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Dellenmark-Blom M, Andersson M, Szymanski KM, Andréasson CL, Vu Minh Arnell M, Sjöström S, Abrahamsson K. Linguistic, Content and Face Validity of the Swedish Version of a Quality-of-Life Assessment for Children, Teenagers and Adults with Spina Bifida. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:624. [PMID: 38791838 PMCID: PMC11121182 DOI: 10.3390/ijerph21050624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/04/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Spina bifida includes a spectrum of different neural tube defects. Myelomeningocele is the most serious type and is associated with a risk of paralysis and sensory dysfunction below the affected level, bladder/bowel dysfunction, brain dysmorphology, and impaired health-related quality of life (HRQoL). The aim of this study was to describe the establishment of linguistic, content and face validity of the Swedish version of a Quality-of-Life Assessment for children (QUALAS-C, n = 10 items), teenagers (QUALAS-T, n = 10 items) and adults with spina bifida (QUALAS-A, n = 15 items) based on the original US English versions. The process included close collaboration with the original instrument developer and complied with international standards on patient-reported outcome measurements. The procedure includes forward translation, expert and patient/parent review and reconciliation, back translation, back translation review and cognitive debriefing interviews with 16 people with spina bifida aged 8 to 33, providing them with the possibility of evaluating the clarity, adequacy, and comprehensiveness of QUALAS-C, QUALAS-T and QUALAS-A, respectively. The interviews lasted a median of 15 min (range 8-16) for QUALAS-C, 10 min (range 9-15) for QUALAS-T and 24 min (range 9-38) for QUALAS-A. Four main issues/topics needed attention and discussion after both the forward and back translation. Following the back translation review, all issues were resolved. The patient feedback revealed recognition of the HRQoL issues included in QUALAS, and also difficulties in understanding some questions. After the patients' evaluation, four items were reworded for clarity. No study participant reported a wish to add to or remove questions from QUALAS. Hence, the Swedish versions of QUALAS became conceptually equivalent to the original US English versions and achieved linguistic, content and face validity. While empowering the voices of people with spina bifida, these results also enable their HRQoL to be properly assessed in research and clinical care in Sweden and in international studies.
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Affiliation(s)
- Michaela Dellenmark-Blom
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, 416 85 Gothenburg, Sweden; (M.A.); (M.V.M.A.); or (S.S.); or (K.A.)
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
| | - Marie Andersson
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, 416 85 Gothenburg, Sweden; (M.A.); (M.V.M.A.); or (S.S.); or (K.A.)
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
| | - Konrad M. Szymanski
- Division of Pediatric Urology, Riley Hospital for Children, Indiana University Health, Indianapolis, IN 46202, USA;
| | - Charlotta Levén Andréasson
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
| | - Magdalena Vu Minh Arnell
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, 416 85 Gothenburg, Sweden; (M.A.); (M.V.M.A.); or (S.S.); or (K.A.)
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
| | - Sofia Sjöström
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, 416 85 Gothenburg, Sweden; (M.A.); (M.V.M.A.); or (S.S.); or (K.A.)
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
| | - Kate Abrahamsson
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, 416 85 Gothenburg, Sweden; (M.A.); (M.V.M.A.); or (S.S.); or (K.A.)
- Department of Pediatric Surgery, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, 416 85 Gothenburg, Sweden;
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Kawahara T, Yamazaki A. Changes in Correlates of Health-Related Quality of Life Between Children with Spina Bifida and Their Parents as Influenced by Their Level of Independence in Toileting Self-Management: A Cross-Sectional Study. Cureus 2024; 16:e60526. [PMID: 38887360 PMCID: PMC11180625 DOI: 10.7759/cureus.60526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
Background Spina bifida (SB) leads to various complications, such as bladder and bowel disorders, which can significantly impact quality of life (QOL). Parents of children with SB are often heavily involved in bladder and bowel management, which can affect their own QOL. Therefore, transitioning to independent bladder and bowel management is pivotal because it influences the QOL of both children with SB and their parents. In this study, we investigated changes in health-related quality of life (HRQOL) among children with SB and their parents in the process of attaining independence in bladder and bowel self-management. Methods Children with SB aged 8-17 years and their parents completed the Japanese version of the QOL assessment in SB for children/teenagers (QUALAS-C/T-J) and the Short Form-8 (SF-8). Independence in bladder and bowel management was assessed using a visual analogue scale (VAS). We calculated the correlation between children's or parents' HRQOL and the children's level of independence in bladder and bowel management. Additionally, we conducted a Mann-Whitney U test on the scores of the higher and lower independence groups. The correlation between parent and child HRQOL was analyzed by dividing children's independence into two groups. Results This study consisted of 83 parent-child pairs. Parents' and children's HRQOL and levels of self-management independence were not significantly correlated, either overall or by level of independence. The parent-child group with less independence, especially in bowel management, showed moderate to strong HRQOL correlations, whereas the group with more independence showed weaker correlations. Conclusions The strength of the correlation for parent-child HRQOL was found to change based on the level of independence in bladder and bowel self-management. These results suggest that the strength of parent-child cohesion tends to be pronounced in regard to the children's degree of independence in bowel management.
