Translation and validation of Pediatric Quality of Life Inventory™ 3.0 Diabetes Module (PedsQL™ 3.0 Diabetes Module) in Brazil-Portuguese language

Quality of life among schoolchildren with type 1 diabetes mellitus and the satisfaction of their guardians towards school health care in Saudi Arabia

AIMS

This study aimed to assess the quality of life of schoolchildren with type 1 diabetes mellitus (T1DM) and determine their guardians' satisfaction of diabetes health care in Saudi Arabian schools.

METHODS

A cross-section multicenter study was conducted from February to July 2022 among Schoolchildren with T1DM in Saudi Arabia. The study included T1DM school children aged 6-18 years. The patients' health-related quality of life (HRQoL) data were collected and determined using a modified version of the PedsQL 3.0 Diabetes Module.

RESULTS

The grand total median PedQL-DM score among the included participants (N = 283) was 64.7, while items related to diabetes symptoms and diabetes management were 61.1 and 68.7, respectively. Schoolchildren who have lower HbA1c levels and take care of regular monitoring of their blood glucose showed significantly better quality of life concerning diabetes symptoms. A significant number of guardians claimed they were not satisfied with the current status of diabetes management at schools.

CONCLUSIONS

The overall HRQoL among schoolchildren with T1DM was average and acceptable to some extent. The PedsQL-DM median score was higher among those who received health care during school time. The guardians' satisfaction of diabetes health care was low, emphasizing the role of health clinics in schools.

Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization

Abstract Objective: This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0–10) vs. 5 (0–10), p=0.018] and prosocial [7 (0–10) vs. 9 (3–10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21–99) vs. 94 (67–100), p<0.001] and higher happiness scores in the PODCI scale [90 (65–100) vs. 80 (0–100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01–1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04–0.43, p=0.001) and screen time ≥3 h/day (OR=0.09; 95%CI 0.02–0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.

A home-based exercise program during COVID-19 pandemic: Perceptions and acceptability of juvenile systemic lupus erythematosus and juvenile idiopathic arthritis adolescents

OBJECTIVES

To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters.

METHODS

This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up.

RESULTS

21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients' feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients' suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05).

CONCLUSION

Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.

Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study

BACKGROUND

Exercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM).

METHOD

This prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep.

FINDINGS

11 patients (out of 27) met the inclusion criteria (91% female; mean ± SD age: 13.5 ± 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (- 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; - 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients' and parents' comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength.

INTERPRETATION

A home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.

Reliability and Validity of Ethiopian Amharic Version of the PedsQLTM 4.0 Generic Core Scales and PedsQLTM 3.0 Diabetes Module

BACKGROUND

The PedsQLTM 4.0 generic core scales (GCS) assess the generic health by integrating with disease-specific PedsQLTM 3.0 diabetes module (DM). The PedsQLTM 3.0 DM measures the health-related quality of life (HrQoL) specific to diabetes. Even though there is no translation to Ethiopian Amharic, the instruments had translated to different languages and validated. The study is aimed to assess the validity and reliability of the Amharic version of the PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM in children and adolescents with diabetes.

METHODS

PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM were administered on 193 children and adolescents with diabetes and their parents. The validity was examined by the exploratory factor analysis, multitrait/multi-item scaling analysis, and multitrait-multimethod and monotrait-multimethod analysis. Cronbach's alpha coefficient checked the reliability.

RESULTS

Cronbach's alpha coefficient for the total PedsQLTM 4.0 GCS (α child self-report= 0.96; α parent proxy report= 0.95) and for total PedsQLTM 3.0 DM (α child self-report= 0.96; α parent proxy report=0.93) were acceptable at individual patient-level analysis. The monotrait-multimethod correlations were higher than multitrait-multimethod correlations. In multitrait/multi-item scale analysis, both total PedsQLTM 4.0 GCS and PedsQLTM 3.0 DM had an excellent item convergent and discriminatory validity success rate.

CONCLUSION

The Amharic versions of the PedsQLTM 4.0 GCS and the PedsQLTM 3.0 DM were valid and reliable instruments to measure the HrQoL of children and adolescents with diabetes.

Canadian-French adaptation and test-retest reliability of the leisure time physical activity questionnaire for people with disabilities

OBJECTIVES

The Leisure Time Physical Activity Questionnaire (LTPAQ) measures the duration of physical activities performed during the past 7 days, and results are expressed in minutes. This study aimed to translate this questionnaire into Canadian-French and to evaluate the content validity and its test-retest reliability in people with physical disabilities.

METHODS

The LTPAQ was translated from English to French by forward and backward translation. To assess content validity, 9 adults with physical disabilities read and provided comments regarding the relevance, wording and understanding of the items of the preliminary Canadian-French version of the questionnaire. For test-retest reliability, 37 adults with physical disabilities completed the questionnaire 2 or 3 times at T1 (baseline), T2 (2 days from baseline) and T3 (7 days from baseline). The test-retest reliability was investigated by intra-class correlation coefficients (ICCs), paired t test and Bland and Altman tests.

RESULTS

The translation and the content validation process resulted in a Canadian-French version of the LTPAQ (LTPAQ-CF). Total LTPAQ-CF scores between T1-T2 and T1-T3 featured strong ICCs, 0.90 and 0.75 (P≤0.01). Paired t tests and Bland and Altman analyses confirmed the good reproducibility of results.

CONCLUSION

The LTPAQ-CF has good test-retest reliability when self-administered or administered by interview to people with physical disabilities.