthalmology practices and 1 nonprofit e ye care foundation. Participants: Eligible participants had to have 1 of the following eye conditions: age-related cataracts, age-related ma cular degeneration, diabetic retinopathy, primary open angle glaucoma, cytomegalovirus retinitis, or low vision from any cause. All eligible persons were older than 21 years, spoke English, and had sufficient c ognitive function to provide informed consent. Results: Among the 246 participants, 2623 problems with vision-related functioning were menti oned. The mean number of problems per person ranged from 13.5 for thos e with diabetic retinopathy to 7.9 for persons with glaucoma. For the sample overall, reading problems were mentioned most frequently, follo wed by driving, general problems with seeing clearly, and mental healt h complaints caused by vision. Although the proportion of persons who reported each problem varied by condition, at least some persons with each eye disease reported each problem. The 3 most common descriptors associated with each problem were difficulty or ease of performance (1 3%), psychological distress associated with performance of the activit y (11%), and complete inability to participate in a visual activity (1 1%). Conclusion: An item-generation strategy for a new questionnaire u sing a standardized focus group method identified content areas and as pects of visual disability that are not included in currently availabl e vision-specific instruments that assess the impact of common eye dis eases on visual functioning in everyday life. Although participants me ntioned problems that were unique to their disease, across conditions the problems mentioned were similar. These findings provide empirical evidence of content validity for a vision-targeted, health-related qua lity-of-life survey designed for use across conditions.