Dimensions and items used in CIVIQ

Dimensions and items used in CIVIQ-20

The 20-item questionnaire, which provides a global index and an outline of 4 quality-of-life dimensions—“pain” (4 items), “physical” (4 items), “psychological” (9 items), and “social” (3 items)—was initially developed in French (CIVIQ-20) (Table 1). Items on the CIVIQ-20 scale were scored from 1 to 5. A low score corresponded to greater patient comfort. The recall period was the previous 4 weeks.

Table 1. Dimensions and items used in CIVIQ-20 (items are not in the same order in the final questionnaire)

Dimension	Item
Pain	Pain in the legs Impairment at work Sleeping poorly Standing for long periods of time
Physical	Climbing several floors Squatting / kneeling Walking at a good pace Doing the housework
Psychological	Feeling nervous Having the impression of being a burden Being embarrassed to show legs Becoming irritable easily Having the impression of being disabled Having no desire to go out Having to take precautions Getting tired easily Difficulty in getting going
Social	Going to parties Performing athletic activity Traveling by car, plane, etc

Dimensions and items used in CIVIQ-14

The factorial instability of the CIVIQ-20 social dimension in different populations necessitated the development of a new “stable” questionnaire to facilitate the interpretation of results from international studies. An iterative process was implemented to eliminate the more unstable items (6 in total), and the social and physical dimensions were combined. The resulting instrument comprised 14 items, split into 3 dimensions (“pain”, “physical”, and “psychological”), and was named CIVIQ-14 (Table 2). The stability of the CIVIQ-14 factorial structure was confirmed in the populations of several countries.¹ As for CIVIQ-20, items on the CIVIQ-14 scale were scored from 1 to 5, and the recall period was the previous 4 weeks.

Table 2. Dimensions and items used in CIVIQ-14

Dimension	Item
Pain	Pain in the legs Impairment at work Sleeping poorly
Physical	Climbing several floors Squatting / kneeling Walking at a good pace Going to parties Performing athletic activities
Psychological	Feeling nervous Having the impression of being a burden Being embarrassed to show legs Becoming irritable easily Having the impression of being disabled Having no desire to go out

The main steps of the design of CIVIQ-14 and CIVIQ-20 are summarized in Table 3.

Table 3. Design steps for CIVIQ-20 (and CIVIQ-14)

Step	Year	N patients	Aim
Item generation	1991	20	Item collection in 5 dimensions (signs and symptoms, functional impact, psychological effect, social consequences, and perception of general health).
Item reduction	1992	150	Check-list of the most important items based on patient preference
Scale construction of CIVIQ-20	1992	1001	Construction of a questionnaire with 20 equally weighted items split into 4 dimensions (“pain”, “physical”, “psychological”, “social”)
Psychometric validation of CIVIQ-20	1993	1001 60	Verification of content, face validity, reliability, reproducibility, and construct validity.
Clinical validation of CIVIQ-20	1994	934	Assessment of responsiveness and sensitivity to changes
Use of CIVIQ-20 in real life.2	1996- 2002	5052	Assessment of reliability, construct and clinical validity, and responsiveness to assess patient response to therapy using the RELIEF* database.
International validation of CIVIQ-20	2010	3956	Validation of consistency, reliability, reproducibility, and responsiveness using databases from 18 countries
Construction of the CIVIQ-14.1	2011	Five databases from Poland, Czech Rep., Spain and France with 1334, 506, 476, 291, and 397 CVD patients, respectively	Construction of a questionnaire with 14 equally weighted items split into 3 dimensions (pain, physical, psychological)
Use of CIVIQ-14 in real life.3	2009- 2011	6232	Assessment of reliability, construct and clinical validity, and responsiveness to assess patient response to therapy using the Vein Consult Program database
Linguistic validation	1994- 2012	International surveys	Forward-backward validation in 14 languages

*RELIEF, Reflux assEssment and quaLity of lIfe improvEment with micronized purified Flavonoid fraction

References

1. Launois R, Lemoine JG, Lozano FS, Mansilha A. Construction and international validation of CIVIQ-14 (a short form of CIVIQ-20), a new questionnaire with a stable factorial structure. Qual Life Res. 2012; 21 (6): 1051-1058.
2. Jantet G and the RELIEF Study Group. Chronic Venous Insufficiency: Worldwide Results of the RELIEF Study. Angiology 2002;53:245-256.
3. Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez Quesada F and VCP coordinators. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2):105-115.