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Measuring skin disease in adolescence: bridging the gap in quality of life assessment [Abstract]

By Muhammed A. K. Basra, Mir-saeed Salek, D. Fenech, A. Howe, Tina Mahbouba, Catherine Jane Golics and Andrew Yule Finlay

Abstract

Adolescence is a unique period of life and teenagers have specific quality of life (QoL) issues that may be different in a number of ways from adults or children. There is a paucity of literature focusing on the impact of skin disease on this particular age group. The aim of this study was to develop and validate a dermatology specific quality of life instrument for adolescents with skin diseases. Semi-structured interviews were conducted with a cohort of 50 adolescents aged 12–19 years recruited from the dermatology out-patient clinic. Interviews were then transcribed verbatim using a standardised technique which resulted in the first version of T-QoL. Content validity was carried out using a pilot study of 20 adolescents and led to a revised second version of T-QoL. This was followed by psychometric evaluation conducted on 153 adolescents including the application of Rasch analysis using RUMM 2030 software to assess the overall fit of the model, the item responses, individual item fit and differential item functioning (DIF). The final validation of the Rasch refined (3rd) version was carried out on a new cohort of adolescents using Classical Test Theory. A total of 33 aspects of adolescents’ QoL were identified from qualitative interviews, leading to a 32-item first version of the T-QoL. 20 adolescents completed the T-QoL and provided feedback on its clarity, focus, relevance, practicality and applicability. Changes were made accordingly resulting in 30-item T-QoL which was then completed by 153 adolescents (M=70, F=83; mean age 16.5, range 13–19). Rasch analysis of the whole scale did not support the validity of the T-QoL as a unidimensional measure of QoL impairment. A factor analysis confirmed the presence of three domains within the scale. Each of the domains was then subjected to Rasch analysis individually. Separately all domains showed adequate fit to the model, good person separation, good internal consistency and no significant differential item bias for gender or age. The final psychometric evaluation of the final (3rd) 18-item version showed promising results. Although there are QoL measures for adults (e.g. DLQI) and children (e.g. CDLQI) with skin conditions it is necessary that a suitable age-specific measure was also available for adolescents, as there are evident differences in the QoL issues faced by adolescents compared to those of adults and children. The results of our study have demonstrated that T-QoL could provide a simple, relevant and valid tool to quantify the impact of ski

OAI identifier: oai:http://orca.cf.ac.uk:32832
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