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Validation of an Egyptian Arabic Version of Skindex-16 and Quality of Life Measurement in Egyptian Patients with Skin Disease

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Abstract

Purpose

To translate and cross-culturally adapt the Skindex-16, a brief skin-disease-specific QoL questionnaire, into Arabic for Egyptians and to evaluate its measurement properties in Egyptian patients with skin disease.

Method

Translation and cultural adaption were performed following guidelines for cross-cultural adaption of health-related quality of life measures. Subsequently, Skindex-16 was administered to 500 consecutive dermatological patients and 500 healthy persons for verification of its reliability and validity. Next, we examined the effect of skin disorders on QoL as well as influences of age, sex, socioeconomic level, education, and use of medication on skin disease-related QoL.

Results

The instrument showed high internal consistency reliability and good construct and content validity. The quality of life was most deteriorated in the emotional domain followed by symptoms domain (mean percentage score 55.5 ± 23.1 and 31.7 ± 26.8 respectively), while functioning was the least affected domain (mean percentage score 29.1 ± 26.8). Higher total Skindex-16 scores were observed for patients with psoriasis, urticaria, acne, and atopic dermatitis than those with vitiligo and alopecia areata. Educational level, social class, medication use, and family history influenced the impact of skin disease on overall QoL.

Conclusion

The adapted Egyptian Arabic version of Skindex-16 is valid and reliable; it showed that skin problems had a clinically significant impact on QoL in Egyptian patients.

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References

  1. Finlay AY. Quality of life measurement in dermatology: a practical guide. Br J Dermatol. 1997;136:305–14.

    Article  CAS  PubMed  Google Scholar 

  2. Jayaprakasam A, Darvay A, Osborne G, McGibbon D. Comparison of assessments of severity and quality of life in cutaneous disease. Clin Exp Dermatol. 2002;27(4):306–8.

    Article  PubMed  Google Scholar 

  3. Jones-Caballero M, Penas PF, Garcia-Diez A, Badia X, Chren MM. The Spanish version of Skindex-29: cultural adaptation and preliminary evidence of validity and equivalence with the original American version. Int J Dermatol. 2000;39:907–12.

    Article  CAS  PubMed  Google Scholar 

  4. Hill J, Bird HA, Lawton CW, Wright V. The arthritis impact measurement scales: an anglicized version to assess the outcome of British patients with rheumatoid arthritis. Br J Rheumatol. 1990;29:193–6.

    Article  CAS  PubMed  Google Scholar 

  5. Kleinman A, Eisenberg L, Good B. Culture, illness and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88:251–8.

    Article  CAS  PubMed  Google Scholar 

  6. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. Clin Epidemiol. 1993;46:1417–32.

    Article  CAS  Google Scholar 

  7. Chren MM, Lasek RJ, Quinn M, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996;107:707–13.

    Article  CAS  PubMed  Google Scholar 

  8. Chren MM, Lasek RJ, Flocke SA, Zyzanski SJ. Improved discriminative and evaluative capability of a refined version of Skindex, a quality of life instrument for patients with skin diseases. Arch Dermatol. 1997;133:1433–40.

    Article  CAS  PubMed  Google Scholar 

  9. Chren MM. The Skindex instruments to measure the effects of skin disease on quality of life. Dermatol Clin. 2012;30:231–6.

    Article  CAS  PubMed  Google Scholar 

  10. Chren MM, Lasek RJ, Sahay AP, Sands LP. Measurement properties of skindex-16: a brief quality of life measure for patients with skin diseases. J Cutan Med Surg. 2001;5:105–10.

    Article  CAS  PubMed  Google Scholar 

  11. Comrey LA, Lee HB. A first course in factor analysis. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1992.

    Google Scholar 

  12. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19:539–49.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Higaki Y, Kawamoto K, Kamo T, Horikawa N, Kawashima M, Chren MM. The Japanese version of Skindex-16: a brief quality-of-life measure for patients with skin diseases. Dermatol. 2002;29:693–8.

    Article  Google Scholar 

  14. Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997;314(7080):572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Hu L, Bentler PM. Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods. 1998;3:424–53.

    Article  Google Scholar 

  16. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6:1–55.

