Skip to main content
Top
Published in: BMC Ophthalmology 1/2014

Open Access 01-12-2014 | Research article

Comparison of the Adult Strabismus Quality of Life Questionnaire (AS-20) with the Amblyopia and Strabismus Questionnaire (ASQE) among adults with strabismus who seek medical care in China

Authors: Zonghua Wang, Hui Ren, Rosemary Frey, Yang Liu, Deborah Raphael, Wei Bian, Xianyuan Wang

Published in: BMC Ophthalmology | Issue 1/2014

Login to get access

Abstract

Background

The impact of strabismus on visual function, self-image, self-esteem, and social interactions might decrease health-related quality of life (HRQoL). This study aimed to evaluate the psychometric properties and clinical applications of two strabismus-specific HRQoL questionnaires in the cultural context of China.

Methods

The Chinese versions of the Adult Strabismus Quality of Life Questionnaire (AS-20) and the Amblyopia and Strabismus Questionnaire (ASQE) were self-administered to 304 adults with strabismus. The Cronbach’s α coefficient was calculated to assess the internal consistency reliability. The criterion-related validity was identified by exploring Spearman’s correlation with the most widely used vision-specific quality of life questionnaire NEI-VFQ-25. One-way ANOVA was employed to examine the differences in the quality of life of strabismus patients with visually normal adults and with other eye diseases patients.

Results

Significantly positive correlations with NEI-VFQ-25 were shown in both scales (r = 0.21 - 0.44, p <0.05, p <0.01). Both scales could distinguish individuals with strabismus from visually normal adults (p <0.001) and adults with other eye diseases (p <0.001). The overall Cronbach’s α value were 0.91 for the AS-20 and 0.89 for the ASQE; and for the subscales, the α value ranged from 0.68 to 0.90.

