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Quality of Life Research

, 17:323 | Cite as

An 18-item standardized Asthma Quality of Life Questionnaire-AQLQ(S)

  • Eirini Grammatopoulou
  • Emmanouil Skordilis
  • Dimitra Koutsouki
  • George Baltopoulos
Article

Abstract

The purpose of the present study was to examine the validity and reliability of the Asthma Quality of Life Questionnaire-AQLQ(S) in a sample of 160 Greek patients with asthma. Following evidence for sample-specific validity, the AQLQ(S) model was examined through exploratory and confirmatory factor analysis. An 18-item AQLQ(S) with the four factors of symptoms, activity limitations, sleep, and exposure in environmental stimuli fits the data (χ2/df ratio = 2.26, NNFI = 0.92, CFI = 0.94, SRMR = 0.05). The 18-item AQLQ(S) showed a high internal consistency (Cronbach’ a coefficient ranged from 0.83 to 0.96) and high 9-week test-retest reliability (overall r = 0.88, ICC = 0.94). Responsiveness was confirmed throughout 2X2 ANOVA and 2X2 MANOVA, with respect to the total score (F = 42.30, P < 0.05), and the four AQLQ(S) factors (Wilks’ λ = 0.68, F = 17.59, P < 0.05). The cross-sectional correlations between the 18-item AQLQ(S) and the: (1) FEV1% predicted and (2) Borg scale were low and moderately high, respectively. In conclusion, the 18-item AQLQ(S) derived from exploratory and confirmatory factor analysis appeared to have sufficient construct validity, cross-sectional validity, responsiveness, satisfactory test-retest reliability and internal consistency evidence for the Greek sample of adults with asthma.

Keywords

Asthma Cross-cultural adaptation Factor analysis Health-related quality of life Reliability Validity 

Notes

Acknowledgements

The authors wish to thank the clinical staff of the asthma department of the Amalia Fleming Hospital in Athens, Greece, and the patients for their valuable contribution and participation in the present study.

