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Overall Quality of Life and Difficulty Paying for Ostomy Supplies in the Veterans Affairs Ostomy Health-Related Quality of Life Study: An Exploratory Analysis

Coons, Stephen Joel PhD*‡; Chongpison, Yuda MS, MBA†; Wendel, Christopher S. MS§; Grant, Marcia RN, DNSc∥; Krouse, Robert S. MD, FACS¶**

doi: 10.1097/MLR.0b013e318074ce9b
Brief Report

Purpose: To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA).

Methods: The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related Quality of Life Study, in which 511 respondents (239 cases, 272 controls) completed a survey instrument that included the modified City of Hope Quality of Life (mCOH-QOL) Ostomy questionnaire, SF-36V, and sociodemographic items. Responses from the 239 cases (ie, patients with intestinal stomas) were used in this analysis. The modified City of Hope Quality of Life Ostomy questionnaire item, “How good is your overall quality of life?,” was the dependent variable for this analysis. The primary independent variable was the response (yes/no) to the item, “If you pay for any of the (ostomy) costs, is it difficult for you?” A hierarchical regression model was used to examine whether difficulty paying was significantly related to overall quality of life after adjusting for age, income, race/ethnicity, and physical health.

Results: After accounting for the proportion of variance explained by age, income, race/ethnicity, and physical health, the additional proportion of variance explained by difficulty paying was statistically significant. Individuals reporting difficulty paying had a roughly 1 point lower (ie, beta-coefficient = −1.052; SE = 0.481) overall quality of life score on the 11-point scale.

Conclusions: We found a significant association between difficulty paying for ostomy supplies and overall quality of life. Although the cross-sectional study design does not allow causal inference, the results suggest a relationship that merits further examination.

From the Departments of *Pharmacy Practice and Science, and †Pharmaceutical Sciences, University of Arizona College of Pharmacy, Tucson, Arizona; ‡Division of Health Promotion Sciences, University of Arizona College of Public Health, Tucson, Arizona; §Research Service and ¶Surgical Care Line, Southern Arizona Veterans Affairs Health Care System, Tucson, Arizona; ∥Department of Nursing Research and Education, City of Hope National Medical Center/Beckman Research Institute, Duarte, California; and **Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona.

Supported by a grant from the Veterans Affairs Health Services Research & Development (HSR&D) Service IIR 02-221-2: Health Related Quality of Life in VA Patients with Intestinal Stomas. Additional support for the preparation of this manuscript was provided by the University of Arizona College of Pharmacy.

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Reprints: Stephen Joel Coons, PhD, The University of Arizona, PO Box 210202, Tucson, AZ 85721-0202. E-mail: coons@pharmacy.arizona.edu.

© 2007 Lippincott Williams & Wilkins, Inc.