Translation, adaptation, and psychometric properties of the Brazilian-Portuguese version of the Quality of Life in Children with Vernal Keratoconjunctivitis questionnaire

Ferreira, Anna Carolina Zamperlini; Mocelin, Lucas Pitrez; Zanini, Fábio; Santos, Myrna Serapião dos; Chong-Neto, Herberto José; Mallozi, Márcia Carvalho; Solé, Dirceu

doi:10.5935/0004-2749.2023-0054

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ORIGINAL ARTICLE • Arq. Bras. Oftalmol. 87 (4) • 2024 • https://doi.org/10.5935/0004-2749.2023-0054 copy

Translation, adaptation, and psychometric properties of the Brazilian-Portuguese version of the Quality of Life in Children with Vernal Keratoconjunctivitis questionnaire

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

The prevalence of ocular allergy varies according to the population and location of the study. Severe forms of ocular allergy are associated with compromised quality of life. In this study, we aimed to evaluate the application of the Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis questionnaire to children and adolescents with different subtypes of allergic conjunctivitis.

Method:

A total of 48 patients (aged 5-12 years) with allergic conjunctivitis were included in this study. They were enrolled and monitored at a specialized center. After the clinical appointment, the children responded to the questionnaire on two occasions at an interval of 30 days. Individual scores (ranging from 0 to 3) of the 16 items were added.

Results:

The Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis questionnaire demonstrated good translation, adaptation, and intellectual properties, with substantial internal consistency (Cronbach’s α coefficient = 0.702). There was no significant difference between the responses of the two interviews, revealing good reproducibility. The moderate/severe forms of allergic conjunctivitis had significantly higher quality of life scores (indicating a poorer quality of life) than the mild forms.

Conclusions:

The Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis proved to be quick, reliable, and reproducible for assessing the quality of life in children with allergic conjunctivitis. However, its ability to detect changes resulting from symptom aggravation or treatment needs to be further evaluated.

Keywords:
Conjunctivitis; allergic; Keratoconjunctivitis; Hypersensitivity; Quality of life; Child; Surveys and questionnaires

Durante as duas últimas semanas, por causa da conjuntivite
1 - ... você sentiu seus olhos queimarem?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
2 - ... você teve problemas para ficar em ambiente com ar-condicionado?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
3 - ... você teve que usar lenços?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
4 - ... seus olhos incharam?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
5 - ... você teve problemas em ambientes iluminados?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
6 - ... você teve lacrimejamento ocular?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
7 - ... você ficou com coceira nos olhos?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
8 - ... você ficou com os olhos vermelhos?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
9 - ... você ficou com a visão turva?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
10 - ... você teve secreção ocular?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
11 - ... você precisou usar colírios?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
12 - ... você teve, pela manhã, olhos fechados e grudentos?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
13 - ... você teve problemas para brincar ao ar livre?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
14 - ... você teve problemas para praticar esportes (futebol, academia)?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
15 - ... você teve dificuldades para fazer amizades?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre
16 - ... você teve problemas para ir a piscinas?
□ 1. Nunca	□ 2. Algumas vezes	□ 3. Sempre

During the last 2 weeks, because of conjunctivitis......
1 - ... did you feel burning in your eyes?
□ 1. Never	□ 2. Sometimes	□ 3. Always
2 - ... did you have trouble staying in air-condiotined room?
□ 1. Never	□ 2. Sometimes	□ 3. Always
3 - ... did you have to use tissues?
□ 1. Never	□ 2. Sometimes	□ 3. Always
4 - ... did you have puffy eyes?
□ 1. Never	□ 2. Sometimes	□ 3. Always
5 - ... did you have problems in the light?
□ 1. Never	□ 2. Sometimes	□ 3. Always
6 - ... did you have tearing?
□ 1. Never	□ 2. Sometimes	□ 3. Always
7 - ... did you have itchy eyes?
□ 1. Never	□ 2. Sometimes	□ 3. Always
8 - ... did you have red eyes?
□ 1. Never	□ 2. Sometimes	□ 3. Always
9 - ... did you have blurred vision?
□ 1. Never	□ 2. Sometimes	□ 3. Always
10 - ... did you have eye secretions?
□ 1. Never	□ 2. Sometimes	□ 3. Always
11 - ... did you have to use eye drops?
□ 1. Never	□ 2. Sometimes	□ 3. Always
12 - ... did you have closed and sticky eyes in the morning?
□ 1. Never	□ 2. Sometimes	□ 3. Always
13 - ... did you have trouble playing outdoors?
□ 1. Never	□ 2. Sometimes	□ 3. Always
14 - ... did you have trouble practicing sports (e.g., football and gym)?
□ 1. Never	□ 2. Sometimes	□ 3. Always
15 - ... did you have trouble meeting your friends?
□ 1. Never	□ 2. Sometimes	□ 3. Always
16 - ... did you have trouble going to swimming pool?
□ 1. Never	□ 2. Sometimes	□ 3. Always

