Filiz ÖZEL, Fisun ŞENUZUN AYKAR, Gökhan KESER, Aynur Esen TÜREYEN

Development and testing of a novel symptom assessment scale for Behçet’s disease

Background/aim: This study was designed to develop a Behçet’s disease (BD) symptom assessment scale based on the theory ofunpleasant symptoms, which deals with understanding symptom experiences in a disease.Materials and methods: The BD Symptom Assessment Scale has two sections: the factors influencing symptoms and the situationsinfluenced by symptoms. Both of these sections were developed through an initial item pool, and expert opinions were consulted duringa pilot test performed with 30 patients with BD. We then tested the validity and reliability of this scale on 218 different patients with BDfulfilling the ISG criteria. Finally, we scored this scale.Results: The validity and reliability study of the first section found that the scale had favorable fit indices (χ2 = 525.86, χ2 / SD = 3.15, GFI= 0.90, CFI = 0.89, IFI = 0.89), constituting three dimensions and 20 items. The validity and reliability study of the second section foundthat the scale had favorable fit indices (χ2 = 579.14, χ2 / SD = 3.48, GFI = 0.91, CFI = 0.89, IFI = 0.89) and constituted three dimensionsand 20 items.Conclusion: This novel symptom assessment scale for BD is a valid and reliable tool for evaluating patients with BD.

