Health Psychology Research / HPR / Volume 4 / Issue 1 / DOI: 10.4081/​hpr.2016.4624
GENERAL

Translation, adaptation and initial validation of Food Allergy Quality  of Life Questionnaire: child form in Greek 

Zoe Morou1 Georgios N. Lyrakos2 Nikolaos G. Papadopoulos3 Nikolaos Douladiris3 Athina Tatsioni4,5 Ioannis D.K. Dimoliatis1
Show Less
1 Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
2 Second Department of Anesthesiology, University of Athens Medical School, Athens, Greece
3 Allergy Department, 2nd Pediatric Clinic, University of Athens, Greece
4 Tufts University School of Medicine, Boston, MA, USA
5 Department of Internal Medicine, University of Ioannina Medical School, Ioannina Greece
Submitted: 27 July 2014 | Revised: 12 November 2015 | Accepted: 5 February 2016 | Published: 23 June 2016
© 2016 by the Author(s). Licensee Health Psychology Research, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

The aim of the study is to determine the reliability and validity of the Greek version of the Food Allergy Quality of life Questionnaire Child Form (FAQLQ-CF). After linguistic validation, the Greek FAQLQ CF, Food Allergy Independent Measure (FAIM) and Pediatric Quality of Life Inventory (PedsQL™) were used by a physician to interview chil dren diagnosed with food allergy and aged 8-12 via telephone. Cronbach’s alpha was used to evaluate reliability, and factor analysis to assess construct validity. The correlation between FAQLQ-CF and FAIM was moderate (rho=0.509, P<0.001) and internal consistency was strong (Cronbach’s alpha 0.905). FAQLQ-CF discriminated well each question’s contribution to children’s quality of life deterioration (32-80%), each child’s quality of life (17-89%), children differing in doing things with others (total score 3.55 vs 2.57, difference =0.98 > mini mal clinical importance difference = 0.5; P<0.001), but not children differing in reporting anaphylaxis. The total FAQLQ-CF score correlat ed with the total PedsQL™ score and with the score of one of PedsQL™ subscales, demonstrating convergent validity. Factor analy sis uncovered an underlying structure of four factors, explaining 50% of the variance. We can conclude that Greek FAQLQ-CF is a reliable, valid, discriminant tool for interviewing food allergic children aged 8 12, detecting those in need for immediate care. 

Keywords
Child; food hypersensitivity; quality of life; questionnaires; vali dation
References

1. Bollen, K.A. (1990). Overall fit in covariance structure models: two types of sample size effects. Psychological Bulletin, 107(2), 256-259. doi:10.1037/0033-2909.107.2.256.
2. Clark, L.A., & Watson, D. (1995). Constructing validity: basic issues in objective scale development. Psychological Assessment, 7, 309-319. doi:10.1037/1040-3590.7.3.309.
3. Factor, J.M., Mendelson, L., Lee, J., Nouman, G., & Lester, M.R. (2012). Effect of oral immunotherapy to peanut on food-specific quality of life. Annals of allergy, asthma & immunology:official publication of the American College of Allergy, Asthma, & Immunology, 109, 348-352. doi: 10.1016/j.anai.2012.08.015.
4. Fayers, P.M., & Machin, D. (2000). Quality of life: assessment, analysis and interpretation. Hoboken: John Willey & Sons. 
5. Field, A. (2011). Discovering statistics using SPSS (4rd ed.). London, Sage.
6. Flokstra-de Blok, B., & Dubois, A. (2009). Quality of life in food allergy: valid scales for children and adults. Current Opinion in Allergy and Clinical Immunology, 9, 214-221. doi: 10.1097/ACI.0b013e32832aa59f.
7. Flokstra-de Blok, B.M., & Dubois, A.E. (2012). Quality of life measures for food allergy. Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology, 42, 1014-1020. doi: 10.1111/j.1365-2222.2011.03927.x.
8. Flokstra-de Blok, B., DunnGalvin, A., Vlieg-Boerstra, B.J., Oude Elberink, J.N., Duiverman, E.J., Hourihane, J.O., & Dubois, A.E. (2009). Development and validation of a self-administered Food Allergy Quality of Life Questionnaire for children. Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology, 39, 127-137. doi: 10.1111/j.1365-2222.2008.03120.x. 
9. Flokstra-de Blok, B.M., van der Velde, J.L., Vlieg-Boerstra, B.J., Oude Elberink, J.N., DunnGalvin, A., Hourihane, J.O., ..., Dubois, A.E. (2010). Health-related quality of life of food allergic patients measured with generic and disease-specific questionnaires. Allergy, 65, 1031-103. doi: 10.1111/j.1398-9995.2009.02304.x
10. Gerbing, D.W., & Anderson, J.C. (1993). Monte Carlo evaluations of goodness-of-fit indices for structural equation models. In: K.A. Bollen, & J.S. Long (Eds.), Testing structural equation models. Newbury Park, CA: Sage. 
11. Gkoltsiou, K., Dimitrakaki, C., Tzavara, C., Papaevangelou, V., Varni, J.W., & Tountas, Y. (2008). Measuring health-related quality of life in Greek children: psychometric properties of the Greek version of the Pediatric Quality of Life InventoryTM 4.0 Generic Core Scales. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation, 17, 299-305. doi: 10.1007/s11136-007-9294-1.
12. Gupta, R.S., Springston, E.E., Warrier, M.R., Smith, B., Kumar, R., Pongracic, J., & Holl, J.L. (2011). The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics, 128, 9-17. doi:10.1001/jamapediatrics.2013.2376.
13. Guyatt, G., Feeny, D., & Patrick, D. (1993). Measuring health-related quality of life. Annals of Internal Medicine, 118 , 622-629. doi: 10.7326/0003-4819-118-8-199304150-00009.
14. Hu, L.T., & Bentler, P. (1995). Evaluating model fit. In R.H. Hoyle (Ed.), Structural Equation Modeling. Concepts, issues, and applications. Newbury: Sage. pp 76-79. 
15. Jaeschke, R., Singer, J., & Guyatt, G.H. (1989). Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials, 10, 407-15. doi: 10.1016/0197-2456(89)90005-6.
16. Juniper, E.F., Guyatt, G.H., Willan, A., & Griffith, L.E. (1994). Determining a minimal important change in a disease-specific quality of life questionnaire. Journal of Clinical Epidemiology, 47(1), 81-87.  doi: 10.1016/0895-4356(94)90036-1.     
17. Lyrakos, G.N., Vini, D., Aslani, H., & Drosou-Servou, M. (2012). Psychometric properties of the Specific Thalassemia Quality of Life Instrument for adults. Patient preference and adherence, 6, 477-497. doi: 10.2147/PPA.S30763.
18. Marsh, H.W., Balla, J.R., & McDonald, R.P. (1988). Goodness of fit indexes in confirmatory factor analysis: the effect of sample size. Psychological Bulletin, 103, 391-410. doi: 10.1037/0033-2909.103.3.391.
19. McDonald, R.P. (1978). A simple comprehensive model for the analysis of covariance structures. British Journal of Mathematical and Statistical Psychology, 31, 59-72. doi: 10.1111/j.2044-8317.1978.tb00573.x
20. Mills, E., Mackie, A.R., Burney, P., Beyer, K., Frewer, L., Madsen, C., ..., van Ree, R. (2007). The prevalence, cost and basis of food allergy across Europe. Allergy, 62, 717-722. doi: 10.1111/j.1398-9995.2009.02046.x
21. Norusis, M.J., SPSS Inc. (1997). SPSS Professional Statistics™ 7.5. Chapter 13 Measuring scales: reliability analysis examples. Chicago: SPSS Inc. 103-111.
22. Rona, R.J., Keil, T., Summers, C., Gislason, D., Zuidmeer, L., Sodergren, E., ..., Madsen, C. (2007). The prevalence of food allergy: a meta-analysis. Journal of Allergy and Clinical Immunology, 120, 638-646. doi: 10.1016/j.jaci.2007.05.026.
23. Stevens, J. (2002). Applied Multivariate Statistics for the Social Sciences. 4th ed. Mahwaw, New Jersey: Lawrence Erlbaum Associates Inc. 
24. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. Interantional Journal of Medical Education, 2, 53-55. doi: 10.5116/ijme.4dfb.8dfd.
25. Van der Velde, J.L., Flokstra-de Blok, B.M., de Groot, H., Oude-Elberink, J.N., Kerkhof, M., Duiverman, E.J., & Dubois, A.E. (2012). Food allergy-related quality of life after double-blind, placebo-controlled food challenges in adults, adolescents, and children. Journal of Allergy and Clinical Immunology, 130(5), 1136-1143. doi: 10.1016/j.jaci.2012.05.037.
26. Van Der Velde, J., Flokstra-de Blok, B.M., DunnGalvin, A., Hourihane, J.O., Duiverman, E.J., & Dubois, A.E. (2011). Parents report better health-related quality of life for their food-allergic children than children themselves. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology, 41, 1431-1439. doi: 10.1111/j.1365-2222.2011.03753.x.
27. Van Der Velde, J.L., Flokstra-de Blok, B.M., Vlieg-Boerstra, B.J., Oude Elberink, J.N., DunnGalvin, A., Hourihane, J.O., ..., Dubois, A.E. (2010). Development, validity and reliability of the food allergy independent measure (FAIM). Allergy, 65, 630-635. doi: 10.1111/j.1398-9995.2009.02216.x.
28. Varni, J., Seid, M., & Kurtin, P. (2001). The PedsQL™ 4.0. Reliability and validity of the Pediatric Quality of Life Inventory TM Version 4.0 Generic Core Scales in Healthy and patient populations. Medical Care, 39, 800-812. doi: 10.1097/00005650-200108000-00006.
29. Wassenberg, J., Cochard, M., DunnGalvin, A., Ballabeni, P., Flokstra-de Blok, B.M., Newman, C.J., ..., Eigenmann, P.A. (2012). Parent perceived quality of life is age-dependent in children with food allergy. Pediatric allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology, 23, 412-419. doi: 10.1111/j.1399-3038.2012.01310.x.
30. Wassenberg, J., Cochard, M.M., DunnGalvin, A., de Blok, B.M.J., Hofer, M., & Eigenmann, P.A. (2011). Qualité de vie chez l’enfant avec allergie alimentaire: validation de la version française des questionnaires spécifiques de qualité de vie. Revue Française d’Allergologie, 51, 437-438. doi: 10.1016/j.reval.2011.02.024
31. WHO. (1993). Measurement of Quality of life in children. Geneva: World Health Organization.
32. WHO. Process of translation and adaptation of instruments. Retrieved from: http://www.who.int/substance_abuse/research_tools/translation/en/

Conflict of interest
The authors declare no potential conflict of interest.
Share
Back to top
Health Psychology Research, Electronic ISSN: 2420-8124 Published by Health Psychology Research