Characteristics	Values
Male (%)	75
Age (mean ± SD, years)	8.9 ± 2.3
Onset age (mean ± SD, years)	4.1 ± 2.5
Age at diagnosis (mean ± SD, years)	6.1 ± 2.3
Personal history
Allergic rhinitis (%)	100
Asthma (%)	87.5
Atopic dermatitis (%)	79.1
Family history
Allergic rhinitis (%)	50
Asthma (%)	52
Atopic dermatitis (%)	18.8
Allergic conjunctivitis (%)	6.3
Severity
Mild (%)	16
Moderate (%)	12.5
Severe (%)	66
Treatment
Allergic conjunctivitis (%)	81.3
Allergic rhinitis (%)	91.6

Question	Initial
Question	Mean	95% CI	Mean	95% CI	Wilcoxon
Related symptoms
Burning eyes	1.35	1.18-1.53	1.71	1.52-1.90	0.01
Air-conditioning	1.62	1.41-1.84	1.60	1.40-1.81	0.46
Use of tissue	1.83	1.63-0.04	1.85	1.64-2.07	0.42
Puffy eyes	2.04	1.86-2.22	1.88	1.70-2.05	0.02
Visual issues in the light	1.97	1.72-2.11	1.88	1.67-2.08	0.49
Tearing	2.04	1.83-2.25	2.19	2.05-2.33	0.06
Itchy eyes	2.48	2.33-2.63	2.46	2.30-2.61	0.06
Red eyes	2.29	2.11-2.47	2.17	1.99-2.34	0.13
Blurred vision	1.54	1.36-1.72	1.67	1.47-1.86	0.12
Eye secretions	1.67	1.50-1.84	1.90	1.70-2.10	0.01
Use of eye drops	2.38	2.18-2.57	2.33	2.11-2.56	0.35
Closed sticky eyes	1.88	1.72-2.03	1.75	1.60-1.90	0.09
Limitations of daily life
Playing indoors	1.65	1.43-1.86	1.73	1.52-1.94	0.22
Practicing sports	1.33	1.17-1.50	1.46	1.26-1.66	0.13
Meeting friends	1.08	1.00-1.16	1.15	1.03-1.27	0.14
Swimming	1.71	1.46-2.00	1.98	1.72-2.24	0.05
Total score
	28.80	27.55-30.08	29.69	28.14-31.23	0.21
Intraclass correlation coefficient = 0.839.

During the last two weeks, because of Conjunctivitis	Initial			Final			Kappa^* * - Excellent: 0.81-1.0; Good: 0.61-0.80; Moderate: 0.41-0.60; Low: 0.21-0.40; Very low: 0.21-0.0.
During the last two weeks, because of Conjunctivitis	Never	Sometimes	Always	Never	Sometimes	Always
Did you feel your eyes burning?	34	11	3	19	24	5	0.165
Did you have trouble staying in air-conditioned rooms?	25	16	7	25	17	6	0.297
Did you use tissues?	16	4	8	17	21	10	0.337
Did you have puffy eyes?	8	30	10	12	30	6	0.385
Did you have visual problems in the light?	13	26	9	15	24	9	0.248
Did you have tearing?	11	24	13	2	35	11	0.224
Did you have itchy eyes?	0	25	23	1	24	23	0.469
Did you have red eyes?	4	26	18	5	30	13	0.206
Did you have blurred vision?	25	20	3	21	22	5	0.384
Did you have eye secretion?	19	26	3	14	25	9	0.259
Did you have to use eye drops?	5	20	23	9	14	25	0.316
Did you have closed sticky eyes in the morning?	10	34	4	14	32	3	0.101
Did you have trouble playing outdoors?	24	17	7	21	19	8	0.257
Did you have trouble practicing sports?	34	12	2	31	12	5	0.343
Did you have trouble meeting your friends?	44	4	0	42	5	1	0.229
Did you have trouble going to swimming pool?	26	10	12	19	11	18	0.580

QUICK	Mild	Moderate/severe	p-value^* * Paired t-test.
Initial	28.3 ± 3.9	31.0 ± 4.1	0.043
Final	29.9 ± 5.5	31.0 ± 4.2	0.227

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E-mail: abo@cbo.com.br

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[1] Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.