Translation,cultural adaptation,and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea

Purpose

The aim of this study was the translation, cross-cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea (OSA).

Methods

Ninety-six patients with OSA completed a series of questionnaires including SAQLI, Epworth Sleepiness Scale (ESS),10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Medical Outcome Survey Short form 12 (SF-12) for assessment of reliability, validity, and responsiveness of Persian version of SAQLI.

Results

The Persian version of SAQLI had a very good internal consistency and also demonstrated good test-retest reliability. Concurrent validity was confirmed by significant correlations with ESS, FOSQ-10 and SF-12 subscale scores. Comparison of SAQLI scores in groups of patients categorized by ESS showed the high discriminative power of this instrument. However, there was no significant difference in the SAQLI scores of patients with mild, moderate, and severe sleep apnea. The results of sensitivity to change verified that the SAQLI was able to detect changes after continuous positive airway pressure (CPAP) treatment.

Conclusion

The findings of this study indicate that the Persian version of SAQLI is a reliable, valid, and responsive measure for evaluation of quality of life in patients with OSA.

     

First validation of the French version of the Gastrointestinal Quality of Life Index (GIQLI)

AIM: Gastrointestinal quality of life index (GIQLI) was initiated in Germany. The aim of this study was to validate its French version (translation). METHODS: The questionnaire includes 36 items asking about symptoms, physical status, emotions, social dysfunction, and effects of medical treatment. The questionnaire has been applied to 615 persons: 335 healthy individuals and 280 patients. Responsiveness and absolute and relative scores were calculated in both groups. Psychometric analysis was done by measuring the validity (convergent and discriminant) and internal consistency. RESULTS: The responsiveness was 93%. The mean score was 126 for healthy individuals and 96 for patients (P < 0.00001). The validity of the questionnaire (both convergent and discriminant) and the internal consistency were demonstrated. Clinical validity was also suggested by the differences between healthy individuals and patients. CONCLUSION: This study allowed the psychometric validation of the French version of GIQLI. This index could be used in France as a reliable method for measuring quality of life related to gastrointestinal diseases.     

Improving Health-Related Quality of Life in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) syndrome is a common and often life-altering sleep-related breathing disorder. It not only adversely affects cardiovascular health, but the quality of life of these patients is also often significantly compromised. They experience excessive daytime sleepiness and poor cognitive, social and exercise performance. Furthermore, they often have marital problems with increased divorce rates, depression, and poor job performance.Our purpose in writing this review is to highlight the various neuropsychiatric domains that are affected in OSA patients and to emphasize that identifying and treating this condition can significantly improve the quality of life of these individuals. In recent years there has been ample evidence supporting the role of treatment for OSA to improve cardiovascular outcomes. We provide similar evidence supporting the treatment of OSA to improve health-related quality of life outcomes for these patients. Surgical, non-surgical and pharmacologic modalities are currently available as effective options for the treatment of OSA, with continuous positive airway pressure therapy appearing to be the most promising.     

The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index

Purpose

The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire that measures sleep quality during the previous month. The aims of this study were to analyze the reliability and validity of the Korean version of the PSQI (PSQI-K) and to evaluate its usefulness.

Methods

We developed the PSQI-K, which involved translating the original PSQI into Korean and then translating back into English to check its accuracy. We tested the validity of the PSQI-K on a total of 394 individuals: 261 with poor sleep (primary insomnia, n?=?211; narcolepsy, n?=?50) and 133 with good sleep. All subjects completed the PSQI-K, 285 had overnight nocturnal polysomnography, and 53 were randomly selected for a retest with the questionnaire after 2?C4?weeks without any intervening treatment. The mean PSQI-K global scores in each group were analyzed after adjusting for age and sex.

Results

Cronbach's ?? coefficient for internal consistency of the total score of the PSQI-K was 0.84 which shows high reliability. Sensitivity and specificity for distinguishing poor and good sleepers were 0.943 and 0.844 using the best cutoff point of 8.5. The total and component scores of the PSQI-K for insomnia and narcolepsy were significantly higher than those for controls (p?p?t tests.

