Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

Psychometric properties of the Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE)

Authors: Wei Bian, Min Li, Zonghua Wang, Xiaolei Wang, Yang Liu, Yan Wu

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Background

Strabismus and amblyopia are known to cause visual dysfunction, self-image disorders, difficulty in seeking employment and social and emotional barriers. These factors can have a serious and detrimental effect upon the patients’ health-related quality of life (HRQOL). Presently, a condition-specific questionnaire is not available for assessing the HRQOL in Chinese patients. This study developed a Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE) and tested its reliability and validity in Chinese adult strabismus patients.

Methods

Chinese strabismus adults, adults with normal vision and patients with a variety of other eye diseases completed the Chinese version of the ASQE. Reliability was established by Cronbach’s alpha and test-retest. Validity was evaluated by content, construct, criterion-related, convergent and discriminative validities.

Results

A total of 202 adult strabismus patients with or without amblyopia, 100 visually normal adults, and 100 patients with other eye diseases (excluding strabismus and amblyopia) participated in this study. Using principal components analysis, six domains were extracted, with a content validity of 0.91. Four items were deleted giving final total of 22 items in the questionnaire. The total score of the ASQE was significantly correlated to the Adult Strabismus Questionnaire (AS-20) (r = 0.642, P < 0.01). The median scores for the adult strabismus patients were significantly lower (worse HRQOL) compared with visually normal adults (66.32 vs. 92.71; P < 0.001) and patients with other eye diseases (66.32 vs. 79.50; P < 0.001) thus demonstrating good discriminative validity for the questionnaire. The Cronbach’s alpha coefficient for internal consistent reliability was 0.887 and the test-retest reliability was 0.946. The mean total score of the ASQE was 65.85 (SD = 15.32) and the domain ‘social contact and appearance’ recorded the lowest mean score 43.78 (SD = 13.92) in strabismus patients.

