Qualidade de vida relacionada à saúde de pacientes com mieloma múltiplo: validade e confiabilidade do módulo EORTC QLQ-MY20 para o Brasil e a influência dos esquemas terapêuticos

Abstract

Multiple myeloma (MM) is an incurable hematological cancer, with a higher prevalence in the elderly. The main objective of MM treatment is to increase patients' life expectancy and improve health-related quality of life (HRQoL). In Brazil, there are still few studies that address this theme and there is no specific instrument for assessing HRQoL for MM validated. The study aimed to analyze the validity and reliability of the QLQ-MY20 instrument and to assess HRQoL in Brazilians. This is a cross-sectional study, with a methodological step that addressed the analyzes of validity and reliability for the QLQ-MY20 instrument. The assessment of HRQoL was carried out using the QLQ-C30 and the specific module QLQ-MY20 among different variables, including therapeutic regimens for the treatment of MM. The study was carried out between April 2019 and February 2020, in onco-hematology outpatient clinics in the public and private outpatient services of Belo Horizonte, Minas Gerais. Data were collected through face-to-face interviews and medical records with the aid of the Questionnaire Development System program (QDS, version 2.6.1.1). The data were exported to the Microsoft Excel® program, followed by the statistical analysis on statistical softwares. For the methodological study, content validity analysis (Content Validity Coefficient - CVC), convergent and divergent validity (Spearman's Correlation Coefficient - CC), internal consistency (Cronbach's Alpha) and temporal reproducibility were evaluated using a test-retest (Intraclass Correlation Coefficient - ICC). In the HRQOL evaluation study, univariate analyzes (Mann-Whitney), multiple comparisons (Kruskal-Wallis) and multiple linear regression were performed. In the methodological study, adequate content validity was observed through the analysis of a committee of judges. There was also good internal consistency of the items and good discrimination power, in addition to good temporal stability, assessed through test-retest. Therefore, satisfactory results were obtained for the validity and reliability of the QLQ-MY20 instrument. With this study it is concluded that there is an association of HRQoL of patients with MM and polypharmacy. However, there was no difference between the schemes used in the specific assessment scales for MM, demonstrating that in the context of Brazil, from the perspective of HRQoL, these schemes can be equivalent