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Transcultural adaptation to Spain of the CDPQOL questionnaire specific for coeliac children

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Abstract

This study aimed to translate, cross-culturally adapt, and validate the CDPQOL questionnaire, a coeliac disease (CD)-specific paediatric health-related quality of life (HRQoL) instrument (CDPQOL), in Spanish children with CD. The CDPQOL questionnaire has two versions for children aged 8–12 and 13–18. Translation and linguistic validation were performed following an international consensus process. Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega coefficients, and convergent validity was assessed with average variance extracted (AVE). Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), when necessary, were carried out to assess the construct validity. A total of 235 children were included. In the 8–12 age group, a change in the distribution of items to a new structure of three dimensions (negative emotions, food feelings and social interaction) was required. In this new model, CFA supported the fit of the model (χ2/gl = 1.79, RMSEA = 0.077 (IC 95% 0.05–0.100), CFI = 0.969, TLI 0.960, SRMR = 0.081) and Cronbach’s alpha and McDonald’s omega coefficients were > 0.7 in all three dimensions. In the 13–18 age group, CFA showed that all fit indexes were acceptable (χ2/gl = 1.702, RMSEA = 0.102 (IC 95% 0.077–0.127), p < 0.001, CFI = 0.956, TLI = 0.947, SRMR = 0.103) and Cronbach’s alpha and McDonald’s omega coefficients were > 0.7 in all three dimensions, except for uncertainty dimension.

    Conclusions: The Spanish version of the CDPQOL questionnaire is a useful instrument to assess quality of life in coeliac children whose native language was Spanish spoken in Spain, with changes in item distribution in the younger age group questionnaire.

What is Known:

• The first specific questionnaire for coeliac children, Dutch Coeliac Disease Questionnaire (CDDUX), which focuses on diet, was translated into Spanish and validated allowing to evaluate the HRQoL of Spanish coeliac children.

• Spanish Children and parents feel the disease had no substantial negative impacts on patient HRQoL using this questionnaire, similar to that observed with other countries.

What is New:

• The age specific for CD children (CDPQOL) was elaborated in the USA and focuses on other aspects not evaluated by CDDUX such as emotional and social issues related to living with CD.

• The CDPQOL was translated into Spanish and validated allowing it to be used to assess Spanish coeliac children’s QoL.

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Data availability

No datasets were generated or analysed during the current study.

Abbreviations

CD:

Coeliac disease

GFD:

Gluten-free diet

HRQoL:

Health-related quality of life

χ 2 :

Absolute reduced chi-square

AVE:

Average variance extracted

CDPQOL:

Celiac disease (CD)-specific paediatric health-related quality of life (HRQoL) instrument

CFI:

Comparative fit index

CFA:

Confirmatory factor analysis

EFA:

Exploratory factorial analysis

KMO:

Kaiser-Meyer-Olkin test

RMSEA:

Root mean squared error of approximation

SRMR:

Standardised root mean square residual

χ 2/gl:

Statistics to the degree of freedom ratio

CDDUX:

The Dutch Coeliac Disease Dux

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Acknowledgements

To coeliac children and their parents who participated in the study. To the collaborators who carried out the recruitment of patients and data collection.

Funding

This study has been funded by Instituto de Salud Carlos III through the project “PI16/00358” (Co-funded by European Regional Development Fund; “A way to make Europe.”

Author information

Authors and Affiliations

  1. Department of Paediatrics, Hospital Universitario de Fuenlabrada, Madrid, Spain

    Josefa Barrio-Torres, Cristina Pérez-Fernández & Beatriz Martínez-Escribano

  2. Centro de Salud Núñez Morgado, Madrid, Spain

    Tomás Sebastián-Viana

  3. Sanitary Area of Santiago de Compostela and Barbanza, Santiago de Compostela, Spain

    Cristina Fernández-Pérez

  4. Department of Paediatrics, Hospital Universitario Puerta Hierro, Madrid, Spain

    Carolina Gutierrez-Junquera, Enriqueta Román & María Luz Cilleruelo

Authors
  1. Josefa Barrio-Torres
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  2. Tomás Sebastián-Viana
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  3. Cristina Fernández-Pérez
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  4. Cristina Pérez-Fernández
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  5. Beatriz Martínez-Escribano
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  6. Carolina Gutierrez-Junquera
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  7. Enriqueta Román
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  8. María Luz Cilleruelo
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Contributions

All authors whose names appear on the submission contributed to the study conception and design. Material preparation was performed by JBT and CFP, MD PhD. Data collection was carried out by JBT, TS, MLC, CPF, ER, BME, CGJ—and statistical analysis was performed by CFP and TS. The first draft of the manuscript was written by JBT and MLC, and JBT, MLC and TS commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Josefa Barrio-Torres.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hospital Universitario de Fuenlabrada (Date. 11-10-2016/No16/46).

Consent to participate

Informed consent was obtained from all participants, either from children, parents or legal guardians of children included in the study in the case of children under 12.

Consent for publication

Participants signed informed consent regarding publishing anonymous quotations from interviews, resulting in study reports and publications.

Competing interests

The authors declare no competing interests.

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Communicated by Peter de Winter

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Barrio-Torres, J., Sebastián-Viana, T., Fernández-Pérez, C. et al. Transcultural adaptation to Spain of the CDPQOL questionnaire specific for coeliac children. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05589-1

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