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Smith MJ, Liehr PR. Middle Range Theory for Nursing. 2nd ed. New York, NY, USA: Springer Publishing Company; 2008.
Lenz ER, Suppe F, Gift AG, Pugh LC, Milligan RA. Collaborative development of middle-range nursing theories: toward a theory of unpleasant symptoms. Adv Nurs Sci 1995; 17: 1-13.
Lenz ER, Pugh LC, Milligan RA, Gift A, Suppe F. The middlerange of theory of unpleasant symptoms: an update. Adv Nurs Sci 1997; 19: 14-27.
Lee SE, Vincent C, Finnegan L. An analysis and evaluation of theory of unpleasant symptoms. Adv Nurs Sci 2017; 40: 16-39.
Tyler R, Pugh LC. Application of the theory of unpleasant symptoms in bariatric surgery. Bariatr Nurs Surg Patient Care 2009; 4: 271-276.
Reishtein JL. Relationship between symptoms and functional performance in COPD. Res Nurs Health 2005; 28: 39-47.
Tsai YF, Hsiung PC, Holzemer WL. Symptom management in Taiwanese patients with HIV/AIDS. J Pain Symptom Manage 2002; 23: 301-309.
Bernabe E, Marcenes W, Mather J. Impact of Behçet’s syndrome on health-related quality of life: influence of the type and number of symptoms. Rheumatology 2010; 49: 2165–2171.
Blackford S, Finlay AY, Roberts DL. Quality of life in Behçet’s syndrome: 335 patients surveyed. Br J Dermatol 1997; 13: 293.
Can G, Aydıner A. Development and validation of the Nightingale Symptom Assessment Scale (N-SAS) and predictors of the quality of life of the cancer patients in Turkey. Eur J Oncol Nurs 2011; 15: 3-11.
Canpolat Ö, Yurtsever S. The quality of life in patients with Behçet’s disease. Asian Nurs Res 2011; 5: 229-235.
De Vito Dabbs A, Hoffman LA, Swigart V. Using conceptual triangulation to develop an integrated model of experience of acute rejection after lung transplantation. Adv Nurs Sci 2004; 27: 138-149.
Eren I, Şahin M, Cüre E, Çivi-İnanlı I, Tunç ŞE. Psychiatric symptoms and quality of life in Behçet’s disease. Neurol Psychiatry Brain Res 2006; 13: 169-174.
Ertam I, Kitapçıoğlu G, Aksu, K. Quality of life and its relation with disease severity in Behçet’s disease. Clin Exp Rheumatol 2009; 27: 18-22.
Gilworth G, Cahmberlain MA, Bhakta B, Haskard D, Silman A, Tennant A. Development of the BD-QOL: a quality of life measure specific to Behçet’s disease. J Rheumatol 2004; 31: 931-936.
Gur A, Sarac AJ, Burkan YK, Nas K, Çevik R. Arthropathy, quality of life, depression, and anxiety in Behçet’s disease: relationship between arthritis and these factors. Clin Rheumatol 2006; 25: 524-531.
Izuno T, Miyakawa M, Sugimori H. The effect of quality of life in Behçet disease patients on subjective life satisfaction. Japanese Journal of Public Health 1998; 45: 979-987.
Karıncaoğlu Y, Kandi Çoşkun B, Seyhan B, Akı T. Demographical and clinical characteristics of Behçet’s disease patients in Malatya and Elazığ. Turkiye Klinikleri Journal of Dermatology 2005; 15: 65-70.
Kim SH, Oh EG, Lee WH, Kim OS, Han KH. Symptom experience in Korean patients with liver cirrhosis. J Pain Symptom Manage 2006; 31: 326-334.
Lang CA, Conrad S, Garrett L, Battistutta D, Cooksley WG, Dunne MP, Macdonald GA. Symptom prevalence and clustering of symptoms in people living with chronic hepatitis C infection. J Pain Symptom Manage 2006; 31: 335-343.
Lee EH. Relationships of mood disturbance, symptom experience, and attentional function in women with breast cancer based upon the theory of unpleasant symptoms. J Korean Acad Nurs 2005; 35: 728-736.
Mohammad A, Mandl T, Sturfelt G, Segelmark M. Incidence, prevalence and clinical characteristics of Behçet’s disease in southern Sweden. Rheumatology 2013; 52: 304-310.
Mumcu G, İnanç N, Ergun T, İkiz K. Oral health related quality of life is affected by disease activity in Behçet’s disease. Oral Dis 2006; 12: 145-151.
Mumcu G, Hayran O, Özalp DO. The assessment of oral health-related quality of life by factor analysis in patients with Behçet’s disease and recurrent aphthous stomatitis. J Oral Pathol Med 2007; 36: 147-152.
Onal S, Savar F, Akman M, Kazokoğlu H. Vision- and healthrelated quality of life in patients with Behçet uveitis. ARCH Ophthalmol 2010; 128: 1265-1271.
Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander- Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 1994; 30: 1326-1336.
Pugh LC, Milligan RA. Patterns of fatigue during pregnancy. Appl Nurs Res 1995; 8: 140-143.
Pugh LC, Milligan RA. Nursing intervention to increase the duration of breastfeeding. Appl Nurs Res 1998; 11: 190-194.
Şahin S, Lawrence R, Direskeneli H. Monocyte activity in Behçet’s disease. Br J Rheumatol 1996; 35: 424-429.
Tanrıverdi N, Taşkıntuna Duru C, Özdal P. Health-related quality of life in Behçet patients with ocular involvement. Jpn J Ophthalmol 2003; 47: 85-92.
Taşcılar NF, Tekin NS, Ankaralı H. Sleep disorders in Behçet’s disease, and their relationship with fatigue and quality of life. J Sleep Res 2012; 21: 281-288.
Tunç R, Keyman E, Melikoğlu M, Fresko I, Yazıcı H. Target organ associations in Turkish patients with Behçet’s disease: a cross sectional study by exploratory factor analysis. J Rheumatol 2002; 29: 2393-2396.
Uğuz F, Dursun R, Kaya N, Çilli AS. Quality of life in patients with Behçet’s disease: the impact of major depression. Gen Hosp Psychiatry 2007; 29: 21-24.
Yazıcı Y, Yazıcı H. Behçet’s Syndrome. New York, NY, USA: Springer; 2010.
Yücel A, Maraklı SS, Aksungur VL. Clinical evaluation of Behçet’s disease: a five year follow-up study. J Dermatol 2005; 32: 365-370.
Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Ali-Reza Nikanfar A. Design and ımplementation of content validity study: development of an instrument for measuring patient-centered communication. J Caring Sci 2015; 4: 165-178.
Büyüköztürk Ş. Sosyal Bilimler için Veri Analizi El Kitabı. Ankara, Turkey: Pegem Akademi Yayınları; 2012 (in Turkish).
Schreiber JB, Nora A, Stage FK, Barlow EA, King J. Reporting structural equation modeling and confirmatory factor analysis results: a review. J Educ Res 2006; 99: 323-338.
Mumcu G, Niazi S, Stewart J. Oral health and related quality of life status in patients from UK and Turkey: a comparative study in Behçet’s disease. J Oral Pathol Med 2009; 38: 406-409.
Kılınç Y, Yıldırım M, Ceyhan AM. Assessing quality of life in patients with Behçet’s disease. SDÜ Tıp Fakültesi Dergisi 2009; 16: 6-10 (in Turkish with English abstract).
Soy M, Erken E, Konca K, Özbek S. Smoking and Behçet’s disease. Clin Rheumatol 2000; 19: 508-509.
Yurtman Havlucu D, İnanır I, Aydemir Ö. Quality of life, anxiety, depression and knowledge of disease in patients with Behçet’s disease. Anatolian Journal of Clinical Investigation 2011; 5: 82-88 (in Turkish with English abstract).
Uğuz F, Dursun R, Kaya N, Çilli AS. Psychiatric symptoms and quality of life in Behçet patients. Anadolu Psikiyatr De 2006; 7: 133-139 (in Turkish with English abstract).
Özdemir L, Kalyoncu U, Akdemir N. The evaluation of sexual problems and influencing factors in Behçet’s disease. Balkan Med J 2010; 7: 238-242.
Bodur H, Borman P, Özdemir Y. Quality of life and life satisfaction in patients with Behçet’s disease: relationship with disease activity. Clin Rheumatol 2006; 25: 329-333.
Kocaman N, Özkan M, Armay Z. The reliability and the validity study of Turkish adaptation of the revised Illness Perception Questionnaire. Anadolu Psikiyatr De 2007; 8: 271-280 (in Turkish with English abstract).
Yılmaz Karabulutlu E, Okanlı A. The evaluation of illness perceptions in hemodialysis patients. Journal of Anatolia Nursing and Health Sciences 2011; 14: 25-31 (in Turkish with English abstract).
Hatemi G, Hamuryudan V. Romatolojik hastalıklarda görülen psikiyatrik bozukluklar. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Sempozyum Dizisi 2008; 62: 263-268 (in Turkish).