Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Nephrology
Published in: BMC Nephrology 1/2014

Open Access 01-12-2014 | Research article

Determining the validity and reliability of the Chinese version of the Kidney Disease Quality of Life Questionnaire (KDQOL-36™)

Authors: Xingjuan Tao, Susan Ka Yee Chow, Frances Kam Yuet Wong

Published in: BMC Nephrology | Issue 1/2014

Login to get access

Abstract

Background

Health-related quality of life is a crucial outcome for the chronic kidney disease population, the Kidney Disease Quality of Life (KDQOL) questionnaire is commonly used as an integral part of clinical evaluations. The abbreviated version of the KDQOL-36™ has been translated into Mandarin Chinese, but has not been tested for use in the Chinese patients. The aim of the study was to evaluate the validity and reliability of the KDQOL-36™ with a sample of Chinese patients.

Methods

The Mandarin Chinese version of the KDQOL-36™ has been translated by Amgen, Inc. and the MAPI Institution following the instrument translation specifications provided by the RAND health. The translated instrument was further reviewed by a Chinese expert panel for content validity and translational equivalence. The KDQOL-36™ along with Beck depression Inventory-II were administrated to 103 chronic renal disease patients recruited through convenience sampling procedure from the renal wards and an outpatient dialysis clinic. The convergent validity was determined through investigating the correlational evidence of the KDQOL-36™ with the Beck depression Inventory-II and the overall health rating. Known-group validity was supported by the evidence that the instrument could differentiate subgroups of patients. The internal consistency was estimated using Cronbach’s α and test-retest reliability was examined using an intraclass correlation coefficient.

Results

For the convergent validity, there were positive correlations between the overall health rating and most of the KDQOL-36™ subscales, and the Beck depression inventory score was inversely correlated with the mental component summary score and disease-specific scores of the scale. Significant correlations were noted between disease-targeted and generic dimensions of the KDQOL-36™. The results of the known-group comparisons indicated females, the unemployed, and patients had a longer dialysis history reported a worse quality of life. With regard to the reliability, the Cronbach’s alpha ranged from 0.69 to 0.78, and the intraclass correlation test-retest was higher than 0.70.

Conclusions

The Mandarin Chinese version of the KDQOL-36™ is a brief, valid, and reliable instrument for use in examining the quality of life of chronic kidney disease patients in China.
Literature
1.
Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS: Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National health and Nutrition Examination Survey. Am J Kidney Dis. 2003, 41: 1-12.CrossRefPubMed
2.
Wen CP, Cheng TY, Tsai MK, Chang YC, Chan HT, Tsai SP, Chiang PH, Hsu CC, Sung PK, Hsu YH, Wen SF: All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet. 2008, 371: 2173-2182. 10.1016/S0140-6736(08)60952-6.CrossRefPubMed
3.
Zhang L, Wang F, Wang L, Wang W, Liu B, Liu J, Chen M, He Q, Liao Y, Yu X, Chen N, Zhang JE, Hu Z, Liu F, Hong D, Ma L, Liu H, Zhou X, Chen J, Pan L, Chen W, Wang W, Li X, Wang H: Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet. 2012, 379: 815-822. 10.1016/S0140-6736(12)60033-6.CrossRefPubMed
4.
Anand S, Bitton A, Gaziano T: The gap between estimated incidence of end-stage renal disease and use of therapy. PLoS One. 2013, 8: e72860-10.1371/journal.pone.0072860.CrossRefPubMedPubMedCentral
5.
Yu HD, Petrini MA: The HRQoL of Chinese patients undergoing haemodialysis. J Clin Nurs. 2010, 19: 658-665. 10.1111/j.1365-2702.2009.03071.x.CrossRefPubMed
6.
7.
Fukuhara S, Lopes AA, Bragg-Gresham JL, Kurokawa K, Mapes DL, Akizawa T, Bommer J, Canaud BJ, Port FK, Held PJ, Worldwide Dialysis Outcomes and Practice Patterns Study: Health-related quality of life among dialysis patients on three continents the Dialysis Outcomes and Practice Patterns Study. Kidney Int. 2003, 64: 1903-1910. 10.1046/j.1523-1755.2003.00289.x.CrossRefPubMed
8.
Chiang C, Peng Y, Chiang S, Yang C, He Y, Hung K, Wu KD, Wu MS, Fang CC, Tsai TJ, Chen W: Health-related quality of life of hemodialysis patients in taiwan: a multicenter study. Blood Purif. 2004, 22: 490-498. 10.1159/000081730.CrossRefPubMed
9.
Lan GH, Zhang L, Li SH: Quality of life in hemodialysis patients. SuZhou Univ J Med Sci. 2007, 27: 78-80. in Chinese
10.
Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, Fukuhara S, Young EW, Kurokawa K, Bommer J, Wolfe RA, Held PJ, Port FK: Health-related quality of life as a predictor of mortality and hospitalization: The dialysis outcomes and practice patterns study (DOPPS). Kidney Int. 2003, 64: 339-349. 10.1046/j.1523-1755.2003.00072.x.CrossRefPubMed
11.
Thong MS, Kaptein AA, Benyamini Y, Krediet RT, Boeschoten EW, Dekker FW, Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) Study Group: Association between a self-rated health question and mortality in young and old dialysis patients: A cohort study. Am J Kidney Dis. 2008, 52: 111-117. 10.1053/j.ajkd.2008.04.001.CrossRefPubMed
12.
Brown CG: Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int. 2008, 74: 930-936. 10.1038/ki.2008.311.CrossRef
13.
Jhamb M, Tamura MK, Gassman J, Garg AX, Lindsay RM, Suri RS, Ting G, Finkelstein FO, Beach S, Kimmel PL, Unruh M: Design and rationale of health-related quality of life and patient-reported outcomes assessment in the frequent haemodialysis network trials. Blood Purif. 2011, 31: 151-158. 10.1159/000321855.CrossRefPubMedPubMedCentral
14.
Unruh ML, Hess R: Assessment of health-related quality of life among patients with chronic kidney disease. Adv Chronic Kidney Dis. 2007, 14: 345-352. 10.1053/j.ackd.2007.07.011.CrossRefPubMed
15.
Reuben DB, Tinetti ME: Goal-oriented patient care – an alternative health outcomes paradigm. N Engl J Med. 2012, 366: 777-779. 10.1056/NEJMp1113631.CrossRefPubMed
16.
Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB: Development of the Kidney Disease Quality of Life (KDQOL™) Instrument. Qual Life Res. 1994, 3: 329-338. 10.1007/BF00451725.CrossRefPubMed
17.
18.
Kalantar-Zadeh K, Unruh M: Health related quality of life in patients with chronic kidney disease. Int Urol Nephrol. 2005, 37: 367-378. 10.1007/s11255-004-0012-4.CrossRefPubMed
19.
Unruh ML, Weisbord SD, Kimmel PL: Health-related quality of life in nephrology research and clinical practice. Semin Dial. 2005, 18: 82-90.CrossRefPubMed
20.
Ricardo AC, Hacker E, Lora CM, Ackerson L, DeSalvo KB, Go A, Kusek JW, Nessel L, Ojo A, Townsend RR, Xie D, Ferrans CE, Lash JP: Validation of the kidney disease quality of life short form 36 (KDQOL-36) US Spanish and English versions in a cohort of Hispanics with chronic kidney disease. Ethn Dis. 2013, 23: 202-209.PubMedPubMedCentral
21.
22.
23.
Hobart JC, Cano SJ, Warner TT, Thompson AJ: What sample sizes for reliability and validity studies in neurology?. J Neurol. 2012, 259: 2681-2694. 10.1007/s00415-012-6570-y.CrossRefPubMed
24.
Javali SB, Gudaganavar NV, Raj SM: Effect of varying sample size in estimation of reliability coefficients of internal consistency. WebmedCentral Biostatistics. 2011, 2: WMC001572-
