Background
Methods
The questionnaires
GWBI
W-BQ12
Other questionnaires
Study 1: The cross-sectional survey
Recruitment procedures
Statistical analyses
Normality issues
Internal consistency reliability and factor structure
Subgroup differences and 'familywise' error in multiple tests
Concurrent validity
Study 2: Prospective study of GH-withdrawal
Results
Cross-sectional study
The patient sample
GH treatment (Maximum N = 91) | No GH treatment (Maximum N = 66) | |
---|---|---|
Women | 51 | 33 |
Men | 40 | 33 |
Childhood onset of GHD | 21 | 9 |
Adult onset of GHD | 70 | 57 |
Isolated GHD | 5 | 1 |
Multiple pituitary hormone deficiencies | 86 | 65 |
Mean age (SD) in years | 47.1 (12.59) | 51.32 (12.41) |
[range] | [23.75–70.92] | [23.83–70.92] |
Mean duration GHD (SD) in years (adult onset patients) | 13.02 (6.78) | 13.18 (7.84) |
Mean duration GH Treatment (SD) in years | 3.6 (2.39) | - |
[range] | [0.5–10.17] | - |
BMI (kg/m2) (SD) | 27.16 (5.54) | 27.99 (5.25) |
Height (cms) (SD) | 167.5 (10.53) | 168.7 (10.6) |
Completion rates
Reliability and factor analyses
GWBI
Question | Factors in an unforced analysis | Forced 1-factor | ||
---|---|---|---|---|
1
|
2
|
3
| ||
Q1 feel in general
|
.586
|
.532
| .222 |
.821
|
Q2 bothered by nerves*
|
.669
| .136 | .104 |
.588
|
Q3 in firm control
|
.678
|
.459
| .026 |
.772
|
Q4 sad hopeless*
|
.644
| .373 | .114 |
.724
|
Q5 under stress*
|
.638
| .066 | .395 |
.620
|
Q6 happy with personal life
|
.550
|
.486
| .146 |
.740
|
Q7 losing control* |
.711
| .082 | .126 |
.591
|
Q8 anxious upset*
|
.782
| .220 | .347 |
.801
|
Q9 wake up rested
| .284 |
.699
| .231 |
.718
|
Q10 illness pain*
| .159 | .304 |
.861
|
.592
|
Q11 life full of interest
| .316 |
.675
| .090 |
.678
|
Q12 disheartened sad*
|
.728
| .382 | .308 |
.853
|
Q13 stable sure
|
.618
|
.545
| .057 |
.795
|
Q14 tired exhausted*
| .351 |
.667
| .374 |
.792
|
Q15 depressed*
|
.744
| .395 | .250 |
.853
|
Q16 tense*
|
.686
| .365 | .117 |
.749
|
Q17 well enough to do things
| .286 |
.632
|
.408
|
.737
|
Q18 energy vitality
| .147 |
.822
| .275 |
.715
|
Q19 worries about health*
| .289 | .376 |
.762
|
.695
|
Q20 active vigorous
| .194 |
.841
| .265 |
.757
|
Q21 cheerful
|
.616
|
.590
| .063 |
.825
|
Q22 relaxed
|
.645
|
.521
| .109 |
.816
|
% of variance | 30.8 | 25.9 | 11.0 | 55.1 |
Question | Factors | |||||
---|---|---|---|---|---|---|
1
|
2
|
3
|
4
|
5
|
6
| |
Q1 feel in general
|
.424
|
.437
| .282 | .386 | .216 | .203 |
Q2 bothered by nerves*
| .113 | .233 | .207 | .153 | .117 |
.878
|
Q3 in firm control
| .343 |
.447
| .279 | .385 | .027 | .384 |
Q4 sad hopeless*
| .220 |
.698
| .100 | .390 | .179 | .146 |
Q5 under stress*
| .063 | .216 |
.749
| .135 | .294 | .099 |
Q6 happy with personal life
| .298 | .225 |
.531
|
.524
| .129 | -.015 |
Q7 losing control* | .132 |
.807
| .284 | -.009 | .068 | .107 |
Q8 anxious upset*
| .204 |
.523
|
.530
| .181 | .286 | .274 |
Q9 wake up rested
|
.686
| .156 | .201 | .258 | .157 | .156 |
Q10 illness pain*
