Measuring asthma-specific quality of life: structured review.

Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.

The understanding of their illness amongst people with irritable bowel syndrome: a Q methodological study.

Irritable Bowel Syndrome (IBS) refers to a collection of gastrointestinal symptoms which affect up to 22% of the Western population. Although the disorder costs the British National Health Service and employers vast sums of money in terms of repeated physician visits, medications, and loss of productivity, the cause or causes of IBS are still unknown, and there is no cure which is lastingly effective. Since IBS is not life-threatening, and the symptoms can be hidden from others, many consider it a trivial disorder. For an individual with IBS, however, the uncertainty regarding cause, diagnosis and treatment may lead to anxiety and constant searching for causes, or to hopelessness and resignation. The present study aims to help clarify these problems by discovering how those who suffer from IBS understand the nature and causality of their own illness. Through use of Q methodology with a sample of 60 people with IBS, a taxonomy of 7 clear and distinct accounts is identified and described. These data (based on Q factor analysis) are described in qualitative detail and discussed in relation to the problem of improving communication with doctors, and untangling issues of responsibility for illness.

Young Women's Accounts of Sexual Activity and Sexual/ Reproductive Health.

The accounts of sexual activity and sexual health from group discussions with young women living in a variety of ethnic communities in East London, UK, were examined. Thematic decomposition was employed to explicate a number of themes: sex as technical knowledge; sexual intercourse as intimacy; naturalizing sexual activity as part of adolescent development; constraints on being sexually active and relations with young men; and constructions of young women's sexual activity within the family. These themes are discussed in terms of the salience of various complex and sometimes contradictory meanings of sex for young women, the social and cultural contexts in which young women are sexually active and seek to negotiate 'safe sex' and the implications for sex and health education addressed to young people.