25.
Walter SD, Eliasziw M, Donner A: Sample size and optimal designs for reliability studies. Stat Med. 1998, 17: 101-110. 10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E.CrossRefPubMed
26.
27.
Steer RA, Rissmiller DJ, Beck AT: Use of the Beck depression inventory-II with depressed geriatric inpatients. Behav Res Ther. 2000, 38: 311-318. 10.1016/S0005-7967(99)00068-6.CrossRefPubMed
28.
Arnau RC, Meagher MW, Norri MP, Bramson R: Psychometric evaluation of the Beck depression inventory-II with primary care medical patients. Health Psychol. 2001, 20: 112-119.CrossRefPubMed
29.
Wang Z, Yuan CM, Huang J, Li ZZ, Chen J, Zhang HY, Fang XR, Xiao ZP: Reliability and validity of the Chinese version of Beck depression inventory-II among depression patients. Chin Ment Health J. 2011, 25: 476-480. in Chinese
30.
Bannigan K, Watson R: Reliability and validity in a nutshell. J Clin Nurs. 2009, 18: 3237-3243. 10.1111/j.1365-2702.2009.02939.x.CrossRefPubMed
31.
Polit DF, Beck CT, Owen SV: Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007, 30: 459-467. 10.1002/nur.20199.CrossRefPubMed
32.
Polit DF, Beck CT: The content validity index: Are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006, 29: 489-497. 10.1002/nur.20147.CrossRefPubMed
33.
Barotfi S, Molnar MZ, Almasi C, Kovacs AZ, Remport A, Szeifert L, Szentkiralyi A, Vamos E, Zoller R, Eremenco S, Novak M, Mucsi I: Validation of the kidney disease quality of life-short form questionnaire in kidney transplant patients. J Psychosom Res. 2006, 60: 495-504. 10.1016/j.jpsychores.2005.09.009.CrossRefPubMed
34.
Abdel-Kader K, Unruh ML, Weisbord SD: Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clin J Am Soc Nephrol. 2009, 4: 1057-1064. 10.2215/CJN.00430109.CrossRefPubMedPubMedCentral
35.
Lee YJ, Kim MS, Cho S, Kim SR: Association of depression and anxiety with reduced quality of life in patients with predialysis chronic kidney disease. Int J Clin Pract. 2013, 67: 363-368. 10.1111/ijcp.12020.CrossRefPubMed
36.
Ismail H: Self-rated health and factors influencing responses among young Egyptian type 1 diabetes patients. BMC Public Health. 2011, 11: 216-10.1186/1471-2458-11-216.CrossRefPubMedPubMedCentral
37.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007, 60: 34-42. 10.1016/j.jclinepi.2006.03.012.CrossRefPubMed
38.
Morsch CM, Goncalves LF, Barros E: Health-related quality of life among haemodialysis patients–relationship with clinical indicators, morbidity and mortality. J Clin Nurs. 2006, 15: 498-504. 10.1111/j.1365-2702.2006.01349.x.CrossRefPubMed
39.
Lopes AA, Bragg-Gresham JL, Goodkin DA, Fukuhara S, Mapes DL, Young EW, Gillespie BW, Akizawa T, Greenwood RN, Andreucci VE, Akiba T, Held PJ, Port FK: Factors associated with health-related quality of life among haemodialysis patients in the DOPPS. Qual Life Res. 2007, 16: 545-557. 10.1007/s11136-006-9143-7.CrossRefPubMed
40.
Mujais SK, Story K, Brouillette J, Takano T, Soroka S, Franek C, Mendelssohn D, Finkelstein FO: Health-related quality of life in CKD patients: Correlates and evolution over time. Clin J Am Soc Nephrol. 2009, 4: 1293-1301. 10.2215/CJN.05541008.CrossRefPubMedPubMedCentral
41.
Laudanski K, Nowak Z, Niemczyk S: Age-related differences in the quality of life in end-stage renal disease in patients enrolled in haemodialysis or continuous peritoneal dialysis. Med Sci Monit. 2013, 19: 378-385.CrossRefPubMedPubMedCentral
42.
DeVon HA, Block ME, Moyle-Wright P, Ernst DM, Hayden SJ, Lazzara DJ, Savoy SM, Kostas-Polston E: A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. 2007, 39: 155-164. 10.1111/j.1547-5069.2007.00161.x.CrossRefPubMed
43.
Ghasemi A, Zahediasl S: Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab. 2012, 10: 486-489. 10.5812/ijem.3505.CrossRefPubMedPubMedCentral
44.
45.
Bataclan RP, Dial MA: Cultural adaptation and validation of the Filipino version of kidney disease quality of life--short form (KDQOL-SF version 1.3). Nephrology (Carlton). 2009, 14: 663-668. 10.1111/j.1440-1797.2009.01130.x.CrossRef
46.
Kaasa S, Bjordal K, Aaronson N, Moum T, Wist E, Hagen S, Kvikstad A: The EORTC core quality of life questionnaire (QLQ-C30): Validity and reliability when analysed with patients treated with palliative radiotherapy. Eur J Cancer. 1995, 31: 2260-2263. 10.1016/0959-8049(95)00296-0.CrossRef
47.
Lim LL, Seubsman SA, Sleigh A: Thai SF-36 health survey: Tests of data quality, scaling assumptions, reliability and validity in healthy men and women. Health Qual Life Outcomes. 2008, 6: 52-10.1186/1477-7525-6-52.CrossRefPubMedPubMedCentral
48.