Conclusions

The PSQI-K is a reliable and valid questionnaire for evaluating sleep quality in patients with sleep disorders.     

Development of the Dementia Quality of Life Instrument-Japanese version

AIM: The aim of this study was to develop the Dementia Quality of Life Instrument-Japanese version (DQoL-Japanese Version). METHODS: The subjects were 72 elderly patients, 19 men and 53 women (Vascular Dementia: 66, Senile dementia Alzheimer type 6) using day care and day services who had obtained approval for participation in the investigation. The interview survey was conducted from October 2002 to January 2003. RESULTS: In the subscales of the DQoL-Japanese Version, "negative feelings" scored the highest and "affirmative feelings" the lowest. There was a significant correlation coefficient between the test and those of a conducted 2 weeks later, ranging from 0.730 to 0.857 (p<0.05). The internal consistency reliability for the five scales ranges from alpha=0.66 to 0.864. There was a significant correlation coefficient between the Geriatric Depression Scale (GDS) and DQOL sub-scales such as "self esteem," "positive affect", "negative feelings" and "feeling of belonging". On the other hand, there was no significant relationship between the GDS and "aesthetics" of the DQoL-Japanese Version. CONCLUSIONS: It was suggested that the DQoL-Japanese Version DQoL is useful to measure subjective QOL of elderly patients with dementia. The subjects who understood the questions of the DQoL-Japanese Version and were able to be interviewed, had a Mini-Mental State score of 13 points or more. It was clarified that DQoL-Japanese Version was reliable and showed evidence of validity as well as the original DQOL.     

Translation and validation of an Iranian version of the Diabetes Quality of Life measure

Aims/Introduction: The objective of this study was to translate and validate an Iranian version of the Diabetes Quality of Life (DQOL) questionnaire in an Iranian population of males and females with a diagnosis of type 2 diabetes. Materials and Methods: A total of 503 patients with type 2 diabetes were recruited from nine diabetes clinics across several Iranian cities. A standard backward and forward translation procedure was used to convert the English version of the DQOL into the Iranian language (Persian). Internal consistency, convergent validity, known group comparison, confirmatory factor analysis (CFA) and factorial invariance were applied for the assessment of psychometric properties of the translated version. Results: The translated version of the DQOL showed adequate internal consistency reliabilities for all subscales (Cronbach’s α >0.70). CFA confirmed the underlying domain structure to be the same as for the original English version, therefore supporting the factorial validity of the translated questionnaire. In addition, questionnaire responsiveness showed good sensitivity to interventions. Conclusions: In conclusion, the translated Iranian version of DQOL has shown high internal reliability and good construct validity, and can potentially be applied as an assessment tool for health‐related quality of life in patients with diabetes. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00217.x, 2012)     

Adaptation and validation of the Turkish version of the Rheumatoid Arthritis Quality of Life Scale

OBJECTIVE: The aim of this study was to adapt the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire for use in Turkey and to test its reliability and validity. METHODS: The translation process included the recent guidelines for cross-cultural adaptation. Reliability of the Turkish RAQoL was assessed by internal consistency and test-retest reliability, internal construct validity by Rasch analysis, and external construct validity by associations with impairments, disability, and general health status. Cross-cultural validity was tested through analysis of differential item functioning (DIF) by comparison with data from the UK version of the RAQoL. RESULTS: Reliability of the adapted version was good, with high internal consistency (Cronbach's alpha 0.95 and 0.96 at times 1 and 2, respectively) and test-retest reliability (Spearman's rho 0.874). Internal construct validity was confirmed by excellent fit to the Rasch model (mean item fit 0.236, SD 1.113) and external construct validity by expected associations. The DIF for culture was found in four items. CONCLUSIONS: Adaptation of the RAQoL for use in Turkey was successful. The instrument can be used in both national and international studies for cross-cultural comparison with the UK, as long as adjustments are made for the few items displaying DIF for culture.     

Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P)

Background  

There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have been associated with numerous diseases. Thus, it is important to assess sleep quality. The Pittsburgh Sleep Quality Index (PSQI) is a self-rating questionnaire that can be completed within 5 min, but no Persian language version is available.     

Translation and validation of the gastrointestinal Quality of Life Index (GIQLI).

OBJECTIVE: To translate into Spanish and validate the GIQLI, a health related quality of life questionnaire for gastrointestinal diseases. PATIENTS AND METHODS: All patients with a diagnosis of cholelithiasis, on waiting list to undergo a cholecystectomy, from three public hospitals, were included in this study. All patients were requested to fulfill the GIQLI and the SF-36 before and three months after the intervention. The validity, reliability and responsiveness of the GIQLI were studied. RESULTS: 353 patients completed both questionnaires before and after the intervention. The GIQLI was able to discriminate among levels of severity, measured by the number of previous biliary colics, between those with less (total GIQLI score: 102.7) or more than 6 colics (89.2). GIQLI domains correlated with those of the SF-36 (Pearson correlation coefficient from 0.58 to 0.79). Internal consistency of its domains was good (Cronbach alpha from 0.70 to 0.86). Responsiveness, measured by the standardized response mean, of the GIQLI ranged between 0.45 to 0.82, better than the generic questionnaire SF-36 (0.20 a 0.56). CONCLUSIONS: GIQLI translation into Spanish provides with a new tool to measure quality of life on gastrointestinal diseases. Our results support the validity, reliability and responsiveness of the GIQLI Spanish version.     

阻塞性睡眠呼吸暂停的治疗进展

谈阻塞性睡眠呼吸暂停（obstructive sleep apnea,OSA）的治疗,首先需要明确的是OSA治疗的目的。OSA是多种原因造成睡眠中上气道不同程度的狭窄或阻塞,而引发的以睡眠打鼾、呼吸暂停和日间嗜睡等症状为主的一个综合征。问题发生在上气道,引发的合并症确遍及全身,对机体的损害涉及心脑血管、呼吸、消化、血液、泌尿生殖和代谢等多个系统。     

Development and validation of the Mini Asthma Quality of Life Questionnaire.

The 32-item Asthma Quality of Life Questionnaire (AQLQ) has shown good responsiveness, reliability and construct validity; properties that are essential for use in clinical trials, clinical practice and surveys. However, to meet the needs of large clinical trials and long-term monitoring, where efficiency may take precedent over precision of measurement, the 15-item self-administered MiniAQLQ has been developed. The MiniAQLQ was tested in a 9-week observational study of 40 adults with symptomatic asthma. Patients completed the MiniAQLQ, the AQLQ, the Short Form (SF)-36, the Asthma Control Questionnaire and spirometry at baseline, 1, 5 and 9 weeks. In patients whose asthma was stable between clinic visits, reliability was very acceptable for the MiniAQLQ (intraclass correlation coefficient (ICC)=0.83), but not quite as good as for the AQLQ (ICC=0.95). Similarly, responsiveness in the MiniAQLQ (p=0.0007) was good but not quite so good as for the AQLQ (p<0.0001). Construct validity (correlation with other indices of health status) was strong for both the MiniAQLQ and the AQLQ. Criterion validity showed that there was no bias between the instruments (p=0.61) and the correlation between them was high (r=0.90). The Mini Asthma Quality of Life Questionnaire has good measurement properties but they are not quite as strong as those of the original Asthma Quality of Life Questionnaire. The choice of questionnaire should depend on the task at hand.     

Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire

The Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire is a disease-specific measure of needs-based quality of life developed in the UK and the Netherlands. This study describes translation, validation, and reliability of the scale into Turkish population. The ASQoL was translated into Turkish using the dual-panel process. Content validity was assessed via cognitive debriefing interviews with ankylosing spondylitis (AS) patients. Patients with AS according to modified New York criteria were recruited into the study from 12 hospitals of all part of Turkey. Psychometric and scaling properties were assessed via a two administration survey involving the ASQoL, the Nottingham Health Profile (NHP), Bath AS Functional Index (BASFI), and Bath AS Disease Activity Index (BASDAI). Classical psychometrics assessed reliability, convergent validity (correlation of ASQoL with NHP, BASFI, and BASDAI) and discriminative validity (correlation of ASQoL with perceived AS-severity and general health). Cognitive debriefing showed the new Turkish ASQoL to be clear, relevant, and comprehensive. Completed survey questionnaires were received from 277 AS patients (80 % Male, mean age 42.2/SD 11.6, mean AS duration 9.4 years/SD 9.4). Test–retest reliability was excellent (0.96), indicating low random measurement error for the scale. Correlations of ASQoL with NHP sections were low to moderate (NHP Sleep 0.34; NHP Emotional Reactions 0.83) suggesting the measures assess related but distinct constructs. The measure was able to discriminate between patients based on their perceived disease severity (p < 0.0001) and self-reported general health (p < 0.0001). The Turkish version of ASQoL has good reliability and validity properties. It is practical and useful scale to assess the quality of life in AS patients in Turkish population.     

睡眠呼吸暂停与鼾症

睡眠呼吸暂停是指睡眠期间呼吸暂时停止超过10秒或以上的一种病理状况,又可依呼吸暂停时胸腹式呼吸运动是否消失分为阻塞性和中枢性。其中阻塞性睡眠呼吸暂停患者睡眠时由于上气道狭窄、软组织松弛、舌根后坠等,在吸气时胸腔负压的作用下,软腭、舌根坠入咽腔紧贴咽后壁,造成上气道阻塞,患者多伴有明显打鼾。     

Sleep Apnea Avoidance Pillow Effects on Obstructive Sleep Apnea Syndrome and Snoring

The study was performed to determine the ability of a new inclined pillow to treat snoring and obstructive sleep apnea syndrome. The SONA Pillow^®is a triangular pillow with space to place your arm under the head while sleeping on the side. Twenty-two patients with nocturnal polysomnogram (NPSG)-proven obstructive sleep apnea syndrome were included in this study; the group included 11 mild, 8 moderate, and 3 severe sleep apnea patients. All patients had a second attended NPSG performed while utilizing this specific inclined pillow. The pillow was found to be an effective and easily used treatment for mild (respiratory disturbance index [RDI] 5 to 19) and moderate (RDI 20 to 40) obstructive sleep apnea and snoring. In this group, RDI ranged from 5.1 to 35.2 and decreased on the average from 17 events per hour to fewer than 5 events per hour while utilizing the inclined pillow (< 0.0001). Also, a statistically significant difference was noted in rapid eye movement (REM) RDI decrement in all patients with mild to moderate sleep apnea (p= 0.001) and the increase in SaO₂was also significant (p= 0.004). Overall, snoring was decreased or eliminated (p= 0.017). Conclusion: A uniquely designed pillow (SONA Pillow^®) is effective in reducing the number of events in patients with mild to moderate obstructive sleep apnea. Using this pillow also reduces snoring.     

Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire

OBJECTIVE: Chronic constipation is characterized by difficult, infrequent, or seemingly incomplete bowel movements. The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire was developed to address the need for a standardized, patient-reported outcomes measure to evaluate constipation over time. MATERIAL AND METHODS: Items for the PAC-QOL were generated from the literature, clinical experts, and patients. Following principal components and multi-trait analyses, 28 items were retained forming four subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction) and an overall scale. Validation studies were conducted in the United States, Europe, Canada, and Australia, to evaluate the internal consistency reliability (Cronbach's alpha), reproducibility (Intraclass Correlation Coefficients (ICCs)), validity (analysis of variance models), and responsiveness (effect size) of the PAC-QOL scales. RESULTS: The PAC-QOL scales were internally consistent (Cronbach's alpha >0.80) and reproducible (ICCs >0.70, except for the satisfaction subscale ICC=0.66). PAC-QOL scale scores were significantly associated with abdominal pain (p<0.001) and constipation severity (p<0.05). Effect sizes in patients reporting improvements in constipation over a 6-week period were moderate to large, with subscale effect sizes ranging from 0.76 to 3.41 and the overall scale effect size=1.77. Similar findings were observed in validation studies conducted in Europe, Canada, and Australia. CONCLUSIONS: The PAC-QOL is a brief but comprehensive assessment of the burden of constipation on patients' everyday functioning and well-being. Multinational studies demonstrate that the PAC-QOL is internally consistent, reproducible, valid, and responsive to improvements over time.     

Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A)

Background  Considering the frequent occurrence of natural disasters in Iran, the need for an inventory assessing the quality of sleep in the posttraumatic stress disorder (PTSD) patients is clearly evident. The Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A) has been recently developed to assess the disruptive nocturnal behaviors in the PTSD patients. This study was aimed to explore the reliability and validity of the Persian version of the PSQI-A. Materials and methods  Eighty-five PTSD patients related to the two recent major earthquakes of Kerman Province were enrolled in the study, and 133 healthy subjects were conveniently selected as the control group. The inventory was translated and then back-translated according to standard methods. The reliability was checked by computing the Cronbach`s alpha coefficient and corrected item-total correlation. The sensitivity and specificity were assessed by comparing the PSQI-A score with the DSM-IV-TR diagnosis. Convergent validity was checked against the General Health Questionnaire 12 (GHQ-12). Results  The mean (±SD) of the two groups were 42.1(±13.8) and 34.2 (±9.8), respectively. The sex distribution was comparable in the two groups (females consisted 55% and 58% of the PTSD and control groups, respectively). There were significant differences between the items comparing the two groups except for the “acting out dreams”. Overall the Cronbach`s alpha coefficient was 0.89, and the item-total correlation of all the seven items were over 0.4 except for the acting out dreams. At cut-off of 7/8, the sensitivity and specificity were 100% and 93%, respectively. The sum score showed a correlation of 0.66 with the GHQ-12. Conclusion  Although the psychometric properties of one of the seven items of the inventory were to some extent unsatisfactory, the overall reliability and validity of the questionnaire were acceptable.     

Cross-cultural adaptation and validation of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire's Arabic version

Health-related quality of life (HRQOL) assessment is considered among the most relevant outcome measures following conservative and surgical interventions for various spinal conditions. Several questions are available to evaluate HRQOL in these conditions. A more recent Italian Spine Youth Quality of Life (ISYQOL) questionnaire was developed for this purpose and showed high validity in measuring HRQOL.To translate and adapt the ISYQOL questionnaire into Arabic language (ISYQOL-Ar) and evaluate its validity and reliability, and to correlate it with the validated revised Scoliosis Research Society (SRS-22r)''s Arabic questionnaire in a cross-sectional multicenter study.The ISYQOL was translated, back-translated, and reviewed by an expert committee. Reliability assessment for the questionnaire domains was performed using Cronbach''s alpha. For construct validation, the Pearson''s correlation coefficient was used.A total of 115 patients were enrolled in the study and completed the ISYQOL-Ar and Arabic SRS-22r questionnaires. A total of 72 patients (63%) completed the first set of questionnaires, and 2 weeks later, 63 patients (55%) completed both sets of questionnaires, with 15.8 a mean age, 39.5° mean Cobb angle of 88.9% females. ISYQOL-Ar showed excellent validity, good reliability, and internal consistency for spine health and brace wear, with Cronbach''s alpha > 0.6, similar to SRS-22r in the same cohort. The correlation was significant between ISYQOL-Ar and Arabic SRS-22r (Pearson''s coefficient = 0.708, P < .001).The ISYQOL-Ar questionnaire is a reliable and valid outcome measure for the assessment of young patients with spinal deformity among the Arabic-speaking population.