    Article  Google Scholar 

  17. He Z, Lu C, Chren MM, Zhang Z, Li Y, Ni X, et al. Development and psychometric validation of the Chinese version of Skindex-29 and Skindex-16. Health Qual Life Outcomes. 2014;12:190.

    Article  PubMed  PubMed Central  Google Scholar 

  18. AlGhamdi KM, AlShammari SA. Arabic version of Skindex-16: translation and cultural adaptation, with assessment of reliability and validity. Int J Dermatol. 2007;46:247–52.

    Article  PubMed  Google Scholar 

  19. Chua SL, Maurer T, Chren MM. Adaptation of a Runyankore version of Skindex-16 for oral administration in Mbarara. Uganda Int J Dermatol. 2011;50:1249–54.

  20. El Fakir S, Baybay H, Bendahhou K, Obtel M, Benchat L, Mernissi FZ, et al. Validation of the Skindex-16 questionnaire in patients with skin diseases in Morocco. J Dermatol Treat. 2012;25:106–9.

    Article  Google Scholar 

  21. Abolfotouh MA, Al-Khowailed MS, Suliman WE, Al-Turaif DA, Al-Bluwi E, Al-Kahtani HS. Quality of life in patients with skin diseases in central Saudi Arabia. Int J Genl Med. 2012;5:633–42.

    Article  Google Scholar 

  22. Lundberg L, Johannesson M, Silverdahl M, Hermansson C, Lindberg M. Health-related quality of life in patients with psoriasis and atopic dermatitis measured with SF-36, DLQI and a subjective measure of disease activity. Acta Derm Venereol. 2000;80(6):430–4.

    Article  CAS  PubMed  Google Scholar 

  23. Zachariae R, Zachariae C, Ibsen HH, Wulf HC, Mortensen JT. Psychological symptoms and quality of life of dermatology outpatients and hospitalized dermatology patients. Acta Derm Venereol. 2004;84:205–12.

    Article  PubMed  Google Scholar 

  24. Coghi S, Bortoletto MC, Sampaio SAP, De Andrade Junior HA, Aoki V. Quality of life is severely compromised in adult patients with atopic dermatitis in Brazil, especially due to mental components. Clinics. 2007;62:235–42.

    Article  PubMed  Google Scholar 

  25. Finlay AY, Khan GK. Dermatology life quality index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210–6.

    Article  CAS  PubMed  Google Scholar 

  26. Kosaraju SKM, Reddy SR, Vadlamani N, Sandhya L, Kalasapati L, Maganti S, et al. Psychological morbidity among dermatological patients in a rural setting. Int J Dermatol. 2015;60:635.

    Google Scholar 

  27. Ghajarzadeh M, Ghiasi M, Kheirkhah S. Associations between skin diseases and quality of life: a comparison of psoriasis, vitiligo, and alopecia areata. Acta Med Iran. 2012;50:511–5.

    PubMed  Google Scholar 

  28. Radtke MA, Schafer I, Gajur A, Langenbruch A, Augustin M. Willingness-to-pay and quality of life in patients with vitiligo. Br J Dermatol. 2009;161:134–9.

    Article  CAS  PubMed  Google Scholar 

  29. Poon E, Seed PT, Greaves MW, Kobza-Black A. The extent and nature of disability in different urticarial conditions. Br J Dermatol. 1999;140(4):667–71.

    Article  CAS  PubMed  Google Scholar 

  30. Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134:454–8.

    Article  CAS  PubMed  Google Scholar 

  31. Grob JJ, Revuz J, Ortonne JP, Auguier P, Lorette G. Comparative study of the impact of chronic urticaria, psoriasis, and atopic dermatitis on the QoL. Int J Dermatol. 2005;152:289–95.

    CAS  Google Scholar 

  32. Chernyshov PV. Health related quality of life in adult atopic dermatitis and psoriatic patients matched by disease severity. G Ital Dermatol Venereol. 2014;151:37–43.

    PubMed  Google Scholar 

  33. Mayrshofer F, Herti M, Sinkgraven R, Sticherling M, Pfeiffer C, Zillikens D, et al. Significant decrease in quality of life in patients with pemphigus vulgaris, result from the German bullous skin disease (BSD) study group. J Dtsch Dermatol Ges. 2005;3:431–5.