Ainsworth BE, Haskell WL, Leon AS, Jacob DR, Montoye HJ, Sallis JF, Paffenbarger RS: Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993, 25: 71-80. 10.1249/00005768-199301000-00011.CrossRefPubMed
49.
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR, Schmitz KH, Emplaincourt PO, Jacobs DR, Leon AS: Compendium of physical activities: an updated of activity codes and MET intensities. Med Sci Sports Exerc. 2000, 32 (Suppl 9): S498-504.CrossRefPubMed
50.
Tsung L, Cruickshank K: Teaching and Learning Chinese in Global Contexts. 2011, New York: Continuum International Publishing Group
51.
Pakpour AH, Yekaninejad M, Molsted S, Harrison AP, Hashemi F, Saffari M: Translation, cultural adaptation assessment, and both validity and reliability testing of the kidney disease quality of life – short form version 1.3 for use with Iranian patients. Nephrology (Carlton). 2011, 16: 106-112. 10.1111/j.1440-1797.2010.01389.x.CrossRef
52.
53.
Park HJ, Kim S, Yong JS, Han SS, Yang DH, Meguro M, Han CW, Kohzuki M: Reliability and validity of the Korean version of kidney disease quality of life instrument (KDQOL-SF). Tohoku J Exp Med. 2007, 211: 321-329. 10.1620/tjem.211.321.CrossRefPubMed
54.
Duarte PS, Ciconelli RM, Sesso R: Cultural adaptation and validation of the “kidney disease and quality of life – short form (KDQOL-SF 1.3)” in Brazil. Braz J Med Biol Res. 2005, 38: 261-270. 10.1590/S0100-879X2005000200015.CrossRefPubMed
55.
Abd ElHafeez S, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, EIWakil HS, Awad NM: Cultural adaptation and validation of the “kidney disease and quality of life – short form (KDQOL-SF) version 1.3” questionnaire in Egypt. BMC Nephrol. 2012, 13: 170-10.1186/1471-2369-13-170.CrossRefPubMedPubMedCentral
56.
Cheung YB, Seow YY, Qu LM, Yee AC: Measurement properties of the chinese version of the kidney disease quality of life-short form (KDQOL-SF) in end-stage renal disease patients with poor prognosis in Singapore. J Pain Symptom Manage. 2012, 44: 923-932. 10.1016/j.jpainsymman.2011.12.282.CrossRefPubMed
57.
Kontodimopoulos N, Niakas D: Determining the basic psychometric properties of the Greek KDQOL-SF. Qual Life Res. 2005, 14: 1967-1975. 10.1007/s11136-005-3868-6.CrossRefPubMed
58.
Onadja Y, Bignami S, Rossier C, Zunzunegui MV: The components of self-rated health among adults in Ouagadougou, Burkina Faso. Popul Health Metr. 2013, 11: 15-10.1186/1478-7954-11-15.CrossRefPubMedPubMedCentral
59.
Rittman M, Northsea C, Hausauer N, Green C, Swanson L: Living with renal failure. ANNA J. 1993, 20: 327-332.PubMed
60.
Gyamlani G, Basu A, Geraci S, Lee F, Moxey M, Clark M, Dubbert PM: Depression, screening and quality of life in chronic kidney disease. Am J Med Sci. 2011, 342: 186-191. 10.1097/MAJ.0b013e3182113d9e.CrossRefPubMed
61.
Paniagua R, Amato D, Vonesh E, Guo A, Mujais S: Health-related quality of life predicts outcomes but is not affected by peritoneal clearance: The ADEMEX trial. Kidney Int. 2005, 67: 1093-1104. 10.1111/j.1523-1755.2005.00175.x.CrossRefPubMed
62.
Anees M, Hameed F, Mumtaz A, Ibrahim M, Saeed Khan MN: Dialysis-related factors affecting quality of life in patients on haemodialysis. Iran J Kidney Dis. 2011, 5: 9-14.PubMed
63.
Lacson E, Xu J, Lin SF, Dean SG, Lazarus JM, Hakim RM: A comparison of SF-36 and SF-12 composite scores and subsequent hospitalisation and mortality risks in long-term dialysis patients. Clin J Am Soc Nephrol. 2010, 5: 252-260. 10.2215/CJN.07231009.CrossRefPubMedPubMedCentral
64.
Goodwin LD, Leech NL: The meaning of validity in the New Standards for Educational and Psychological Testing: Implications for measurement courses. Meas Eval Couns Dev. 2003, 36: 181-191.
Metadata
Title
Determining the validity and reliability of the Chinese version of the Kidney Disease Quality of Life Questionnaire (KDQOL-36™)
Authors
Xingjuan Tao
Susan Ka Yee Chow
Frances Kam Yuet Wong
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2014
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-15-115

Other articles of this Issue 1/2014

BMC Nephrology 1/2014 Go to the issue

Research article

Comparison of AMG 416 and cinacalcet in rodent models of uremia

Review

Is the inflammasome a potential therapeutic target in renal disease?

Research article

Non-linear association of serum 25-hydroxyvitamin D with urinary albumin excretion rate in normoalbuminuric subjects

Research article

Urine YKL-40 is associated with progressive acute kidney injury or death in hospitalized patients

Research article

Risk of intracranial hemorrhage associated with autosomal dominant polycystic kidney disease in patients with end stage renal disease

Research article

Actual versus ideal body weight for acute kidney injury diagnosis and classification in critically Ill patients

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits