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Adaptation and validation of the Bulgarian version of the Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL)

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Abstract

Objective

Systemic lupus erythematosus (SLE) is a heterogeneous disease with multiple clinical manifestations, which causes a significant deterioration in the quality of life (QoL). The Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) is a lupus-specific measure used to determine the burden of the disease and it applies the need-based model of QoL. Our aim was to produce the first successfully validated foreign language version of the questionnaire.

Methods

The development of the Bulgarian version involved three stages: translation, field testing and psychometric evaluation. Translation was conducted by an expert linguist working with a developer of the original L-QoL, followed by interviews with monolingual lay individuals. Face and content validity of the translation were assessed by cognitive debriefing interviews with Bulgarian SLE patients. Finally, the L-QoL was validated by administering the questionnaire to a random sample of SLE patients on two occasions, 2 weeks apart to evaluate its reliability and validity.

Results

In the validation survey, the new Bulgarian version demonstrated high internal consistency (the Cronbach’s alpha coefficient was 0.92), and test–retest reliability (0.97). Additionally, scores on the L-QoL were correlated with those on the SF-36 sections to determine convergent validity and the strongest correlation was observed between L-QoL scores and the social functioning section of the SF-36. Known group validity was established by testing the ability of the Bulgarian L-QoL to distinguish between subgroups of patients from the study pool.

Conclusions

The demonstrated excellent psychometric properties ensure that the Bulgarian L-QoL accurately captures the impact of SLE on the quality of life.

Key points

• The Bulgarian version of the L-QoL is a valid and reliable measure of QoL in lupus patients.

• The Bulgarian version of the L-QoL can be used as an outcome measure in research, clinical trials and routine clinical practice.

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Acknowledgements

The authors would like to thank all participants in the bilingual and lay translation panels and all the patients for their participation. The authors would also like to thank Alice Heaney and Evdokiya Sotirova for their contributions to the study.

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Authors and Affiliations

  1. Department of Physiology and Pathophysiology, Medical University of Sofia, Sofia, Bulgaria

    Daliya Tsvetanova Pencheva

  2. Department of Rheumatology, University Clinical Hospital ‘St. Ivan Rilski’, Sofia, Bulgaria

    Daliya Tsvetanova Pencheva & Simeon Valentinov Monov

  3. Galen Research Ltd, Manchester, UK

    Anna Coffey & Stephen P. McKenna

  4. School of Health Sciences, University of Manchester, Manchester, UK

    Stephen P. McKenna

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  1. Daliya Tsvetanova Pencheva
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  2. Anna Coffey
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  3. Stephen P. McKenna
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  4. Simeon Valentinov Monov
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Contributions

Study concept and design: SPM and AC. Data collection: DTP and SVM. Statistical analysis and data interpretation: SPM and AC. DTP prepared the first version of the manuscript and all authors contributed to critical revision of the manuscript. All authors read and approved the final version.

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Correspondence to Daliya Tsvetanova Pencheva.

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Pencheva, D.T., Coffey, A., McKenna, S.P. et al. Adaptation and validation of the Bulgarian version of the Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL). Clin Rheumatol 42, 1811–1817 (2023). https://doi.org/10.1007/s10067-023-06523-w

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  • DOI: https://doi.org/10.1007/s10067-023-06523-w

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