Despite the existence of numerous knee-joint specific patient-reported outcome measures, the content contained within such instruments does not completely capture the spectrum of injury and impairments experienced by multi-ligament knee injured patients. Based on this shortcoming, the overall objective of the current study was to develop, and to test the reliability and validity of a novel disease-specific quality of life instrument for patients with multi-ligament knee injuries. The World Health Organization’s International Classification of Functioning, Disability, and Health was used to guide content development. Using a mixed methods approach (surveys, patient focus groups, expert interviews), the final Multi-ligament Quality of Life (MLQOL) instrument was comprised of 52 items distributed over 4 domains. This instrument demonstrated excellent content validity, test-retest reliability, and construct validity. Future work will evaluate the responsiveness of the MLQOL and will implement its use in randomized trials.

Despite the existence of numerous knee-joint specific patient-reported outcome measures, the content contained within such instruments does not completely capture the spectrum of injury and impairments experienced by multi-ligament knee injured patients. Based on this shortcoming, the overall objective of the current study was to develop, and to test the reliability and validity of a novel disease-specific quality of life instrument for patients with multi-ligament knee injuries. The World Health Organization’s International Classification of Functioning, Disability, and Health was used to guide content development. Using a mixed methods approach (surveys, patient focus groups, expert interviews), the final Multi-ligament Quality of Life (MLQOL) instrument was comprised of 52 items distributed over 4 domains. This instrument demonstrated excellent content validity, test-retest reliability, and construct validity. Future work will evaluate the responsiveness of the MLQOL and will implement its use in randomized trials.

The rapid growth in opioid therapy for non-cancer pain has occurred without an adequate appreciation of the consequences of this growth. Few studies provide patient-centered evidence that can be used to inform the current proposed standards for efficacious (safe and effective) opioid prescribing in non-cancer pain. Furthermore, different terms may be used interchangeably in the literature to refer to opioid-taking behaviors, resulting in imprecise or vague interpretation of existing evidence. We therefore sought to explore patterns of opioid-taking behavior and their biopsychosocial-spiritual determinants in African-American adults with sickle cell disease (SCD). Many questions surround opioid use for non-cancer pain, but little has been published about behavioral patterns of taking opioids in these conditions. The main objective of this study was to develop a disease-specific scale for describing prescribed opioid taking in patients with sickle cell disease (SCD). As part of a multiphase, mixed-methods study, we used an adaptation of several published methods to construct 9 sequential, chronological steps for developing a new scale. We report here wide-ranging quantitative and semi-structured, qualitative interviews of 13 male and 11 female African-American adults with SCD, average age 36 years, from various socioeconomic and educational levels. We used grounded theory, priori and posteriori procedures to analyze the qualitative data, and to conduct an appraisal of translational validity. Scale development results have led to inclusion in the draft scale of new concepts namely momentary medication-taking behavior. The scale also captures concrete patterns of adherence for as-needed and scheduled medication and allows for several discovered conceptual domains that explain observed opioid-taking behaviors. These concepts challenge the current theories and models of medication-taking behavior and adherence. In summary, we found that contextual factors may drastically affect opioid-taking behaviors. Together, These uncovered phenomena raise new hypotheses that may challenge current theories and models of medication-taking behaviors and methods of assessing adherence. These hypotheses call for a new round of research on opioid-taking behavior, and need to be rigorously tested in future research