Comparison of the Dutch and English versions of the Carolinas Comfort Scale: a specific quality-of-life questionnaire for abdominal hernia repairs with mesh

K Nielsen, M M Poelman, F M den Bakker, T van der Ploeg, H J Bonjer, W H Schreurs
Hernia: the Journal of Hernias and Abdominal Wall Surgery 2014, 18 (4): 459-64

PURPOSE: Repair of abdominal wall hernias with mesh is one of the most common procedures in general surgery. The introduction of hernia repair with mesh has lowered recurrence rates and shifted the focus to quality of life after surgery, raising the need for a specific tool measuring quality of life. The Carolinas Comfort Scale (CCS) is a questionnaire designed specifically for patients having hernia repair with mesh. The aim of this study is to validate the Dutch CCS and to compare it to the generic short form-36 (SF-36).

METHODS: The CCS questionnaire was translated into Dutch. Patients undergoing mesh hernia repair between April 2010 and December 2011 completed the CCS, the SF-36 and four questions comparing these two questionnaires in the first week after surgery. After 3 weeks, the CCS was repeated. Correlations between the two surveys were calculated using the Spearman's rank correlation test with a 95 % confidence interval to determine validity.

RESULTS: The response rate was 60.3 % (100/168). The CCS showed excellent reliability with a Cronbach's α of 0.948. Significant correlation existed between the CCS and the domains physical functioning, bodily pain, role-physical, vitality and social functioning of the SF-36. Seventy-nine percent of the patients preferred the CCS to the SF-36, and 83 % considered the CCS a better reflection of their quality of life after hernia repair with mesh.

CONCLUSION: The Dutch CCS appears a valid and clinically relevant tool for assessing quality of life after repair of abdominal wall hernia with mesh.

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