References

  1. 1.
    Schipper, H., Clinch, J., & Powell, V. (1996). Definitions and conceptual issues. In B. Spilker (Ed.), Quality of life and pharmacoeconomics in clinical trials (pp. 11–23). Philadelphia: Lippincott-Raven.Google Scholar
  2. 2.
    Juniper, E. F., Guyatt, G. H., Streiner, D. L., & King, D. R. (1997). Clinical impact versus factor analysis for quality of life questionnaire construction. Journal of Clinical Epidemiology, 50, 233–238.PubMedCrossRefGoogle Scholar
  3. 3.
    Ehrs, P. O., Sundblad, B. M., & Larsson, K. (2006). Quality of life and inflammatory markers in mild asthma. Chest, 129, 624–631.PubMedCrossRefGoogle Scholar
  4. 4.
    Juniper, E. F., Guyatt, G. H., Epstein, R. S., Ferrie, P. J., Jaeschke, R., & Hiller, T. K. (1992). Evaluation of impairment of health related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax, 47, 76–83.PubMedCrossRefGoogle Scholar
  5. 5.
    Juniper, E. F., Buist, S., Cox, F. M., Ferrie, P. J., & King, D. R. (1999). Validation of standardized version of the asthma quality of life questionnaire. Chest, 115, 1265–1270.PubMedCrossRefGoogle Scholar
  6. 6.
    Leroyer, C., Lebrun, T., Proust, A., Lenne, X., Lucaw, E., & Rio, G. (1998). Knowledge, self-management and quality of life in asthma: A cross-sectional study of the French version of the asthma quality of life questionnaire. Quality of Life Research, 7, 267–272.PubMedCrossRefGoogle Scholar
  7. 7.
    Sanjuas, C., Alonso, J., Ferrer, M., Curull, V., Broquetas, J. M., & Antò, J. M. (2001). Adaptation of the asthma quality of life questionnaire to a second language preserves its critical properties: The Spanish version. Journal of Clinical Epidemiology, 54, 182–189.PubMedCrossRefGoogle Scholar
  8. 8.
    Spirić, V. T., Bogić, S. M., Janković, S., Maksimović, N., Miljanović, S. M., Popadić, Α. P., Rasković, S., & Milić, N. (2004). Assessment of the asthma quality of life questionnaire (AQLQ): Serbian translation. Croatian Medical Journal, 45, 188–194.Google Scholar
  9. 9.
    Tan, W. C., Tan, J. L., Wee, E. L., Niti, M., & Ng, T. P. (2004). Validation of the English version of the asthma quality of life questionnaire in a multi-ethnic Asian population. Quality of Life Research, 13, 551–556.PubMedCrossRefGoogle Scholar
  10. 10.
    Oguzturk, O., Ekici, A., Kara, M., Ekici, M., Arslan, M., Iteginli, A., Kara, T., & Kurtipek, E. (2005). Psychological status and quality of life in elderly patients with asthma. Psychosomatics, 46, 41–46.PubMedCrossRefGoogle Scholar
  11. 11.
    Apter, A. J., Reisine, S. T., Affleck, G., Barrows, E., & ZuWallack, R. L. (1999). The influence of demographic and socioeconomic factors on health- related quality of life in asthma. Journal of Allergy and Clinical Immunology, 103, 72–78.PubMedCrossRefGoogle Scholar
  12. 12.
    Grammatopoulou, E., Skordilis, E., & Koutsouki, D. (2007). Validity and Reliability of the Standardized Asthma Quality of Life Questionnaire—AQLQ(S) in Greece. In M. A. Lange (Ed.), Leading edge psychological tests and testing research (pp. 89–108). New York: Nova Science Publishers.Google Scholar
  13. 13.
    Rowe, B. H., & Oxman, A. D. (1993). Performance of an asthma quality of life questionnaire in an outpatient setting. American Review of Respiratory Disorders, 148, 675–681.Google Scholar
  14. 14.
    Rutten-van Mölken, M. H., Custers, F., van Doorslaer, E. A., Jansen, C. M., Heurmann, L., & Maesen, F. V. (1995). Comparison of performance of four instruments in evaluating the effects of salmeterol on asthma quality of life. European Respiratory Journal, 8, 888–898.PubMedGoogle Scholar
  15. 15.
    Juniper, E. F., Guyatt, G. H., Ferrie, P. J., & Griffith, L. E. (1993). Measuring quality of life in asthma. American Review of Respiratory Disorders, 147, 832–838.Google Scholar
  16. 16.
    Leidy, Ν. Κ., Chan, K. S., & Coughlin, C. (1997). Psychometric performance of the asthma quality of life questionnaire in a US sample. Quality of Life Research, 7, 127–134.CrossRefGoogle Scholar
  17. 17.
    Juniper, E. F., Norman, G. R., Cox, F. M., & Roberts, J. N. (2001). Comparison of the standard gamble, rating scale, AQLQ and SF-36 for measuring quality of life in asthma. European Respiratory Journal, 18, 38–44.PubMedCrossRefGoogle Scholar
  18. 18.
    Sherrill, C., & O’Connor, J. (1999). Guidelines for improving adapted physical activity research. Adapted Physical Activity Quarterly, 16, 1–8.Google Scholar
  19. 19.
    Sawilowsky, S. (2000). Psychometrics versus datametrics: Comment on Vacha-Haase’s ‘reliability generalization’ method and some EPM editorial policies. Educational and Psychological Measurement, 60, 174–195.Google Scholar
  20. 20.
    Thompson, B., & Vacha-Haase, T. (2000). Psychometrics is datametrics: The test is not reliable. Educational and Psychological Measurement, 60, 174–195.Google Scholar
  21. 21.
    Yun, J., & Ulrich, D. (2002). Estimating measurement validity: A tutorial. Adapted Physical Activity Quarterly, 19, 32–47.Google Scholar
  22. 22.
    Herdman, M., Fox- Rushby, J., & Badia, X. (1997). ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Quality of Life Research, 6, 237–247.PubMedCrossRefGoogle Scholar
  23. 23.
    Global strategy for asthma management and prevention. Global initiative for asthma (GINA) 2006. Retrieved March 8, 2007 from http://www.ginasthma.org
  24. 24.
