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A new measure for end of life planning, preparation, and preferences in Huntington disease: HDQLIFE end of life planning
Journal article   Open access   Peer reviewed

A new measure for end of life planning, preparation, and preferences in Huntington disease: HDQLIFE end of life planning

Noelle Carlozzi, E Hahn, S Frank, J Perlmutter, N Downing, M McCormack, S Barton, M Nance, S G Schilling, Praveen Dayalu, …
Journal of neurology, Vol.265(1), pp.98-107
01/01/2018
DOI: 10.1007/s00415-017-8677-7
PMCID: PMC5762414
PMID: 29143208
url
https://www.ncbi.nlm.nih.gov/pmc/articles/5762414View
Open Access

Abstract

Background Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life. Aim The purpose of this study was to develop a new measure to evaluate end of life planning. Design We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine the psychometric properties of items; exploratory factor analysis was used to establish meaningful subscales. Participants Participants included 508 individuals with pre-manifest or manifest Huntington disease. Results Item response theory supported the retention of all 16 items on the huntington disease quality of life (“HDQLIFE”) end of life planning measure. Exploratory factor analysis supported a four-factor structure: legal planning, financial planning, preferences for hospice care, and preferences for conditions (locations, surroundings, etc.) at the time of death. Although a handful of items exhibited some evidence of differential item functioning, these items were retained due to their relevant clinical content. The final 16-item scale includes an overall total score and four subscale scores that reflect the different end of life planning constructs. Conclusions The 16-item HDQLIFE end of life planning measure demonstrates adequate psychometric properties; it may be a useful tool for clinicians to clarify patients’ preferences about end of life care.
Huntingtons Disease Quality of Life Quantitative Psychology Factor analysis Financial planning Literature reviews

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