| .314 | .090 | .183 | .107 |
.855
| .024 |
Q11 life full of interest
| .357 | .056 | .095 |
.746
| .210 | .166 |
Q12 disheartened sad*
| .267 |
.426
|
.500
| .386 | .289 | .225 |
Q13 stable sure
| .340 |
.488
| .200 |
.539
| .112 | .197 |
Q14 tired exhausted*
|
.705
| .175 | .357 | .183 | .254 | .124 |
Q15 depressed*
| .321 |
.490
|
.412
| .314 | .223 | .339 |
Q16 tense*
|
.421
| .288 |
.649
| .114 | -.043 | .313 |
Q17 well enough to do things
|
.690
| .211 | .150 | .120 | .325 | .239 |
Q18 energy vitality
|
.828
| .184 | .106 | .239 | .189 | -.036 |
Q19 worries about health*
| .350 | .196 | .168 | .191 |
.775
| .147 |
Q20 active vigorous
|
.799
| .157 | .091 | .328 | .213 | .078 |
Q21 cheerful
| .369 |
.412
| .357 |
.592
| .087 | .069 |
Q22 relaxed
| .377 | .193 |
.497
|
.474
| .080 | .347 |
% variance | 19.9 | 14.2 | 13.4 | 12.8 | 9.5 | 7.5 |
W-BQ12
Item (subscale) | Factors in forced 3-factor analysis | Forced 1-factor analysis | ||
---|---|---|---|---|
1
|
2
|
3
| ||
1: crying spells*(Negative Well-being) | -.357 |
.753
| .185 |
-.732
|
2: downhearted* (Negative Well-being) | -.313 |
.575
|
.511
|
-.773
|
3: afraid no reason* (Negative Well-being) | -.125 |
.866
| .127 |
-.603
|
4: upset panicky* (Negative Well-being) | -.248 |
.805
| .213 |
-.698
|
5: energetic active (Energy) |
.691
| -.130 |
-.436
|
.763
|
6: dull sluggish* (Energy) | -.321 | .260 |
.825
|
-.772
|
7: worn out* (Energy) | -.291 | .210 |
.862
|
-.744
|
8: wake rested (Energy) |
.646
| -.135 |
-.449
|
.742
|
9: happy (Positive Well-being) |
.711
| -.325 | -.327 |
.823
|
10: lived life wanted (Positive Well-being) |
.769
| -.287 | -.176 |
.768
|
11: eager tackle tasks (Positive Well-being) |
.829
| -.172 | -.285 |
.803
|
12: cope (Positive Well-being) |
.772
| -.350 | -.093 |
.761
|
% variance | 31.37 | 23.18 | 19.99 | 56.3 |
Subgroup differences
Men | Women | Significance of differences | |
---|---|---|---|
Mean (SD) [Median] (Minimum N = 71) | Mean (SD) [Median] (Minimum N = 81) | ||
GWBI Total | 48.07 (15.27) [47] | 53.70 (16.76) [52] | t(150) = -2.15, p = 0.033 |
W-BQ12
| |||
General Well-being total | 24.50 (7.86) [25] | 20.55 (8.23) [21] | t(154) = 3.05, p = 0.003 |
Negative Well-being | 1.84 (2.32) [1] | 3.68 (2.89) [3] | U = 1853.5, p < 0.001, N = 157 |
Energy | 6.87 (3.32) [7] | 5.92 (3.20) [6] | n.s (p = 0.07) |
Positive Well-being | 7.47 (3.16) [8] | 6.36 (3.33) [7] | n.s (p = 0.035)* |
Correlations with duration of GH treatment
Concurrent validity with SF-36 subscales
GH-Withdrawal study
Discussion
-
excellent reliability, both of the whole scale and of the three subscales, with no indication of item redundancy;
-
a clear factor structure supporting the use of subscales of Negative Well-being, Energy and Positive Well-being;
-
fewer items (12 compared with 22 in the GWBI) and shorter response options (these are relatively long and vary from item to item in the GWBI, causing greater respondent burden);
-
preliminary evidence of sensitivity to change.