Conclusions

The revised 22-item Chinese version of the ASQE showed good psychometric properties. It is suggested that this questionnaire provides a potentially useful measurement tool in clinical or research programs involving Chinese strabismus patients with or without associated amblyopia.
Literature
1.
go back to reference Beauchamp GR, Black BC, Coats DK, Enzenauer RW, Hutchinson AK, Saunders RA, et al. The Management of Strabismus in Adults—III. The Effects on Disability. J Am Assoc Pediatr Ophthalmol Strabismus. 2005;9:455–9.CrossRef Beauchamp GR, Black BC, Coats DK, Enzenauer RW, Hutchinson AK, Saunders RA, et al. The Management of Strabismus in Adults—III. The Effects on Disability. J Am Assoc Pediatr Ophthalmol Strabismus. 2005;9:455–9.CrossRef
2.
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 Am Assoc Pediatr Ophthalmol Strabismus. 2010;14:469–71.CrossRef 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 Am Assoc Pediatr Ophthalmol Strabismus. 2010;14:469–71.CrossRef
3.
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 Am Assoc Pediatr Ophthalmol Strabismus. 2008;12:72–6. e71.CrossRef 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 Am Assoc Pediatr Ophthalmol Strabismus. 2008;12:72–6. e71.CrossRef
4.
5.
go back to reference Coats DK, Paysse EA, Towler AJ, Dipboye RL. Impact of large angle horizontal strabismus on ability to obtain employment. Ophthalmology. 2000;107:402–5.PubMedCrossRef Coats DK, Paysse EA, Towler AJ, Dipboye RL. Impact of large angle horizontal strabismus on ability to obtain employment. Ophthalmology. 2000;107:402–5.PubMedCrossRef
6.
go back to reference Lukman H, Kiat JE, Ganesan A, Chua WL, Khor KL, Choong YF. Strabismus-related prejudice in 5-6-year-old children. Br J Ophthalmol. 2010;94:1348–51.PubMedCrossRef Lukman H, Kiat JE, Ganesan A, Chua WL, Khor KL, Choong YF. Strabismus-related prejudice in 5-6-year-old children. Br J Ophthalmol. 2010;94:1348–51.PubMedCrossRef
7.
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;39:203–8.PubMed Menon V, Saha J, Tandon R, Mehta M, Khokhar S. Study of the psychosocial aspects of strabismus. J Pediatr Ophthalmol Strabismus. 2002;39:203–8.PubMed
8.
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;3:209–11.PubMedCrossRef Olitsky SE, Sudesh S, Graziano A, Hamblen J, Brooks SE, Shaha SH. The negative psychosocial impact of strabismus in adults. J AAPOS. 1999;3:209–11.PubMedCrossRef
9.
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;153:614–9.PubMedCentralPubMedCrossRef Hatt SR, Leske DA, Liebermann L, Holmes JM. Changes in Health-Related Quality of Life 1 Year Following Strabismus Surgery. Am J Ophthalmol. 2012;153:614–9.PubMedCentralPubMedCrossRef
10.
go back to reference Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119:1050–8.PubMedCrossRef Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119:1050–8.PubMedCrossRef
11.
go back to reference Wolffsohn JS, Cochrane AL. Design of the low vision quality-of-life questionnaire (LVQOL) and measuring the outcome of low-vision rehabilitation. Am J Ophthalmol. 2000;130:793–802.PubMedCrossRef Wolffsohn JS, Cochrane AL. Design of the low vision quality-of-life questionnaire (LVQOL) and measuring the outcome of low-vision rehabilitation. Am J Ophthalmol. 2000;130:793–802.PubMedCrossRef
12.
go back to reference Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, et al. Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status. Med Care. 1992;30:1111–26.PubMedCrossRef Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, et al. Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status. Med Care. 1992;30:1111–26.PubMedCrossRef
13.
go back to reference Cole SR, Beck RW, Moke PS, Celano MP, Drews CD, Repka MX, et al. The amblyopia treatment index. J Am Assoc Pediatr Ophthalmol Strabismus. 2001;5:250–4.CrossRef Cole SR, Beck RW, Moke PS, Celano MP, Drews CD, Repka MX, et al. The amblyopia treatment index. J Am Assoc Pediatr Ophthalmol Strabismus. 2001;5:250–4.CrossRef
14.
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;143:305–10. e301.PubMedCrossRef 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;143:305–10. e301.PubMedCrossRef
15.
go back to reference van de Graaf ES, Felius J, van Kempen-du SH, Looman CW, Passchier J, Kelderman H, et al. Construct validation of the Amblyopia and Strabismus Questionnaire (A&SQ) by factor analysis. Graefes Arch Clin Exp Ophthalmol. 2009;247:1263–8.PubMedCentralPubMedCrossRef van de Graaf ES, Felius J, van Kempen-du SH, Looman CW, Passchier J, Kelderman H, et al. Construct validation of the Amblyopia and Strabismus Questionnaire (A&SQ) by factor analysis. Graefes Arch Clin Exp Ophthalmol. 2009;247:1263–8.PubMedCentralPubMedCrossRef
16.
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;12:181–93.PubMedCrossRef 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;12:181–93.PubMedCrossRef
17.
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;245:1589–95.PubMedCrossRef 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;245:1589–95.PubMedCrossRef
18.
go back to reference Bujak MC, Leung AK, Kisilevsky M, Margolin E. Monovision correction for small-angle diplopia. Am J Ophthalmol. 2012;154:586–92.PubMedCrossRef Bujak MC, Leung AK, Kisilevsky M, Margolin E. Monovision correction for small-angle diplopia. Am J Ophthalmol. 2012;154:586–92.PubMedCrossRef
19.
go back to reference Zong-Hua Wang WB, Hui Ren, Rosemary Frey, Ling-Fei Tang, Xian-Yuan Wang1: 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. Zong-Hua Wang WB, Hui Ren, Rosemary Frey, Ling-Fei Tang, Xian-Yuan Wang1: 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.
20.
go back to reference Garyfallos G, Karastergiou A, Adamopoulou A, Moutzoukis C, Alagiozidou E, Mala D, et al. Greek version of the General Health Questionnaire: accuracy of translation and validity. Acta Psychiatr Scand. 1991;84:371–8.PubMedCrossRef Garyfallos G, Karastergiou A, Adamopoulou A, Moutzoukis C, Alagiozidou E, Mala D, et al. Greek version of the General Health Questionnaire: accuracy of translation and validity. Acta Psychiatr Scand. 1991;84:371–8.PubMedCrossRef
21.
22.
go back to reference Polit D, Beck C. Nursing Research: Principles and methods. 2004. Polit D, Beck C. Nursing Research: Principles and methods. 2004.
23.
go back to reference Pallant J. SPSS survival manual: A step by step guide to data analysis using SPSS. McGraw-Hill Education: Open University Press; 2010. Pallant J. SPSS survival manual: A step by step guide to data analysis using SPSS. McGraw-Hill Education: Open University Press; 2010.
24.
go back to reference Marcon GB, Pittino R. The Italian version of the Amblyopia and Strabismus Questionnaire: translation, validation, and reliability. Strabismus. 2014;22:100–10.PubMedCrossRef Marcon GB, Pittino R. The Italian version of the Amblyopia and Strabismus Questionnaire: translation, validation, and reliability. Strabismus. 2014;22:100–10.PubMedCrossRef
25.
go back to reference Yu H, Yang X, Ye T, Chen J, Zhang F, Yu X. Development and evaluation of a Chinese version of the Adult Strabismus Questionnaire (AS-20). Ophthalmic Epidemiol. 2013;20:239–47.PubMedCrossRef Yu H, Yang X, Ye T, Chen J, Zhang F, Yu X. Development and evaluation of a Chinese version of the Adult Strabismus Questionnaire (AS-20). Ophthalmic Epidemiol. 2013;20:239–47.PubMedCrossRef
26.
go back to reference Kong D, Wang F, Ma L-X, Yun-Yan W, Guo L, Lv F-f. Investigating the quality of life in adult strabismus patients. Nurs Manag. 2014;14:339–40. Kong D, Wang F, Ma L-X, Yun-Yan W, Guo L, Lv F-f. Investigating the quality of life in adult strabismus patients. Nurs Manag. 2014;14:339–40.
27.
go back to reference Chang H, Holt G. A chinese perspective on face as inter-relational concern. 1994. Chang H, Holt G. A chinese perspective on face as inter-relational concern. 1994.
28.
go back to reference Marella M, Pesudovs K, Keeffe JE, O'Connor PM, Rees G, Lamoureux EL. The psychometric validity of the NEI VFQ-25 for use in a low-vision population. Invest Ophthalmol Vis Sci. 2010;51:2878–84.PubMedCrossRef Marella M, Pesudovs K, Keeffe JE, O'Connor PM, Rees G, Lamoureux EL. The psychometric validity of the NEI VFQ-25 for use in a low-vision population. Invest Ophthalmol Vis Sci. 2010;51:2878–84.PubMedCrossRef
29.
go back to reference Baker JD. The value of adult strabismus correction to the patient. J Am Assoc Pediatr Ophthalmol Strabismus. 2002;6:136–40.CrossRef Baker JD. The value of adult strabismus correction to the patient. J Am Assoc Pediatr Ophthalmol Strabismus. 2002;6:136–40.CrossRef
30.
go back to reference Bez Y, Coşkun E, Erol K, Cingu AK, Eren Z, Topçuoğlu V, et al. Adult strabismus and social phobia: A case-controlled study. J Am Assoc Pediatr Ophthalmol Strabismus. 2009;13:249–52.CrossRef Bez Y, Coşkun E, Erol K, Cingu AK, Eren Z, Topçuoğlu V, et al. Adult strabismus and social phobia: A case-controlled study. J Am Assoc Pediatr Ophthalmol Strabismus. 2009;13:249–52.CrossRef
31.
go back to reference Jackson S, Harrad RA, Morris M, Rumsey N. The psychosocial benefits of corrective surgery for adults with strabismus. Br J Ophthalmol. 2006;90:883–8.PubMedCentralPubMedCrossRef Jackson S, Harrad RA, Morris M, Rumsey N. The psychosocial benefits of corrective surgery for adults with strabismus. Br J Ophthalmol. 2006;90:883–8.PubMedCentralPubMedCrossRef
Metadata
Title
Psychometric properties of the Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE)
Authors
Wei Bian
Min Li
Zonghua Wang
Xiaolei Wang
Yang Liu
Yan Wu
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0269-6

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue