Validation of Italian multiple sclerosis quality of life 54 questionnaire

Objectives-Health related quality of life (HRQOL) inventories are multidime nsional measures of patient-centred health status developed for clinical re search. The MS quality of life 54 (MSQOL-54) is an MS-specific HRQOL invent ory originally devised for English speaking patients. It consists of a core measure, the 36-item short form health survey (SF-36) previously adapted i nto Italian, and 18 additional items exploring domains relevant to patients with MS (MS-18 module). The authors translated and culturally adapted into Italian the MS-18 module of the MSQOL-54 questionnaire, and clinically val idated the whole questionnaire. Methods-The MS-18 module was translated following the methodology of the In ternational Quality of Life Assessment (IQOLA) project. The MSQOL-54 was va lidated in 204 consecutive patients with MS seen between April and Septembe r 1997 at three participating centres. The questionnaire was explained by t he physician who also administered the expanded disability status scale (ED SS) and mini mental status scale examination, and the patient filled in the MSQOL-54 and Beck depression inventory questionnaires (BDI), with assistan ce if required. The contribution of impairments and disabilities to MSQOL-5 4 scores were assessed, and mean scores were compared with normative data f or the general Italian population, and with the original sample of United S tates MS patients. Results-The mean age of the 204 patients was 42 years; mean EDSS score was 4.5 (range 0-8.5). Patients' participation in the assessment was satisfacto ry and all scales satisfied the usual psychometric standards. The character istics of the United States sample matched those of our patients in all but gender (72% United States patients v 52% Italian patients were women), and education (90% United States patients and 44% Italian patients completed h igh school); MSQOL-54 profiles were also similar. The EDSS was significantl y associated with the physical health composite but not with the mental hea lth composite score. Multiple linear regression modelling showed that age a nd BDI independently predicted physical health composite (p < 0.001), and m ental health composite (p < 0.001). Clinical worsening in the previous year had an independent effect on the physical health composite (p < 0.001). Conclusions-The Italian version of MSQOL-54 is easy to administer and is we ll accepted by patients. Neurological impairment has a limited influence on perceived quality of life, while age and depressive symptoms has a major i nfluence.