Pohontsch N^a, Lühmann D^a, Balzer K^b, Silies K^b

^aDepartment of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf

^bNursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck

Background

The care for people living with long-term conditions like chronic diseases or multimorbidity is a challenge for healthcare systems worldwide. Health services are expected to provide person-centered, targeted and effective support.

The Long-Term Conditions Questionnaire (LTCQ) is a generic tool to capture how affected people experience the impact of these conditions and aims at evaluating the intended outcome of person-centred care [1]. The short version with eight items (LTCQ-8, [2]) can reduce the burden of responding for the target group. As there is no German version of the LTCQ-8 we translated the original questionnaire to German.

Methods

We followed the Oxford University Innovation Translation Protocol for non-certified translations. The steps to translate the LTCQ included forward/back translation, developer’s review and cognitive interviews (n = 6). Three female and two male residents of two nursing homes in Hamburg and Lübeck participated in cognitive interviews. We conducted one additional interview with a younger community-dwelling male. All interviewees had at least one chronic condition. Interviews were audio recorded and transcribed verbatim. We summarized the results and revised the items accordingly after discussion in the study team. We used the German version in the Expand-Care study (DRKS00028708) to assess self-care in 68 nursing home inhabitants.

Results

Cognitive interviewing led to minor modifications and showed overall good face validity and acceptability. Interviewees had neither difficulties to understand the introduction to the questionnaire nor the questions’ stem or response options, but showed difficulties with the concept of “Zuhause” (“home”) in two questions. They did not apply it to the nursing home but to their last home before moving to the nursing home. Therefore, we added the term “jetziges (Zuhause)” (“current (home)”) to resolve this confusion. Application of the questionnaire with nursing home residents in the Expand-Care study revealed no further problems and proved its usability.

Conclusions

The German version of the LTCQ-8 can be used for people living in nursing homes with slight adaptations to the original translation. It allows the brief self-reported measurement of how well frail people are able to live with existing long-term conditions (incl. multi-morbidity) and may be a useful patient-reported outcome measurement tool for future trials and health service research in this population.

1. Potter CM, Batchelder L, A’Court C, Geneen L, Kelly L, Fox D, et al. Long-Term Conditions Questionnaire (LTCQ): initial validation survey among primary care patients and social care recipients in England. BMJ Open. 2017;7:e019235.

2. Batchelder L, Fox D, Potter CM, Peters M, Jones K, Forder JE, et al. Rasch analysis of the long-term conditions questionnaire (LTCQ) and development of a short-form (LTCQ-8). Health Qual Life Outcomes. 2020;18:375.

Pohontsch N, Lühmann D, Balzer K, Silies K (2023, 22.-24. März). Translation of the Long-Term Conditions Questionnaire short form (LTCQ-8) to German [Vortrag]. 24. Jahrestagung des EbM-Netzwerks, Potsdam, Deutschland.