Klaske van Sluis

100 6.3. Results represented as one outcome measure r-QoL. The average combined r-QoL rat- ing is 14.4 (scale 0-20). It appears that respondents under 60 years of age and who have had their TL procedure less than two years ago at the time of the questionnaire rate their r-QoL much lower. Sex, educational level and country of residence did not have a significant influence ( p > .05) on the r-QoL rating. 6.3.3 Average number of reported experienced issues per theme Figure 6.2 shows the average percentage of reported issues per patient per theme (as a percentage of the number of questions in that theme), and the influence of the grouping of respondents on the number of reported issues. The figures do not represent the percentage of respondents that experiences these issues, but the percentage of specific issues within the theme that an average respondent will have experienced or encountered. Because the results are aver- aged over a large group of respondents, it gives a sensitive comparison method. See Appendix A for an overview of the grouped questionnaire questions per theme and their response rate. Educational level and country of residence did not have a significant influence ( p > .05) on the experienced issues per theme and were therefore excluded from the presentation of the results. Sex, age and time since TL procedure do all have an influence on the number of experi- enced issues of almost all themes. In general, younger respondents ( < 60 yrs), especially women, who have had the TL procedure less than two years ago, are uniquely disadvantaged in terms of reported participation and functional issues. 6.3.4 Correlations between r-QoL rating and themes The correlations between the r-QoL and different themes, representing overar- ching issues, can be found in Table 6.2 and Figure 6.3. To illustrate, as seen in Table 2 approximately 29% of the variance R 2 in the r-QoL ratings can be explained by the reported issues in the themes ‘experienced limitations in daily activities’ (71% of the 29%) and ‘avoiding social activities’ (29% of the 29%). However, the theme ‘pulmonary issues’ seems to play an important role and has a significant correlation to most other themes: approximately 41% of the variance (textitR 2 ) can be explained by the reported issues in the themes ‘experienced limitations in daily activities’ (22% of the 41%) , ‘avoiding social activities’ (10% of the 41%), ‘communication issues’ (16% of the 41%), ‘experi- enced vulnerability due to environmental factors’ (20% of the 41%), and ‘sleep issues’ (32% of the 41%). The significance of the pulmonary issues can be illustrated by the fact that of the specific included questions within this ‘pulmonary issues’ theme, for example 89% of the respondents report they have to clean out mucus from their stoma or HME several times a day (see Appendix A, 7.5.), and 47% of