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Development and validation of a PROM to capture holistic outcomes in traditional, complementary and integrative medicine - The Warwick Holistic Health Questionnaire (WHHQ-18)
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Brough, Nicola, Stewart-Brown, Sarah L., Parsons, Helen and Perera, Chinthana (2021) Development and validation of a PROM to capture holistic outcomes in traditional, complementary and integrative medicine - The Warwick Holistic Health Questionnaire (WHHQ-18). European Journal of Integrative Medicine, 47 . 101375. doi:10.1016/j.eujim.2021.101375 ISSN 1876-3820.
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WRAP-Development-validation-PROM-holistic-traditional-complementary-integrative-medicine-WHHQ-18-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1251Kb) | Preview |
Official URL: https://doi.org/10.1016/j.eujim.2021.101375
Abstract
Introduction: Existing patient reported outcome measures (PROMs) do not capture all holistic outcomes observed in Traditional, Complementary and Integrative Medicine (TCIM). This study reports development and validation of a PROM to support research on craniosacral therapy (CST) and other TCIMs.
Methods: Using a conceptual framework and items developed and evaluated with clients and practitioners in a CST setting, a questionnaire was developed and tested using mixed methods approaches. Evaluation included an iterative process. Psychometric tests: structural validity (exploratory factor analysis, EFA), internal consistency (Cronbach's alpha), convergent validity (correlations with Warwick-Edinburgh Mental Wellbeing Scale, Short Form-12v2 (SF-12), Harry Edwards Healing Impact Questionnaire), repeatability and responsiveness (t-tests; intra class coefficients, ICC).
Results: The Warwick Holistic Health Questionnaire (WHHQ-18) was resolved covering mental, physical, emotional and spiritual wellbeing, self-awareness, engaging in life, responsibility for self, living in the moment and satisfaction with life.
EFA revealed four correlated sub-scales. Internal reliability was good (alpha = 0.852). Convergent validity showed strong positive correlation with other wellbeing measures, but no correlation with health-related quality of life (SF-12). Repeatability testing showed good agreement (ICC=0.822) and no differences in scores for test-retest (paired t-test: t = 0.355, p = 0.723). Responsiveness analysis showed significant differences in scores (paired t-test t = 6.15, p < 0.001) with 46% of participants having an effect size of 0.5 or more.
Conclusion: WHHQ-18 is the first PROM developed for CST practice and captures outcomes important to TCIM more broadly. Good internal consistency, test-retest reliability and responsive at individual and group level make this new PROM an attractive resource for evaluators. Lack of convergent validity with SF-12 scales suggests WHHQ-18 be added to rather than replace HRQol measures in clinical studies.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RZ Other systems of medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Outcome assessment (Medical care), Medical care -- Evaluation, Patient satisfaction , Alternative medicine , Integrative medicine, Traditional medicine , Craniosacral therapy , Holistic medicine | |||||||||
| Journal or Publication Title: | European Journal of Integrative Medicine | |||||||||
| Publisher: | Urban und Fischer Verlag | |||||||||
| ISSN: | 1876-3820 | |||||||||
| Official Date: | October 2021 | |||||||||
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| Volume: | 47 | |||||||||
| Article Number: | 101375 | |||||||||
| DOI: | 10.1016/j.eujim.2021.101375 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Copyright Holders: | Elsevier | |||||||||
| Date of first compliant deposit: | 19 October 2021 | |||||||||
| Date of first compliant Open Access: | 20 October 2021 | |||||||||
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