Psychometric properties of the kidney disease quality of life-36 (KDQOL-36) in Ethiopian patients undergoing hemodialysis

• Published in: Health and quality of life outcomes Vol. 20; no. 1; p. 24
• Main Authors: Gebrie, Mignote Hailu, Asfaw, Hussen Mekonnen, Bilchut, Workagegnehu Hailu, Lindgren, Helena, Wettergren, Lena
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.02.2022; BioMed Central; BMC
• Subjects: Care and treatment; Chi-square test; Chronic kidney failure; Complications and side effects; Confirmatory factor analysis; Correlation coefficient; Correlation coefficients; Cross-Sectional Studies; Diabetes; Dialysis; End stage renal disease; Ethiopia; Evaluation; Factor analysis; Health aspects; Health surveys; Hemodialysis; Humans; Interpreters; KDQOL-36; Kidney Diseases; Kidneys; Medicin och hälsovetenskap; Middle Aged; Morbidity; Psychometrics; Quality of Life; Quantitative psychology; Questionnaires; Reliability; Reliability analysis; Renal Dialysis; Reproducibility of Results; Signs and symptoms; Statistical analysis; Surveys and Questionnaires; Translations; Validation studies; Validity; Variance analysis; Ethiopia; Africa; Validity; Hemodialysis; Confirmatory factor analysis; End stage renal disease; Reliability; Ethiopia; KDQOL-36; Quality of life
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-022-01932-y

Health-related quality of life (HRQOL) has a direct association with increased morbidity and mortality among end stage renal disease patients. Valid and reliable instruments to measure the HRQOL of patients with end stage renal disease are therefore required. This study aimed to translate, culturally adapt and evaluate the psychometric properties of the Amharic version of the Kidney Disease Quality of Life-36 (KDQOL-36) instrument in Ethiopian patients with end stage renal disease undergoing hemodialysis. The KDQOL-36 instrument was developed for individuals with kidney disease who are being treated with dialysis and includes both generic and disease-specific components. The KDQOL-36 was translated to Amharic language and distributed to a cross-sectional sample of 292 hemodialysis patients. The psychometric evaluation included construct validity through corrected item-total correlation, confirmatory factor analysis and known group analysis. Convergent validity was evaluated by correlations between each of the three kidney disease targeted scales (symptoms/problems list, burden of kidney disease and effects of kidney diseases) and the European Quality of Life 5D-5L and Visual Analog Scales. Regarding reliability, internal consistency and test-retest reliability were assessed. Two hundred ninety-two patients with a mean age of 48 (SD ± 14.7) completed the questionnaire. Corrected item- total correlation scores were > 0.4 for all items. Confirmatory factor analysis revealed a two χ /df was 4.4, Root Mean Square Error of Approximation (RMSEA) = 0.108 (90% CI 0.064-0.095), Comparative Fit Index (CFI) = 0.922, Tucker Lewis Index (TLI) = 0.948 and Standardized Root mean-squared residual (SRMR) = 0.058) and three χ /df = 3.1, RMSEA = 0.085 (90% CI 0.064-0.095), CFI = 0.854, TLI = 0.838 and SRMR = 0.067) factor models for the generic and disease specific components respectively. The mean scores of the three kidney disease targeted domains were correlated to the EQ-5D-5L & VAS with correlation coefficients of large magnitude (0.55-0.81). The reliability of the instrument was satisfactory (Cronbach's alpha = 0.81-0.91) and Intra-class correlation (ICC) = 0.90-0.96). The Amharic version of the KDQOL-36 is a reliable and valid instrument recommended for assessment of HRQOL of Ethiopian patients on hemodialysis.