A self-report quality of life questionnaire, was constructed for patients with leg ulcers. The content of the questionnaire was derived from patient conversations. The first version was completed by 33 patients and refined using standard psychometric procedures. The final version measured functional limitations and emotional reactions and was used to quantify quality of life deficits in a group of 50 patients. Although some functional limitations, such as pain impairing mobility or dressing management restricting holidays, were caused directly by the ulcer, many restrictions were due to patients adopting an avoidance strategy to minimise the risk of future leg ulcers. Such strategies included staying away from crowded shopping places and children. Functional limitations and emotional reactions were intercorrelated. Approximately one-third of patients in the final sample reported substantial functional limitations and negative emotions because of their ulcer. The nurses' perceptions of whether the ulcer was healing were similar to those of the patients. Self-care behaviour was unrelated to level of pain or quality of life.

Background Despite considerable investment in research priority setting within diverse fields of healthcare, little is known about the extent to which different stakeholder groups share research priorities. Conflicting priorities may jeopardize stakeholder engagement in research.Objective To identify the research priorities of different stakeholder groups within mental health care and examine the extent and nature of agreement between them.Design Using a Delphi technique, we conducted parallel consultation processes within four different stakeholder groups. Each group process consisted of three rounds.Setting and participants The study was carried out within a mental health and learning disabilities trust in southern England. Participants were recruited from the following groups: mental health service users (34), informal carers (26), mental health practitioners (35) and service managers (23).Findings There were striking differences between the four groups in respect of their ability and willingness to make priority decisions. These differences notwithstanding, there was considerable overlap in respect of their research interests. All groups identified and attached high importance to issues relating to the promotion of independence, self-esteem and recovery. The quality of in-patient care, the place of psychological therapies and the relationship between physical and mental health also emerged across the board. ConclusionsThe confluence of four different stakeholder groups around a number of clear themes is highly encouraging, providing a framework within which to construct a research agenda and suggesting that mental health research can be built on solid partnerships.

Objectives. To determine whether quality of life (QOL) changes during the menopause as a function of menopausal status and other medical and lifestyle variables. Design. A postal questionnaire sent to three different samples of women. Method. A total of 1188 questionnaires were received from (a) two samples recruited from two Family Health Service Association (FHSA) lists and (b) one sample recruited through an advertisement in a women's magazine. The questionnaires consisted of (a) a seven domain, 48‐item, condition‐specific QOL questionnaire which was developed for this study (MQOL), (b) a single item global QOL questionnaire (GQOL), (c) questions about medical history, (d) questions about work status, (e) questions assessing menopausal status using two different techniques. Results. Both the MQOL and GQOL indicated a relationship with menopausal status. GQOL and MQOL showed a U‐shaped relationship with menopausal status, with lowest scoresassociated with the middle of the menopause. However, domain scores of Sleep and Energy failed to reach the levels reported by women who perceive themselves to be pre‐menopausal, and domain scores of Symptom Impact and Social Interaction indicate steady decline during the menopausal transition. Women who experienced the menopause long ago reported the highest GQOL, feelings and cognition domain scores. Medical history and work outside the home play an important role in determining MQOL‐womenwho had undergone hysterectomy, those who had tried but discontinued HRT while still in the middle of the climacteric, and those with greater co‐morbidity had poorer QOL. Those who worked outside the home reported better MQOL, and those recruited through the magazine reported poorer QOL. Conclusions. QOL is affected by the menopause, but the way it is affected depends on the measure of QOL used. QOL during the menopause is also affected by medical and lifestyle variables. QOL during the menopause is a complex interaction of several different kinds of variable.

The Asthma Bother Profile assesses one of the components of asthma experience: asthma distress. An initial questionnaire was constructed from the content of earlier asthma quality of life research and modified by comments of 32 asthmatics in focus groups. Psychometric analysis of responses of 131 asthmatics to the final questionnaire showed that the 15 ¿bother items' constitute a unidimensional measure of asthma distress with high internal consistency, and the seven ¿management items' assess the patient's confidence of asthma knowledge, perception of the quality of care and confidence in managing asthma attacks. Patients who had attended a self-management clinic reported more knowledge of asthma, more bother from treatment but not significantly less bother in other contexts. Knowledge about when to call the doctor but not knowledge about medicine or asthma was correlated with total bother. Self-management programmes that encourage problem-focused coping strategies may not reduce asthma distress unless distress reduction counselling is included within the education programme.

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