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Vol. 46. Issue 4.
Pages 165-175 (April 2010)
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Vol. 46. Issue 4.
Pages 165-175 (April 2010)
Original Article
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Validation of the Spanish Version of the Revised Cystic Fibrosis Quality of Life Questionnaire in Adolescents and Adults (CFQR 14+ Spain)
Validación de la versión española del cuestionario revisado de calidad de vida para fibrosis quística en adolescentes y adultos (CFQR 14+ Spain)
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Gabriel Olveiraa,b, Casilda Olveirac,
Corresponding author
casi1547@separ.es

Corresponding author.
, Inmaculada Gaspard, Ivette Cruze, Antonio Doradoc, Estela Pérez-Ruizf, Nuria Porrasa, Federico Soriguera,b
a Unidad de Fibrosis Quística, Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
b CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
c Unidad de Fibrosis Quística, Servicio de Neumología, Hospital Regional Universitario Carlos Haya, Málaga, Spain
d Servicio de Neumología, Hospital Costa del Sol, Marbella, Málaga, Spain
e Departments of Psychology and Pediatrics, University of Miami, United States, Málaga, Spain
f Unidad de Fibrosis Quística, Servicio de Pediatría, Hospital Regional Universitario Carlos Haya, Málaga, Spain
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Abstract
Background

The aim of this study was to assess the validity and reliability of the Spanish version of the revised disease-specific health related quality of life questionnaire for adolescents and adults with cystic fibrosis (CFQR 14+ Spain).

Patients and methods

A total of 43 cystic fibrosis (CF) patients completed the CFQR 14+ Spain. Forced expiratory volume in 1 second, in percentage of predicted - FEV1 (%) -, number of respiratory exacerbations, 6-minute walk test, Bhalla score (based on computerized tomography of the chest), fat-free mass index, body mass index (BMI), faecal fat and St George's Respiratory Questionnaire were included as measurements of health status.

Results

Ten out of the twelve scales had alpha coefficients above 0.70. Test-retest correlations (Spearman) ranged from 0.49 to 0.95 and they were significant in all scales. Intraclass correlations ranged from 0.47 to 0.95 (ten out of the twelve scales were >0.70) forty out of the fifty items have correlations between items and scale above 0.70. All the CFQR 14+ scales, except the digestive symptoms scale, discriminated significantly between patients with mild, moderate and severe disease (according to FEV1 [%]). Other respiratory parameters also discriminated significantly between patients with mild-moderate and severe disease. Only some scales discriminated significantly between nourished and malnourished patients. All of the scales met standards for floor effects (<15% of the responders with the lowest score) but not for ceiling effects (only five out of the twelve).

Conclusion

The Spanish CFQR 14+ (Spain) is a reliable and valid instrument for measuring the health-related quality of life in Spanish adolescents and adults with CF, though with the exception of a few of its subscales.

Keywords:
Cystic fibrosis
Cystic fibrosis quality of life questionnaire
CFQR 14+ Spain
Lung function
Pulmonary exacerbations
6-minute walk test
Computerized tomography of the chest
Body mass index
Fat-free mass index
Diabetes
Resumen
Objetivos

Estudiar la validez y fiabilidad de la versión española del cuestionario revisado de calidad de vida para fibrosis quística (FQ) en adolescentes y adultos (CFQR 14+ Spain).

Pacientes y métodos

Se estudiaron 43 adolescentes y adultos con FQ, clínicamente estables. Se utilizaron como medidas del estado de salud parámetros radiológicos, espirométricos, número de reagudizaciones, prueba de la marcha de 6 min, antropométricos (índice de masa corporal, desnutrición de masa magra), grasa en heces y el cuestionario respiratorio de St. George (SGRQ).

Resultados

El alfa de Cronbach fue ≥0,70 para todas las escalas, excepto para «síntomas digestivos» y «carga de tratamiento». Cuarenta ítems (de 50) presentaron correlaciones ítems-escala mayores a 0,70 y el 98% mayores a 0,40. La reproductibilidad test-retest (coeficiente de Spearman) osciló entre 0,49-0,95 y el coeficiente de correlación intraclase alcanzó puntuaciones mayores de 0,70 en 10 de 12 escalas. Todas las dimensiones correlacionaron significativamente con las puntuaciones del SGRQ. Se observaron correlaciones significativas entre las dimensiones del cuestionario y las variables respiratorias y nutricionales que pretendían medir y permitió diferenciar adecuadamente los distintos grados de gravedad en función de los parámetros respiratorios evaluados. La desnutrición y la malabsorción condicionaron significativamente peores puntuaciones sólo en algunos dominios relacionados (como problemas con el peso). El efecto suelo fue menor al 15% en todas las dimensiones y el efecto techo fue elevado en 7 dimensiones.

Conclusiones

El cuestionario CFQR 14+ Spain es válido y fiable para su aplicación en España, aunque podría ser mejorado en algunas de las subescalas.

Palabras clave:
Calidad de vida
CFQR 14+
Fibrosis quística
Función pulmonar
Reagudizaciones
Tomografía computerizada de alta resolución
Prueba de la marcha de 6 minutos
Índice de masa corporal
Índice de masa magra
Diabetes
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