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Affiliation(s)
- Tae Kawahara
- Pediatric and Family Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, JPN
| | - Akemi Yamazaki
- Pediatric and Family Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, JPN
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Yang SH, Ji Y, Lee YS, Kim SW, Bae E, Park J, Yun H, Szymanski KM, Choi EK. Cross-cultural adaptation and validation of the Korean modified version of the QUAlity of Life Assessment in Spina bifida for Young Adults (QAULAS-YA-Km). Disabil Rehabil 2023; 45:3359-3365. [PMID: 36073860 DOI: 10.1080/09638288.2022.2118378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The QUAlity of Life Assessment in Spina bifida (QUALAS) for adults (QUALAS-A) evaluates the health-related quality of life (HRQOL), reflecting the condition specificity of adults with spina bifida (SB). The study's purpose was to translate and cross-culturally adapt the QUALAS-A into Korean and validate a Korean-modified version of the QUALAS for Young Adults (QUALAS-YA-Km). METHOD Face and content validity were evaluated in the pilot study. Internal consistency and test-retest reliability were confirmed in the main study. Factor analysis was performed, and convergent and divergent validity was verified using the World Health Organization Quality of Life assessment instrument abbreviated version (WHOQOL-BREF). RESULTS Forty-seven adults had myelomeningocele. Five items with low communality were deleted through the factor analysis, and the domains were renamed. The QUALAS-YA-Km showed good internal consistency (Cronbach's alpha 0.73-0.83) and excellent test-retest reliability (intraclass correlation coefficient 0.84-0.89). The QUALAS-YA-Km showed good convergent and divergent validity, with weak to strong correlations with the WHOQOL-BREF. CONCLUSIONS Developed with consideration of Korea's cultural characteristics, the QUALAS-YA-Km is a convenient and reliable instrument, with good internal consistency, stability, and construct validity. This can be a useful tool in clinical and research settings for HRQOL optimization in young adults with SB.Implications for RehabilitationOptimizing health-related quality of life (HRQOL) is one of the goals of people with spina bifida (SB), which requires HRQOL measurements that reflect the condition specificity of SBThe QUAlity of Life Assessment of Spina bifida for Adults (QUALAS-A) is a self-reported HRQOL questionnaire for adults with SB developed in the United States, which is used in research and clinical practiceThe present study revealed that the Korean modified version of the QUAlity of Life Assessment of Spina bifida for Young Adults (QUALAS-YA-Km), developed in consideration of the cultural characteristics of Korea, is a valid, convenient, and reliable toolThe QUALAS-YA-Km, is a useful tool that can be used in clinical and research settings for HRQOL optimization in adults with SB.
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Affiliation(s)
- Seung Hyeon Yang
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Yoonhye Ji
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
- Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Healthcare System, Seoul, South Korea
| | - Yong Seung Lee
- Department of Urology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Woon Kim
- Department of Urology, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunjeong Bae
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Jieun Park
- Bladder-Urethra Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Healthcare System, Seoul, South Korea
- Graduate School of Nursing, Yonsei University, Seoul, South Korea
| | - Hyeseon Yun
- Department of Nursing, Yonsei University Graduate School, Seoul, South Korea
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - Eun Kyoung Choi
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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Abstract
Quality of Life (QOL) and Health-Related Quality of Life (HRQOL) are important concepts across the life span for those with spina bifida (SB). This article discusses the SB Quality of Life Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. The focus of these QOL Guidelines was to summarize the evidence and expert opinions on how to mitigate factors that negatively impact QOL/HRQOL or enhance the factors positively related to QOL/HRQOL, the measurement of QOL/HRQOL and the gaps that need to be addressed in future research.
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Affiliation(s)
- Kathleen J. Sawin
- Department of Nursing Research and Evidenced-Based Practice, Children’s Wisconsin, Milwaukee, WI, USA
- College of Nursing, University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Timothy J. Brei
- Spina Bifida Association, USA
- Department of Pediatrics, Division of Developmental Medicine, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Amy J. Houtrow
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Hughes TL, Simmons KL, Tejwani R, Barton KD, Wiener JS, Todd Purves J, Routh JC. Sexual Function and Dysfunction in Individuals with Spina Bifida: A Systematic Review. Urology 2021; 156:308-319. [PMID: 33930458 DOI: 10.1016/j.urology.2021.03.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To conduct a systematic review of self-reported experiences of sexual function and dysfunction in individuals with spina bifida (SB). MATERIALS AND METHODS Medline, Embase, and Web of Science were systematically searched. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: Genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia. Two authors independently assessed eligibility, extracted data, and cross-checked results, with disagreements resolved by consensus. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: Genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia. RESULTS Systematic search yielded 23 studies representing 1441 patients (816 males, 625 females). Eight utilized questionnaires validated in non-SB adults; the remainder used semi-structured interviews and non-validated instruments. Eleven assessed dysfunctions in both sexes, 10 in males, and 2 in females. Erectile function and orgasm were the most commonly assessed outcomes in males and females respectively. 12%-88% of males experienced erectile dysfunction; a majority (51%-90%) reported normal ejaculatory function. Many females were unable to experience orgasm (28%-63%). CONCLUSION Males with SB report significant erectile and ejaculatory dysfunction. Both sexes report impaired orgasms and genital sensitivity. SB-specific instruments assessing sexual dysfunction are needed in order to improve multidisciplinary care for this population.
