The VEINES-QOL/Sym questionnaire is a reliable and valid disease-specific quality of life measure for deep vein thrombosis in elderly patients.

PURPOSE To prospectively evaluate the psychometric properties of the Venous Insufficiency Epidemiological and Economic Study (VEINES-QOL/Sym) questionnaire, an instrument to measure disease-specific quality of life and symptoms in elderly patients with deep vein thrombosis (DVT), and to validate a German version of the questionnaire. METHODS In a prospective multicenter cohort study of patients aged ≥ 65 years with acute venous thromboembolism, we used standard psychometric tests and criteria to evaluate the reliability, validity, and responsiveness of the VEINES-QOL/Sym in patients with acute symptomatic DVT. We also performed an exploratory factor analysis. RESULTS Overall, 352 French- and German-speaking patients were enrolled (response rate of 87 %). Both language versions of the VEINES-QOL/Sym showed good acceptability (missing data, floor and ceiling effects), reliability (internal consistency, item-total and inter-item correlations), validity (convergent, discriminant, known-groups differences), and responsiveness to clinical change over time in elderly patients with DVT. The exploratory factor analysis of the VEINES-QOL/Sym suggested three underlying dimensions: limitations in daily activities, DVT-related symptoms, and psychological impact. CONCLUSIONS The VEINES-QOL/Sym questionnaire is a practical, reliable, valid, and responsive instrument to measure quality of life and symptoms in elderly patients with DVT and can be used with confidence in prospective studies to measure outcomes in such patients.

Quality of life after pulmonary embolism: validation of the French version of the PEmb-QoL questionnaire.

BackgroundThe PEmb-QoL is a validated 40-item questionnaire to quantify health-related quality of life in patients having experienced pulmonary embolism (PE). It covers six health dimensions: frequency of complaints, activities of daily living limitations, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we sought to prospectively validate the psychometric properties of a French version of the PEmb-QoL.MethodsWe performed a forward and backward translation of the English version of the PEmb-QoL into French. French-speaking consecutive adult patients with an acute, objectively confirmed PE admitted to the emergency department of a Swiss university hospital between 08/2009 and 09/2011 were recruited telephonically. We used standard psychometric tests and criteria to evaluate the acceptability, reliability, and validity of the French version of the PEmb-QoL. We also performed an exploratory factor analysis.ResultsOverall, 102 patients were enrolled in the study. The French version of the PEmb-QoL showed good reliability (internal consistency, item¿total and inter-item correlations), reproducibility (test-retest reliability), and validity (convergent, discriminant) in French-speaking patients with PE. The exploratory factor analysis suggested three underlying dimensions: limitations in daily activity (items 4b-m, 5a-d), symptoms (items 1a-h and 7), and emotional complaints (items 9a-f and j).ConclusionWe successfully validated the French version of the PEmb-QoL questionnaire in patients with PE. Our results show that the PEmb-QoL is a valuable tool for assessing health-related quality of life after PE in French-speaking patients.

Quality of life after pulmonary embolism: Prospective validation of the German version of the PEmb-QoL questionnaire.

BACKGROUND The Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL) is a 40-item questionnaire to measure health-related quality of life in patients with pulmonary embolism. It covers six 6 dimensions: frequency of complaints, limitations in activities of daily living, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we prospectively validated a German version of the PEmb-QoL. METHODS A forward-backward translation of the English version of the PEmb-QoL into German was performed. German-speaking consecutive adult patients aged ≥18 years with an acute, objectively confirmed pulmonary embolism discharged from a Swiss university hospital (01/2011-06/2013) were recruited telephonically. Established psychometric tests and criteria were used to evaluate the acceptability, reliability, and validity of the German PEmb-QoL questionnaire. To assess the underlying dimensions, an exploratory factor analysis was performed. RESULTS Overall, 102 patients were enrolled in the study. The German version of the PEmb-QoL showed a good internal consistency (Cronbach's alpha ranging from 0.72 to 0.96), item-total (0.53-0.95) and inter-item correlations (>0.4), and test-retest reliability (intra-class correlation coefficients 0.59-0.89) for the dimension scores. A moderate correlation of the PEmb-QoL with SF-36 dimension and summary scores (0.21-0.83) indicated convergent validity, while low correlations of PEmb-QoL dimensions with clinical characteristics (-0.16-0.37) supported discriminant validity. The exploratory factor analysis suggested four underlying dimensions: limitations in daily activities, symptoms, work-related problems, and emotional complaints. CONCLUSION The German version of the PEmb-QoL questionnaire is a valid and reliable disease-specific measure for quality of life in patients with pulmonary embolism.

Polarisierung als Strategie. Die Polarisierung des Schweizer Parteiensystems im internationalen Vergleich

Im letzten Beitrag erweitern Klaus Armingeon und Sarah Engler die Perspektive und analysieren die Polarisierung des Schweizer Parteiensystems im internationalen Vergleich. Ausgangspunkt ihres Kapitels ist die Erkenntnis, dass in kaum einem anderen europäischen Land die programmatischen Positionen der grossen Parteien so weit voneinander entfernt sind wie in der Schweiz. Während schon andere Studien die Parteipolarisierung in der Schweiz untersucht haben (Brändle 1 999; Hug und Schulz 2007; Ladner et al. 2010), nehmen Armingeon und Engler erstmalig einen direkten Vergleich der Parteipolarisierung und der Bevölkerungspolarisierung aus einer international komparativen Perspektive unter Einbezug der Schweiz vor. Konkret befassen sie sich mit der Frage, wie die programmatische Polarisierung der Schweizer Parteien mit der ideologischen Polarisierung der Gesamtwählerschaft und der Polarisierung der einzelnen Parteiwählerschaften in den drei zentralen Dimensionen des politisch en Wettbewerbs zusammenhängt (d.h. wenn es um mehr oder weniger Staatseingriffe in die Wirtschaft, um libertäre oder konservativ-autoritäre Werte sowie um den Grad der internationalen Öffnung des Landes geht). Im Falle der Konfliktlinie «Öffnung vs. Schliessung» weisen Armingeon und Engler darauf hin, dass sich die Parteienpolarisierung in der Schweiz nicht etwa auf ein hohes Niveau der Fremdenfeindlichkeit oder eine starke Polarisierung der Gesamtwählerschaft zurückführen lässt. Vielmehr zeigen sie, dass es den Parteien umso besser gelingt, ihre Zielwählerschaften in einer Dimension anzusprechen, je stärker sie sich programmatisch polarisieren. Diese Sortierungsleistung geht somit auf eine strategische Entscheidung der Parteien zurück, sich in einer Dimension des politischen Wettbewerbs zu profilieren und damit optimal ihr Wählerpotenzial auszuschöpfen. Dabei ist es der SVP am besten gelungen, den Konflikt zwischen Öffnung und Schliessung zielgruppengerecht zu thematisieren und zu ihrem Kernprogramm zu machen. Damit werden vor allem all jene Wähler von der Volkspartei angesprochen, die sich durch Globalisierung, Europäisierung und Migrationsströme besonders bedroht fühlen. In diesem Sinne ist die SVP gemäss Armingeon und Engler Schweizer Meisterin im Heraussortieren ihrer Wählerschaft aus einer insgesamt ziemlich homogenen Wählerschaft.