The Hyperemesis Impact of Symptoms Questionnaire: Development and validation of a clinical tool

Background: The Hyperemesis Impact of Symptoms Questionnaire is a clinical tool designed to assess holistically the impact of the physical and psychosocial symptoms of hyperemesis gravidarum (HG) on individuals. Its purpose is to aid planning and implementation of tailored care for women with HG. To our knowledge no similar tool exists. Objective: To assess the validity and reliability of the HIS questionnaire. Design: As no similar tool exists, we compared the HIS with three tools that reflect its key areas: physical impact (Pregnancy Unique Quantification of Emesis - PUQE score and markers of severity of HG), psychological impact (Hospital Anxiety and Depression Score HADS) and social impact (SF12 quality of life score). Setting: A large regional referral, women and children's hospital in the North West of England. Participants: The HIS was evaluated on 50 women admitted to hospital with HG and 50 women recruited from ante-natal clinic without severe nausea and vomiting of pregnancy and with an uncomplicated pregnancy. Results: Good criterion validity was demonstrated by strong significant correlations with all three scores (PUQE, r = 0.75, p < 0.001, HADS, depression r = 0.76, p < 0.001, and SF12, mental component r = -0.65, p < 0.001). The HIS showed good internal consistency, Cronbach alpha 0.87, split half 0.80. Conclusions: There is evidence for the validity and reliability of the HIS to assess the impact of the physical and psychosocial symptoms of HG. Further research is currently underway to establish the clinical utility of the HIS questionnaire in the care of women hospitalised with HG. (C) 2009 Elsevier Ltd. All rights reserved.