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Affiliation(s)
- Taylor L Hughes
- School of Medicine, Duke University Medical Center, Durham, NC
| | | | - Rohit Tejwani
- Division of Urology, Duke University Medical Center, Durham, NC
| | - Karen D Barton
- Duke University Medical Center Library & Archives, Durham, NC
| | - John S Wiener
- Division of Urology, Duke University Medical Center, Durham, NC
| | - J Todd Purves
- Division of Urology, Duke University Medical Center, Durham, NC
| | - Jonathan C Routh
- Division of Urology, Duke University Medical Center, Durham, NC.
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Kawahara T, Sugita Y, Momose H, Szymanski KM, Hida E, Yamazaki A. Development and Validation of the Japanese Version of Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J). Pediatr Int 2021; 63:423-429. [PMID: 32745355 DOI: 10.1111/ped.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously developed the Japanese version of The Quality of Life Assessment of Spina Bifida in Teenagers, a health-related quality-of-life instrument specific to children aged 13-17 years with spina bifida (SB). The Quality of Life Assessment of Spina Bifida in Children is a version of this questionnaire for children aged 8-12 years. The purpose of this study was to develop a Japanese version of the Quality of Life Assessment of Spina Bifida in Children (QUALAS-C-J) and verify its reliability and validity. METHODS Three urologists specializing in SB, 2 nurses, and 1 statistician developed the QUALAS-C-J and conducted a pilot and main survey. Participants included children with SB and non-disabled (ND) children. Participants completed the QUALAS-C-J and the Japanese version of KIDSCREEN-27 (J-KIDSCREEN) without parental help. RESULTS Five children with SB participated in the pilot study and provided face and content validity. Sixty-three children with SB and 40 age- and sex-matched ND children participated in the main survey. The intraclass correlation coefficient in the retest was 0.80, and Cronbach's alpha in each domain was 0.73. The validity was verified by factor analysis, convergent / divergent validity, and known-groups validity. Factor analysis converged to the same two-factor structure as the original version. The correlation between QUALAS-C-J and J-KIDSCREEN-27 was weak (r=-0.06-0.30). The scores of both groups for the two domains of the QUALAS-C-J were significantly lower in SB than ND children. CONCLUSIONS QUALAS-C-J is easy to answer, suitable for Japanese children with SB, reliable, and valid. It can be a communication tool for children with SB, medical staff, families, communities, and school teachers.
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Affiliation(s)
- Tae Kawahara
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yoshifumi Sugita
- Department of Urology, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Hitoshi Momose
- Department of Urology, Japan Community Health-care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Akemi Yamazaki
- Division of Health Sciences, Departments of Pediatric and Family Nursing, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Pompermaier J, Andrade MCD, Cruz MLD, Macedo Júnior A. TRANSLATION AND VALIDATION OF THE BRAZILIAN VERSION OF THE "QUALITY OF LIFE ASSESSMENT IN SPINA BIFIDA" QUESTIONNAIRE FOR CHILDREN AND TEENAGERS. ACTA ACUST UNITED AC 2020; 39:e2019312. [PMID: 32876304 PMCID: PMC7457465 DOI: 10.1590/1984-0462/2021/39/2019312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/01/2020] [Indexed: 12/04/2022]
Abstract
Objective: To assess the reliability and validity of the Quality of Life Assessment in
Spina Bifida (QUALAS), children and teenager’s versions (QUALAS C and T,
respectively). This is the first self-applicable quality of life assessment
tool for patients under 13 years of age, which also addresses the issue of
urinary and fecal incontinence. Methods: Two urologists performed the translation of both QUALAS versions. A
commission produced a consensus version (Version 2), which was applied as a
pilot study to define Version 3. It was then backtranslated into English and
compared with the original version for equivalence of concepts. Internal
consistency with Cronbach’s alpha and the intraclass correlation coefficient
(ICC) reproducibility was analyzed after two assessments with an interval
from two to four weeks. Convergent and divergent validities between the
QUALAS and a generic health-related quality of life questionnaire, the
KIDSCREEN-27, were studied through Pearson’s correlation. Results: The reliability analysis showed good internal consistency for QUALAS-C
(α=0.73) and QUALAS-T (α=0.79) and good reproducibility in both
questionnaires (QUALAS-C - ICC=0.86; QUALAS-T - ICC=0.92). For QUALAS-C
convergent validity, there was a low correlation between its items (r=0.35).
In addition, a low correlation was also found in the divergent validity
analysis, when compared to the KIDSCREEN-27 (r≤0.33). Convergent and
divergent validities of the QUALAS-T questionnaire had similar results:
r=0.46 and r≤0.49, respectively. Conclusions: After the adaptation and validation process, QUALAS-C and QUALAS-T
questionnaires showed to be reliable and valid instruments for measuring the
health-related quality of life of children and teenagers with spina bifida
aged 8 years or older.
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