Conclusion

This was the first cross-sectional study to compare the psychometric properties of two strabismus-targeted questionnaires, AS-20 and ASQE in the context of Chinese culture. Both AS-20 and ASQE showed satisfactory and comparable properties for measuring HRQoL in strabismus patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hatt SR, Leske DA, Holmes JM: Responsiveness of health-related quality-of-life questionnaires in adults undergoing Strabismus surgery. Ophthalmology. 2010, 117 (12): 2322-2328. 10.1016/j.ophtha.2010.03.042. e2321CrossRefPubMedPubMedCentral Hatt SR, Leske DA, Holmes JM: Responsiveness of health-related quality-of-life questionnaires in adults undergoing Strabismus surgery. Ophthalmology. 2010, 117 (12): 2322-2328. 10.1016/j.ophtha.2010.03.042. e2321CrossRefPubMedPubMedCentral
2.
go back to reference Hatt SR, Leske DA, Liebermann L, Holmes JM: Changes in health-related quality of life 1 year following strabismus surgery. Am J Ophthalmol. 2012, 153 (4): 614-619. 10.1016/j.ajo.2011.10.001.CrossRefPubMedPubMedCentral Hatt SR, Leske DA, Liebermann L, Holmes JM: Changes in health-related quality of life 1 year following strabismus surgery. Am J Ophthalmol. 2012, 153 (4): 614-619. 10.1016/j.ajo.2011.10.001.CrossRefPubMedPubMedCentral
3.
go back to reference Wilson IB, Cleary PD: Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995, 273 (1): 59-65. 10.1001/jama.1995.03520250075037.CrossRefPubMed Wilson IB, Cleary PD: Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995, 273 (1): 59-65. 10.1001/jama.1995.03520250075037.CrossRefPubMed
4.
go back to reference WHOQOL-Group: The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995, 41 (10): 1403-1409.CrossRef WHOQOL-Group: The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995, 41 (10): 1403-1409.CrossRef
5.
go back to reference Beaton DE, Schemitsch E: Measures of health-related quality of life and physical function. Clin Orthop Relat Res. 2003, 413: 90-105.CrossRefPubMed Beaton DE, Schemitsch E: Measures of health-related quality of life and physical function. Clin Orthop Relat Res. 2003, 413: 90-105.CrossRefPubMed
6.
go back to reference Schumacher M, Olschewski M, Schulgen G: Assessment of quality of life in clinical trials. Stat Med. 1991, 10 (12): 1915-1930. 10.1002/sim.4780101207.CrossRefPubMed Schumacher M, Olschewski M, Schulgen G: Assessment of quality of life in clinical trials. Stat Med. 1991, 10 (12): 1915-1930. 10.1002/sim.4780101207.CrossRefPubMed
7.
go back to reference Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics. 1999, 15 (2): 141-155. 10.2165/00019053-199915020-00003.CrossRefPubMed Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics. 1999, 15 (2): 141-155. 10.2165/00019053-199915020-00003.CrossRefPubMed
8.
go back to reference Guyatt GH, Feeny DH, Patrick DL: Measuring health-related quality of life. Ann Intern Med. 1993, 118 (8): 622-629. 10.7326/0003-4819-118-8-199304150-00009.CrossRefPubMed Guyatt GH, Feeny DH, Patrick DL: Measuring health-related quality of life. Ann Intern Med. 1993, 118 (8): 622-629. 10.7326/0003-4819-118-8-199304150-00009.CrossRefPubMed
9.
go back to reference Patrick DL, Deyo RA: Generic and disease-specific measures in assessing health status and quality of life. Med Care. 1989, 27 (Suppl 3): S217-S232.CrossRefPubMed Patrick DL, Deyo RA: Generic and disease-specific measures in assessing health status and quality of life. Med Care. 1989, 27 (Suppl 3): S217-S232.CrossRefPubMed
10.
go back to reference Clarke SA, Eiser C: The measurement of health-related quality of life (QOL) in paediatric clinical trials: a systematic review. Health Qual Life Outcomes. 2004, 2: 66-10.1186/1477-7525-2-66.CrossRefPubMedPubMedCentral Clarke SA, Eiser C: The measurement of health-related quality of life (QOL) in paediatric clinical trials: a systematic review. Health Qual Life Outcomes. 2004, 2: 66-10.1186/1477-7525-2-66.CrossRefPubMedPubMedCentral
11.
go back to reference Hatt SR, Leske DA, Kirgis PA, Bradley EA, Holmes JM: The effects of strabismus on quality of life in adults. Am J Ophthalmol. 2007, 144 (5): 643-647. 10.1016/j.ajo.2007.06.032.CrossRefPubMedPubMedCentral Hatt SR, Leske DA, Kirgis PA, Bradley EA, Holmes JM: The effects of strabismus on quality of life in adults. Am J Ophthalmol. 2007, 144 (5): 643-647. 10.1016/j.ajo.2007.06.032.CrossRefPubMedPubMedCentral
12.
go back to reference Menon V, Saha J, Tandon R, Mehta M, Khokhar S: Study of the psychosocial aspects of strabismus. J Pediatr Ophthalmol Strabismus. 2002, 39 (4): 203-208.PubMed Menon V, Saha J, Tandon R, Mehta M, Khokhar S: Study of the psychosocial aspects of strabismus. J Pediatr Ophthalmol Strabismus. 2002, 39 (4): 203-208.PubMed
13.
go back to reference Olitsky SE, Sudesh S, Graziano A, Hamblen J, Brooks SE, Shaha SH: The negative psychosocial impact of strabismus in adults. J AAPOS. 1999, 3 (4): 209-211. 10.1016/S1091-8531(99)70004-2.CrossRefPubMed Olitsky SE, Sudesh S, Graziano A, Hamblen J, Brooks SE, Shaha SH: The negative psychosocial impact of strabismus in adults. J AAPOS. 1999, 3 (4): 209-211. 10.1016/S1091-8531(99)70004-2.CrossRefPubMed
14.
go back to reference Nelson BA, Gunton KB, Lasker JN, Nelson LB, Drohan LA: The psychosocial aspects of strabismus in teenagers and adults and the impact of surgical correction. J AAPOS. 2008, 12 (1): 72-76. 10.1016/j.jaapos.2007.08.006. e71CrossRefPubMed Nelson BA, Gunton KB, Lasker JN, Nelson LB, Drohan LA: The psychosocial aspects of strabismus in teenagers and adults and the impact of surgical correction. J AAPOS. 2008, 12 (1): 72-76. 10.1016/j.jaapos.2007.08.006. e71CrossRefPubMed
15.
go back to reference Durnian JM, Owen ME, Baddon AC, Noonan CP, Marsh IB: The psychosocial effects of strabismus: effect of patient demographics on the AS-20 score. J AAPOS. 2010, 14 (6): 469-471. 10.1016/j.jaapos.2010.08.013.CrossRefPubMed Durnian JM, Owen ME, Baddon AC, Noonan CP, Marsh IB: The psychosocial effects of strabismus: effect of patient demographics on the AS-20 score. J AAPOS. 2010, 14 (6): 469-471. 10.1016/j.jaapos.2010.08.013.CrossRefPubMed
16.
go back to reference Carlton J, Kaltenthaler E: Health-related quality of life measures (HRQoL) in patients with amblyopia and strabismus: a systematic review. Br J Ophthalmol. 2011, 95 (3): 325-330. 10.1136/bjo.2009.178889.CrossRefPubMed Carlton J, Kaltenthaler E: Health-related quality of life measures (HRQoL) in patients with amblyopia and strabismus: a systematic review. Br J Ophthalmol. 2011, 95 (3): 325-330. 10.1136/bjo.2009.178889.CrossRefPubMed
17.
go back to reference van de Graaf ES, van der Sterre GW, Polling JR, van Kempen H, Simonsz B, Simonsz HJ: Amblyopia & strabismus questionnaire: design and initial validation. Strabismus. 2004, 12 (3): 181-193. 10.1080/09273970490491196.CrossRefPubMed van de Graaf ES, van der Sterre GW, Polling JR, van Kempen H, Simonsz B, Simonsz HJ: Amblyopia & strabismus questionnaire: design and initial validation. Strabismus. 2004, 12 (3): 181-193. 10.1080/09273970490491196.CrossRefPubMed
18.
go back to reference Felius J, Beauchamp GR, Stager DR, Van De Graaf ES, Simonsz HJ: The amblyopia and strabismus questionnaire: English translation, validation, and subscales. Am J Ophthalmol. 2007, 143 (2): 305-310. 10.1016/j.ajo.2006.09.046.CrossRefPubMed Felius J, Beauchamp GR, Stager DR, Van De Graaf ES, Simonsz HJ: The amblyopia and strabismus questionnaire: English translation, validation, and subscales. Am J Ophthalmol. 2007, 143 (2): 305-310. 10.1016/j.ajo.2006.09.046.CrossRefPubMed
19.
go back to reference van de Graaf ES, van der Sterre GW, van Kempen-du SH, Simonsz B, Looman CW, Simonsz HJ: Amblyopia and Strabismus Questionnaire (A&SQ): clinical validation in a historic cohort. Graefes Arch Clin Exp Ophthalmol. 2007, 245 (11): 1589-1595. 10.1007/s00417-007-0594-5.CrossRefPubMed van de Graaf ES, van der Sterre GW, van Kempen-du SH, Simonsz B, Looman CW, Simonsz HJ: Amblyopia and Strabismus Questionnaire (A&SQ): clinical validation in a historic cohort. Graefes Arch Clin Exp Ophthalmol. 2007, 245 (11): 1589-1595. 10.1007/s00417-007-0594-5.CrossRefPubMed
20.
go back to reference Guillemin F, Bombardier C, Beaton D: Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993, 46 (12): 1417-1432. 10.1016/0895-4356(93)90142-N.CrossRefPubMed Guillemin F, Bombardier C, Beaton D: Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993, 46 (12): 1417-1432. 10.1016/0895-4356(93)90142-N.CrossRefPubMed
21.
go back to reference Hatt SR, Leske DA, Bradley EA, Cole SR, Holmes JM: Development of a quality-of-life questionnaire for adults with strabismus. Ophthalmology. 2009, 116 (1): 139-144. 10.1016/j.ophtha.2008.08.043. e135CrossRefPubMed Hatt SR, Leske DA, Bradley EA, Cole SR, Holmes JM: Development of a quality-of-life questionnaire for adults with strabismus. Ophthalmology. 2009, 116 (1): 139-144. 10.1016/j.ophtha.2008.08.043. e135CrossRefPubMed
22.
go back to reference Leske DA, Hatt SR, Holmes JM: Test-retest reliability of health-related quality-of-life questionnaires in adults with strabismus. Am J Ophthalmol. 2010, 149 (4): 672-676. 10.1016/j.ajo.2009.11.004.CrossRefPubMedPubMedCentral Leske DA, Hatt SR, Holmes JM: Test-retest reliability of health-related quality-of-life questionnaires in adults with strabismus. Am J Ophthalmol. 2010, 149 (4): 672-676. 10.1016/j.ajo.2009.11.004.CrossRefPubMedPubMedCentral
23.
go back to reference Durnian JM, Owen ME, Marsh IB: The psychosocial aspects of strabismus: correlation between the AS-20 and DAS59 quality-of-life questionnaires. J AAPOS. 2009, 13 (5): 477-480. 10.1016/j.jaapos.2009.06.006.CrossRefPubMed Durnian JM, Owen ME, Marsh IB: The psychosocial aspects of strabismus: correlation between the AS-20 and DAS59 quality-of-life questionnaires. J AAPOS. 2009, 13 (5): 477-480. 10.1016/j.jaapos.2009.06.006.CrossRefPubMed
24.
go back to reference Sousa VD, Rojjanasrirat W: Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011, 17 (2): 268-274. 10.1111/j.1365-2753.2010.01434.x.CrossRefPubMed Sousa VD, Rojjanasrirat W: Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011, 17 (2): 268-274. 10.1111/j.1365-2753.2010.01434.x.CrossRefPubMed
25.
go back to reference Wang ZH, Bian W, Ren H, Frey R, Tang LF, Wang XY: Development and application of the Chinese version of the adult strabismus quality of life questionnaire (AS-20): a cross-sectional study. Health Qual Life Outcomes. 2013, 11: 180-10.1186/1477-7525-11-180.CrossRefPubMedPubMedCentral Wang ZH, Bian W, Ren H, Frey R, Tang LF, Wang XY: Development and application of the Chinese version of the adult strabismus quality of life questionnaire (AS-20): a cross-sectional study. Health Qual Life Outcomes. 2013, 11: 180-10.1186/1477-7525-11-180.CrossRefPubMedPubMedCentral
26.
go back to reference Wang CW, Chan CL, Jin HY: Psychometric properties of the Chinese version of the 25-item National Eye Institute Visual Function Questionnaire. Optom Vis Sci. 2008, 85 (11): 1091-1099. 10.1097/OPX.0b013e31818b9f23.CrossRefPubMed Wang CW, Chan CL, Jin HY: Psychometric properties of the Chinese version of the 25-item National Eye Institute Visual Function Questionnaire. Optom Vis Sci. 2008, 85 (11): 1091-1099. 10.1097/OPX.0b013e31818b9f23.CrossRefPubMed
27.
go back to reference Tabachnick BG, Fidell LS: Using Multivariate Statistics. 2001, Boston: Allyn and Bacon, 4 Tabachnick BG, Fidell LS: Using Multivariate Statistics. 2001, Boston: Allyn and Bacon, 4
28.
go back to reference Pallant J: SPSS Survival Manual: a Step by Step Guide to Data Analysis Using SPSS. 2010, Australia: Allen & Unwin Pallant J: SPSS Survival Manual: a Step by Step Guide to Data Analysis Using SPSS. 2010, Australia: Allen & Unwin
30.
go back to reference George D, Mallery P: SPSS for Windows Step by Step: A simple Guide and Reference. 11.0 update. 2003, Boston: Allyn & Bacon, 4 George D, Mallery P: SPSS for Windows Step by Step: A simple Guide and Reference. 11.0 update. 2003, Boston: Allyn & Bacon, 4
32.
go back to reference Wang Y, Wang J, Maitland E, Zhao Y, Nicholas S, Lu M: Growing old before growing rich: inequality in health service utilization among the mid-aged and elderly in Gansu and Zhejiang Provinces, China. BMC Health Serv Res. 2012, 12: 302-10.1186/1472-6963-12-302.CrossRefPubMedPubMedCentral Wang Y, Wang J, Maitland E, Zhao Y, Nicholas S, Lu M: Growing old before growing rich: inequality in health service utilization among the mid-aged and elderly in Gansu and Zhejiang Provinces, China. BMC Health Serv Res. 2012, 12: 302-10.1186/1472-6963-12-302.CrossRefPubMedPubMedCentral
33.
go back to reference Hagquist C, Bruce M, Gustavsson JP: Using the Rasch model in nursing research: an introduction and illustrative example. Int J Nurs Stud. 2009, 46 (3): 380-393. 10.1016/j.ijnurstu.2008.10.007.CrossRefPubMed Hagquist C, Bruce M, Gustavsson JP: Using the Rasch model in nursing research: an introduction and illustrative example. Int J Nurs Stud. 2009, 46 (3): 380-393. 10.1016/j.ijnurstu.2008.10.007.CrossRefPubMed
34.
go back to reference Leske DA, Hatt SR, Liebermann L, Holmes JM: Evaluation of the Adult Strabismus-20 (AS-20) questionnaire using Rasch analysis. Invest Ophthalmol Vis Sci. 2012, 53 (6): 2630-2639. 10.1167/iovs.11-8308.CrossRefPubMedPubMedCentral Leske DA, Hatt SR, Liebermann L, Holmes JM: Evaluation of the Adult Strabismus-20 (AS-20) questionnaire using Rasch analysis. Invest Ophthalmol Vis Sci. 2012, 53 (6): 2630-2639. 10.1167/iovs.11-8308.CrossRefPubMedPubMedCentral
35.
go back to reference Mallinson T: Why measurement matters for measuring patient vision outcomes. Optom Vis Sci. 2007, 84 (8): 675-682. 10.1097/OPX.0b013e3181339f44.CrossRefPubMed Mallinson T: Why measurement matters for measuring patient vision outcomes. Optom Vis Sci. 2007, 84 (8): 675-682. 10.1097/OPX.0b013e3181339f44.CrossRefPubMed
36.
go back to reference Vianya-Estopa M, Elliott DB, Barrett BT: An evaluation of the Amblyopia and Strabismus Questionnaire using Rasch analysis. Invest Ophthalmol Vis Sci. 2010, 51 (5): 2496-2503. 10.1167/iovs.09-4381.CrossRefPubMed Vianya-Estopa M, Elliott DB, Barrett BT: An evaluation of the Amblyopia and Strabismus Questionnaire using Rasch analysis. Invest Ophthalmol Vis Sci. 2010, 51 (5): 2496-2503. 10.1167/iovs.09-4381.CrossRefPubMed
37.
go back to reference Ng AK: Why Asians are Less Creative than Westerners. 2001, Singapore: Prentice Hall Ng AK: Why Asians are Less Creative than Westerners. 2001, Singapore: Prentice Hall
38.
go back to reference Chang HC, Holt GR: A Chinese Perspective on Face as Inter-Relational Concern. In The Challenge of Facework: Cross-Cultural and Interpersonal Issues. Edited by: Ting-Toomey S. 1994, The United States of America: SUNY Press Chang HC, Holt GR: A Chinese Perspective on Face as Inter-Relational Concern. In The Challenge of Facework: Cross-Cultural and Interpersonal Issues. Edited by: Ting-Toomey S. 1994, The United States of America: SUNY Press
Metadata
Title
Comparison of the Adult Strabismus Quality of Life Questionnaire (AS-20) with the Amblyopia and Strabismus Questionnaire (ASQE) among adults with strabismus who seek medical care in China
Authors
Zonghua Wang
Hui Ren
Rosemary Frey
Yang Liu
Deborah Raphael
Wei Bian
Xianyuan Wang
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2014
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-14-139

Other articles of this Issue 1/2014

BMC Ophthalmology 1/2014 Go to the issue