The Serbian QOLIE-AD-48: translation, cultural adaptation, and preliminary psychometric evaluation

Psychometric properties of the Czech versions of the Impact of Pediatric Epilepsy Scale (IPES) and Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48)

OBJECTIVE

In order to introduce a complex system of monitoring and evaluation of the heath-related quality of life (HRQoL) of children and adolescents with epilepsy (CWE) and their families in the Czech Republic, we aimed to validate the Czech versions of two appropriate instruments - the Impact of Pediatric Epilepsy Scale (IPES) and the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48).

METHODS

The verification of the 11-item IPES was carried out in the group of parents of 248 CWE aged 2-18 years. One hundred and thirty-five CWE from the given group aged 11-18 years then completed the 48-item QOLIE-AD-48. Internal consistency, test-retest reliability (with a three-month interval) and the factorial structure of the Czech versions were determined and compared with the original instruments.

RESULTS

We found that the Czech version of the IPES exhibited very good psychometric properties including high internal consistency (Cronbach's alpha, α, of 0.93), high test-retest reliability (intraclass correlation coefficient, ICC, of 0.76) and the same 3-factor structure as the original instrument. The superiority of this 3-factor solution over the alternate 2-factor model proposed for some language versions of the IPES was determined using confirmatory factor analysis. We found 8 items in the Czech version of the QOLIE-AD-48 belonging to original Attitudes towards epilepsy and Social support subscales that do not fit well with the Czech version due to their low correlation with the total score and insufficient test-retest reliability and should be omitted. For the remaining 40 items, we have determined high internal consistency (α = 0.95) and test-retest reliability (ICC = 0.82). Confirmatory factor analysis revealed that the 6-factor solution derived from the original instrument (without two removed subscales) was appropriate for the Czech version. The individual subscales exhibited high internal consistency with α = 0.61-0.91. The external validation of both instruments was confirmed based on a significant correlation between test results and physicians' reports of the characteristics of the child's epilepsy.

CONCLUSIONS

The Czech versions of both instruments studied are reliable and valid, and can be used in the next research focusing on the effect of different treatment approaches on the HRQoL of CWE and their families.

Health-related quality of life in adolescents with epilepsy in Montenegro

OBJECTIVE

The objective of this study was to establish potential risk factors for poor health-related quality of life among adolescents with epilepsy in Montenegro.

MATERIAL AND METHODS

A sample of 104 adolescents with epilepsy (age: 11-19years) at a tertiary referral center in Podgorica, Montenegro, completed the validated Serbian version of the QOLIE-AD-48 questionnaire. They were divided into two groups: a group with active epilepsy (60 adolescents) and a group with inactive epilepsy (44 adolescents). Demographic and clinical data were collected.

RESULTS

Adolescents with active epilepsy had low quality of life and felt the negative impact of the disease. They also had more cognitive impairments, felt more stigmatized, and had considerably more distorted perception of their health than adolescents with inactive epilepsy (p<0.05). Females reported better social support than males (p<0.05). Older males had lower grades at school (p<0.05) than the younger ones. As expected, adolescents with the highest number of seizures in the past two years had the lowest quality of life (p<0.05).

CONCLUSION

In our study, the quality of life in adolescents with epilepsy was determined by severity of the disease, age, and gender.

Impact of choice of coping strategies and family functioning on psychosocial function of young people with epilepsy

Both medical and psychological factors have an important impact upon the psychosocial functioning of young people with epilepsy. The purpose of this study was to identify factors that distinguish young people with epilepsy and high psychosocial functioning from those with lower levels. The participants were 114 young people (40 males, 74 females) with active epilepsy and a mean age of 17.92years (SD=3.90) who completed either a paper (60.5%) or a web-based survey (39.5%) comprising demographic, medical, and psychosocial measures. Psychosocial measures included family functioning, adolescent coping, anxiety, depression, and quality of life. A latent class analysis produced two psychosocial functioning groups based on participants' scores for anxiety, depression, and quality of life. Young people were more likely to be members of the group with poor psychosocial functioning if they had a seizure in the last month (Wald=5.63, p<.05), came from families with lower levels of communication and problem solving (Wald=5.28, p<.05), and made greater use of non-productive (emotion-focused) coping strategies such as wishful thinking, withdrawal, and worry (Wald=12.00, p<.01). The findings suggest that, in addition to standard medical treatment, clinicians may promote better outcomes by strengthening family functioning and encouraging less use of nonproductive coping strategies.

Health-related quality of life in adolescents with chronic physical illness in northern Russia: a cross-sectional study

Background

Health related quality of life (HRQoL) is an important subjectively evaluated outcome of adolescents physical, mental, and social functioning. It gives us the possibility to assess the disease impact on life of adolescents, and to sort out target groups of adolescents for future psychological interventions. The objective of this cross-sectional survey was to study HRQoL in 173 adolescents with chronic physical illness (CPI - diabetes, asthma, and epilepsy), and to find HRQoL predictors in each disease group.

Methods

Disease-specific questionnaires were completed by each adolescent recruited from the local outpatient clinic; mothers answered the questions on socioeconomic status (SES); and the patients’ clinicians evaluated the severity of the disease.

Results

A high proportion of adolescents in each disease specific sample reported moderate to high levels of HRQoL. Gender was the most prominent predictor of HRQoL in all three studied groups, while disease severity predicted HRQoL in the diabetic group and to some extent in the asthma group.

Conclusions

Our results provide evidence that adolescents with diabetes, asthma, and epilepsy in northern Russia maintain relatively moderate to high levels of HRQoL. The domains affecting HRQoL were related to both disease-specific (severity) and non-disease factors (gender and SES). Our study suggests that future psychosocial interventions should focus on aspects of CPI impacting adolescents in gendered ways, furthermore taking into account disease specific factors.

Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): preliminary data for the Serbian version

The objectives of this study were to translate into Serbian the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) and to provide preliminary data on its measurement properties. Translation, cultural adaptation, and pretesting were performed first, followed by evaluation of several reliability aspects of this version administered to 50 children with epilepsy and their parents. The mean scores of the CHEQOL-25 subscales ranged from 12.2 to 14.4 for children and from 12.4 to 15 for parents (possible range: 5-20). The internal consistency coefficients of the subscales ranged from 0.11 to 0.87. Between the children's and parents' reports, there was a moderate level of agreement (0.43-0.57). It was concluded that the Serbian version is a feasible measure, all subscales except one demonstrate sufficient reliability, and a parent form could be used as a proxy measure.

Reliability and validity of a Chinese version of the Impact of Pediatric Epilepsy Scale

The Impact of Pediatric Epilepsy Scale (IPES) is an accurate, acceptable, and quick tool that assesses the impact of epilepsy on the child with epilepsy and his or her family. The aim of this study was to investigate its applicability in China. After multistage translation and cultural adaptation, the final Chinese version was administered to 110 parents of children with epilepsy to evaluate its validity, reliability, and sensitivity. All items contributed significantly to the summary measure. With respect to validity, all items were substantially correlated with the criterion questionnaire subscales, and principal component analysis indicated that three factors accounted for 72% of the variance of the scale. The internal consistency coefficients of the first and second tests for the total were 0.916 and 0.930, respectively, and test-retest reliability ranged from 0.891 to 0.992. Additionally, the IPES can detect differences in health-related quality of life (HRQOL) between subjects according to epilepsy severity. In conclusion, this study indicates that the Chinese IPES has good validity, reliability, and sensitivity, and is an epilepsy-specific HRQOL questionnaire that is a brief, accurate, and valid assessment of the influence of epilepsy on the child and family.

The Chinese QOLIE-AD-48: translation, validity, and reliability

The aim of this study was to translate into Chinese the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48) and to evaluate its psychometric properties. After a multistage translation and cultural adaptation, the final Chinese version was administered to 99 adolescents with epilepsy to evaluate its validity and reliability. Interitem correlations, correlations with the Pediatric Quality of Life Inventory (PedsQL), internal consistency, and sensitivity were examined. Mean total score was 66.1, and all subscales contributed significantly to the summary measure. Considering the validity of the translation, each item correlated more significantly with its own subscale than with the other subscales, whereas all subscales were substantially correlated with the PedsQL subscales (r=0.73). The internal consistency coefficients of the subscales ranged between 0.62 and 0.92, and this coefficient was 0.94 for the total. Finally, the QOLIE-AD-48 could detect differences in quality of life between the subjects. In conclusion, this study showed that the Chinese QOLIE-AD-48 possesses good validity, reliability, and sensitivity, and is an appropriate instrument for health-related quality of life assessment in Chinese adolescents with epilepsy.

[Pediatric health-related quality of life instrument. Part II: General guidelines for translation and cultural adaptation]

<zakljucak> Prenosenje koncepta kvaliteta zivota iz jednog u drugi kulturoloski okvir slozen je proces i obuhvata vise etapa od pripreme do krajnjeg izvestaja o prevodjenju. Smernice za prevodjenje i adaptaciju upitnika o kvalitetu zivota u pedijatriji, kao i za njihovo koriscenje u unakrsnim kulturoloskim studijama ne postoje. Stoga, potrebno je detaljno istrazivanje ovog koncepta u raznim kulturoloskim okvirima, kako bi bile postavljene prave preporuke. Precizno izvedeno prevodjenje i kulturoloski senzitivna adaptacija predstavljaju proces kojim se verodostojno originalni upitnik prebacuje u drugi kulturoloski okvir, kako bi mogao da sluzi istoj svrsi. Samo pazljivo izvedena verzija originala, koja ce naknadno biti psihometrijski proverena i verifikovana, moze da meri na pravi nacin ono za sta je namenjena.

[Pediatric health-related quality of life instrument. Part I: general guidelines for selection]

<zakljucak> Ubrzan razvoj koncepta kvaliteta zivota u pedijatriji omogucio je razvoj velikog broja upitnika za njegovu procenu. Odabir pravog upitnika zahtevan je i slozen proces i svi koji ce ga koristiti moraju pri selekciji da obrate paznju na niz zahteva. Selekciju odredjuju precizno postavljen cilj, adekvatan dizajn procene (ili dizajn studije), odredjene karakteristike ispitanika i karakteristike upitnika. Ovi koraci, sa svim svojim elementima, znacajno su zavisni i medjusobno povezani. Ukoliko neki od njih bude izostavljen, neadekvatan upitnik moze biti znacajan izvor greske u proceni kvaliteta zivota, a narocito u poredjenju podataka dobijenih iz drugih izvora. Stoga, vazno je razumeti da kombinacija ovih atributa odredjuje populaciju za procenu, nacin i tip procene, rezultate i zakljucke procene, a ne samo upitnik za merenje kvaliteta zivota.

The Brazilian version of the Quality of Life in Epilepsy Inventory for Adolescents: translation, validity, and reliability

OBJECTIVE

The aim of this study was to translate and adapt the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48) into Brazilian Portuguese, as well as to evaluate the psychometric properties of this Brazilian version.

METHODS

The QOLIE-AD-48 Brazilian version was tested with respect to reliability and validity in 93 adolescents with epilepsy. Patients completed the Self-Esteem Inventory (SEI), Children's Depression Evaluation Scale (CDES), and Adverse Events Profile (AEP). A subset of these patients were reexamined after 3-4 weeks to evaluate the test-retest reliability of the inventory. We assessed validity by comparing the QOLIE-AD-48 Brazilian version with external measures.

RESULTS

Internal consistency was satisfactory (Cronbach's alpha=0.87). Test-retest reliability was acceptable as well (intraclass correlation coefficient=0.52-0.81). Moreover, the QOLIE-AD-48 Brazilian version was highly correlated with other scales, demonstrating strong validity.

CONCLUSIONS

We conclude that the QOLIE-AD-48 Brazilian version has psychometric properties equivalent to those of the original American-English version and is a valid and reliable instrument for assessment of health-related quality of life in adolescents with epilepsy in Brazil or other Portuguese-speaking countries.

Quality of life in children with epilepsy and cognitive impairment: a review and a pilot study

Various methods have recently been proposed to assess the physical, psychological or social dimensions of quality of life (QoL) in children with epilepsy (CwE) and their families. Some methods are based exclusively on parental report and others emphasize the importance of an interview with the patient himself. In children with epilepsy and severe cognitive deficit only parental report is possible in practice; however, some parental based methods to evaluate QoL in CwE have excluded children with cognitive deficit. The present pilot study explores which items are suitable for a parental-based QoL evaluation in CwE and special educational needs, and the most frequently reported parental concerns in this special population of children.

Health-related quality of life in adolescents with well-controlled epilepsy

OBJECTIVE

The purpose of the work described in this article was to evaluate the health-related quality of life (HRQOL) of adolescents with well-controlled epilepsy.

METHODS

The Quality of Life in Epilepsy Inventory for Adolescents 48 (QOLIE-AD-48) was completed by 71 subjects with uncomplicated epilepsy who had been seizure-free for more than a year. HRQOL was measured in eight domains: Health Perception, Epilepsy Impact, Memory/Concentration, Physical Functioning, Stigma, Social Support, School Behavior, and Attitudes toward Epilepsy. In addition, antiepileptic drug (AED) therapy and concern over seizures recurring were analyzed in relation to HRQOL.

RESULTS

The mean HRQOL total scores were 83.9 for boys and 83.06 for girls. The highest scores were observed in the Physical Functioning and School Behavior domains; the lowest in the Attitudes toward Epilepsy domain. Girls reported more positive perceptions in the Stigma and Social Support domains. Greater intake of AEDs and concern over seizures recurring accounted for poorer HRQOL.

CONCLUSIONS

Adolescents with favorable seizure control evaluated their HRQOL as satisfactory. However, they perceived their best adjustment to epilepsy to be in the Physical Functioning and School Behavior domains. AED intake and concern over seizures recurring were predictors of HRQOL in this group.