  34. Paradisi A, Sampogna F, Di Pietro C, Cianchini G, Didora B, Ferri R, et al. Quality-of-life assessment in patients with pemphigus using a minimum set of evaluation tools. J Am Acad Dermatol. 2009;60(2):261–9.

    Article  PubMed  Google Scholar 

  35. Prinsen CA, Lindeboom R, Sprangers M, Legierse CM, De Korte J. Health-related quality of life assessment in dermatology: interpretation of Skindex-29 scores using patient-based anchors. J Invest Dermatol. 2010;130:1318–22.

    Article  CAS  PubMed  Google Scholar 

  36. Gurel MS, Yanik M, Simsek Z, Kati M, Karaman A. Quality of life instrument for Turkish people with skin diseases. Int J Dermatol. 2005;44:933–8.

    Article  PubMed  Google Scholar 

  37. Tabolli S, Pagliarello C, Di Pietro C, Abeni D. Limited role of marital status in the impact of dermatological diseases on quality of life. Eur J Dermatol. 2012;22:672–7.

    PubMed  Google Scholar 

  38. Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57:245–54.

    Article  CAS  PubMed  Google Scholar 

  39. Al Robaee AA. Assessment of general health and quality of life in patients with acne using a validated generic questionnaire. Acta Dermatoven Alp Panonica Adriat. 2009;18:157–64.

    Google Scholar 

  40. Leeyaphan C, Wanitphakdeedeche R, Manuskiatti W, Kulthanan K. Measuring melasma patients’ QoL using willingness to pay and time trade-off methods in thai population. BMC Dermatol. 2011;11:6.

    Article  Google Scholar 

  41. Sampogna F, Spagnoli A, Di Pietro C, Pagliarello C, Paradis A, Tabolli S, et al. Field performance of the Skindex-17 quality of life questionnaire: a comparison with the Skindex-29 in a large sample of dermatological outpatients. J Invest Dermatol. 2013;133:104–9.

    Article  CAS  PubMed  Google Scholar 

  42. Al Robaee AA. Assessment of quality of life in Saudi patients with vitiligo in a medical school in Qassim province. Saudi Arabia Saudi Med J. 2007;28:1414–7.

  43. Szepietowski JC, Reich A, Wesolowska-Szepietowska E, Baran E. Quality of life in patients suffering from seborrheic dermatitis: influence of age, gender and educational level. Mycoses. 2009;52:357–63.

    Article  PubMed  Google Scholar 

  44. Jobanputra R, Bachmann M. The effect of skin diseases on quality of life in patients from different social and ethnic groups in Cape Town. South Africa Int J Dermatol. 2000;39(11):826–31.

  45. Quandt SA, Schulz MR, Vallejos QM, Feldman SR, Verma A, Fleischer AB, et al. The association of dermatologist-diagnosed and self-reported skin diseases with skin-related quality of life in Latino migrant farm workers. Int J Dermatol. 2008;47:236–41.

    Article  PubMed  Google Scholar 

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Acknowledgements

Skindex-16 instrument is used with permission from Dr. M. Chren and Mapi Research Trust, Lyon, France. E-mail: PROinformation@mapi-trust.org—Internet: www.proqolid.org

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Authors and Affiliations

  1. Department of Dermatology and Venereology, Assiut University Hospital, Assiut, 71526, Egypt

    Nagwa Essa, Sara Awad & Mariam Nashaat

Authors
  1. Nagwa Essa
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  2. Sara Awad
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  3. Mariam Nashaat
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Corresponding author

Correspondence to Sara Awad.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

“The study has been approved by the local ethical committee of our institution and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.”

Informed Consent

“Informed consent was obtained from all individual participants included in the study.”

Funding Sources

This work is not supported by external funding sources.

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Essa, N., Awad, S. & Nashaat, M. Validation of an Egyptian Arabic Version of Skindex-16 and Quality of Life Measurement in Egyptian Patients with Skin Disease. Int.J. Behav. Med. 25, 243–251 (2018). https://doi.org/10.1007/s12529-017-9677-9

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  • DOI: https://doi.org/10.1007/s12529-017-9677-9

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