QUALITY-OF-LIFE IN PATIENTS UNDERGOING TREATMENT FOR CHRONIC RADIATION-INDUCED RECTAL BLEEDING

Background Laser and formalin therapy have recently been shown to be s afe methods of haemostasis in patients with chronic radiation-induced rectal bleeding (CRRB). The effectiveness of this treatment in terms o f improved quality of life remains to be determined. The aim of this s tudy was to develop a questionnaire measure of self-perceived quality of life in patients with CRRB. Methods A self-completed Rectal Bleedin g Quality of Life Scale (RBQOLS) based on the social and emotional pro blems experienced by patients with CRRB was developed using standard p sychometric methods. Before laser and formalin therapy, 34 consecutive patients completed the questionnaire which was repeated I month after treatment and again 5 months later. The validity of the scale was ass essed in relation to patient response to treatment. Results The RBQOLS had high reliability (alpha = 0.89) and its concurrent validity was c onfirmed by a significant association with the pretreatment severity o f CRRB assessed endoscopically, The mean RBQOLS score increased from 1 02 (95 per cent confidence interval 90-114) before treatment to 126 (1 11-141) after treatment (t = 3.1, 33 d.f., P = 0.004) and 136 (122-151 ) at follow-up attesting to its predictive validity. Conclusion The RB QOLS is a reliable and valid device for assessing quality of life of p atients with this uncommon, previously intractable and potentially lif e threatening complication of radiotherapy.