Development of an Elderly Low Vision Quality of Life Questionnaire for less-developed areas of China

To develop a quality of life questionnaire appropriate for elderly low-vision patients in less-developed areas of China. The study was conducted at the Wenzhou Medical University Affiliated Eye Hospital. In the initial development of the questionnaire, we identified visual function concerns with individual interviews and designed a questionnaire and an empirical assessment of the questionnaire. Each individual visual function concern was then transformed into a question and put into a rating scale from 0 to 4. Then, questionnaire interviews were conducted on 188 low-vision patients and 63 normal control patients for item reduction and evaluation of psychometric properties. We first identified 24 concerns that older adults with serious vision loss thought most affected their daily lives. The initial item list of the Elderly Low Vision Quality of Life Questionnaire (ELVQoL) consisted of 28 items, including the 24 identified items and 4 additional concerns about general vision. Psychometric item reduction removed 9 items, and a 19-item questionnaire was generated. Assessment showed that the resulting questionnaire had acceptable internal consistency, reliability, and validity (Cronbach's alpha > 0.9, mean item-total correlations > 0.6, test-retest reliability > 0.9, and concurrent validity range from 0.6 to 0.9). Low education level, need for a full range of working distances, and retinal diseases were all predictors of reduced visually related quality of life. A patient-derived ELVQoL Questionnaire was developed specifically for elderly, uneducated, rural Chinese. All the psychometric properties met accepted levels for a disease-specific Qol Questionnaire.