Validation of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV)

Authors


William L. Holzemer Professor and Chair, Department of Community Health Systems, University of California San Francisco, San Francisco, CA 94143–0608, USA. E-mail: nursing%bill_holzemer@ccmail.ucsf.edu

Abstract

Validation of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV)

Symptom management for persons living with HIV disease is recognized as an extremely important component of care management. This article reports the validation of a new sign and symptom assessment tool designed to assess the intensity of HIV-related symptoms using two samples (study 1: n=247; study 2: n=686) of people living with HIV disease. Study 1 data were collected between 1994 and 1996 before the initiation of highly active antiretroviral therapy (HAART). Study 2 data were collected between 1997 and 1998 after the wide adoption of HAART therapy. The initial version of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV) included 41 signs and symptoms. This scale was submitted to a principal components factor analysis with a varimax rotation. The final solution reports six factors explaining 68·9% of the variance. The six symptom clusters (factors), the number of items in the factor, and the Cronbach alpha reliability estimates were: malaise/weakness/fatigue (six items, alpha=0·90); confusion/distress (four items, alpha=0·90); fever/chills (four items, alpha=0·85); gastrointestinal discomfort (four items, alpha=0·81); shortness of breath (three items, alpha=0·79); and nausea/vomiting (three items, alpha=0·77). These six factors have strong reliability estimates and a stable factor structure that supports the construct validity of the 26-item instrument. Additional evidence supports the concurrent validity of the scale as well as its sensitivity to change over time. The final version of the SSC-HIV is a 26-item scale available for use by clinicians and researchers to measure the patient’s self-report of HIV-related signs and symptoms.

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