    Borg, G. V. (1982). Psychological bases of perceived exertion. Medicine and Science in Sports and Exercise, 14, 377–381.PubMedGoogle Scholar
  25. 25.
    Pfeifer, K. A., Pivarnik, J. M., Womack, C. J., Reeves, M. J., & Malina, R. M. (2002). Reliability and validity of the Borg and OMNI rating of perceived exertion scales in adolescent girls. Medicine and Science in Sports and Exercise, 34, 2057–2061.CrossRefGoogle Scholar
  26. 26.
    Thomas, J., & Nelson, J. (1996). Research methods in physical activity. Champaign: Human Kinetics.Google Scholar
  27. 27.
    Pedhazur, E., & Pedhazur-Schmelkin, L. (1991). Measurements, design, and analysis: An integrated approach. Hillsdale: Erlbaume.Google Scholar
  28. 28.
    Gill, D., & Deeter, T. (1988). Development of the sport orientation questionnaire. Research Quαrterly, 59, 191–202.Google Scholar
  29. 29.
    Bentler, P. M. (1995). EQS structural equations program manual. Los Angeles: BMDP Statistical Software.Google Scholar
  30. 30.
    Hoyle, H., & Panter, T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modelling: Concepts, issues and applications (pp. 158–176). Thousand Oaks: Sage.Google Scholar
  31. 31.
    Skordilis, E. K., Sherrill, C., Yilla, A., Koutsouki, D., & Stavrou, N. A. (2002). Use of the sport orientation questionnaire with wheelchair athletes: examination of evidence of validity. Perceptual and Motor Skills, 95, 197–207.PubMedGoogle Scholar
  32. 32.
    Bentler, P. M., & Bonett, G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606.Google Scholar
  33. 33.
    Byrne, M. A. (1989). A primer of LISREL: Basic applications and programming for confirmatory factor analytic models. New York: Springer-Verlag.Google Scholar
  34. 34.
    Tabachnick, B. G., & Fidell, L. S. (1998). Using multivariate statistics. New York: Harper Collins.Google Scholar
  35. 35.
    Jöreskog, K., & Sorbom, D. (1993). LISREL 8: Structural modeling with the SIMPLIS command language. Hillsdale: Erlbaum.Google Scholar
  36. 36.
    Steinger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioural Research, 25, 173–180.CrossRefGoogle Scholar
  37. 37.
    Hu, I., & Bentler, P. M. (1999). Cut-off criteria for the fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling, 6, 1–55.CrossRefGoogle Scholar
  38. 38.
    Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis. Upper Saddle River: Prentice-Hall International.Google Scholar
  39. 39.
    Mardia, V. (1970). Measures of multivariate skewness and kurtosis with applications. Biometrics, 57, 519–530.CrossRefGoogle Scholar
  40. 40.
    Safrit, M. J. (1990). Introduction to measurement in physical education and exercise science. Boston: Times Mirror/Mosby: College Publishing.Google Scholar
  41. 41.
    Stevens, J. (1996). Applied multivariate statistics for the social sciences. New Jersey: Lawce Erlbaum Associates.Google Scholar
  42. 42.
    Bentler, P. M., & Chou, C. P. (1987). Practical issues in structural modelling. Sociological Methods and Research, 16, 78–117.CrossRefGoogle Scholar
  43. 43.
    Juniper, E. F., Guyatt, G. H., Cox, F. M., Ferrie, P. J., & King, D. R. (1999). Development and validation of the mini asthma quality of life questionnaire. European Respiratory Journal, 14, 32–38.PubMedCrossRefGoogle Scholar
  44. 44.
    Juniper, E. F., Wisniewski, M. E., Cox, F. M., Emmett, A. H., Nielsen, K. E., & O’Byrne, P. M. (2004). Relationship between quality of life and clinical status in asthma: A factor analysis. European Respiratory Journal, 23, 287–291.PubMedCrossRefGoogle Scholar
  45. 45.
    Juniper, E. F., O’Byrne, P. M., Ferrie, P. J., King, D. R., & Roberts, J. N. (2000). Measuring asthma control, clinic questionnaire or daily diary? American Journal of Respiratory Critical Care Medicine, 162, 1330–1334.Google Scholar
  46. 46.
    Babiniotis G. (2002). Dictionary of the New Greek language. Athens: E.P.E. Center L.Google Scholar
  47. 47.
    Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46, 1417–1432.PubMedCrossRefGoogle Scholar
  48. 48.
    Juniper, E. F. (2005). Assessing asthma quality of life: Its role in clinical practice. Breathe, 1, 193–204.Google Scholar
  49. 49.
    Hays, R. D., & Hadorn, D. (1992). Responsiveness to change: An aspect of validity, not a separate dimension. Quality of Life Research, 1, 73–75.PubMedCrossRefGoogle Scholar
  50. 50.
    Feinstein, A. R. (1983). An additional basic science for clinical medicine: IV. The development of clinimetrics. Annals of International Medicine, 99, 843–848.Google Scholar
  51. 51.
    Hyland, M. E. (2003). A brief guide to the selection of quality of life instrument. Health and Quality of Life Outcomes, 1, 1–5.CrossRefGoogle Scholar
  52. 52.
    Schmidt, S., & Bullinger, M. (2003). Current issues in cross-sectional quality of life instrument. Archives of Physical Medicine and Rehabilitation, 84, 29–34.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Eirini Grammatopoulou
    • 1
  • Emmanouil Skordilis
    • 1
  • Dimitra Koutsouki
    • 1
  • George Baltopoulos
    • 2
  1. 1.Laboratory of Adapted Physical Activity/Developmental and Physical Disabilities, Department of Physical Education and Sport SciencesNational and Kapodistrian University of AthensAthensGreece
  2. 2.School of NurseNational and Kapodistrian University of AthensAthensGreece

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