Original article
Development and Testing of the Quality of Life in Children with Vernal Keratoconjunctivitis Questionnaire

https://doi.org/10.1016/j.ajo.2007.06.028Get rights and content

Purpose

To develop and validate a questionnaire that measures health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC).

Design

Prospective, observational case series.

Methods

An initial list of 42 items was developed and administered to 30 children with active VKC (six girls and 24 boys; mean age, nine ± two years). The 30 most significant items were selected and converted into questions on a three-step scale for validation in 41 children with active VKC (eight girls and 33 boys; mean age, 9.5 ± 2.1 years). Twenty-two children also completed the generic KINDL questionnaire. Clinical signs were evaluated and scored and total sign scores (TSSs) were calculated. Validation was performed by factorial analysis and Pearson correlation. Internal consistency was computed by the Chronbach α on the extracted factors.

Results

Factorial analysis extracted two factors with good internal consistency: symptoms (12 items; α = 0.89) and daily activities (four items; α = 0.77). Correlations of Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) scores to KINDL scores were in the expected direction. Most patients reported itching (93%), burning (90%), redness (90%), the need to use eye drops (90%), tearing (83%), and photophobia (80%). The children’s greatest concerns were limitations on going to the pool (71%), playing sports (58%), and meeting friends (58%). QUICK symptom scores were correlated significantly to conjunctival hyperemia (P < .001), secretion (P = .042), chemosis (P = .012), superficial punctate keratopathy (P < .001), and TSS (P = .010).

Conclusions

The QUICK questionnaire is a new, simple instrument to measure HRQoL in children with severe allergic conjunctivitis. This test is effective for the global evaluation of the impact of VKC on children’s daily lives.

Section snippets

Methods

This study was carried out in two separate phases: the development and the validation processes, involving two different groups of patients with VKC. The questionnaire was developed using a standard multistep method. These phases are described in detail below.

Subject Characteristics

Thirty children (24 boys and six girls) with VKC completed the initial list of 42 items for the development of the new questionnaire, and 41 children with VKC (33 boys and eight girls) completed the preliminary QUICK test of 30 items for the validation phase. All patients were between five and 12 years of age. The characteristics of patients are listed in Table 1. All patients showed signs and symptoms of conjunctival inflammation with conjunctival hyperemia (100%), mucus discharge (58%), and

Discussion

This study describes the development and initial validation of an age- and disease-specific quality-of-life questionnaire for allergic keratoconjunctivitis in a group of children with VKC. VKC is, together with atopic keratoconjunctivitis, the most severe form among ocular allergies.1, 2, 14, 19 VKC is a rare disease affecting young patients with severe ocular symptoms that undoubtedly interferes with their quality of life. In addition to their intense ocular discomfort, children with VKC often

Marta Sacchetti, MD, is a PhD student of Ocular Immunology at the University of Rome “Campus Bio-Medico”. She received her medical degree from University of Rome “Tor Vergata” where she completed her residency program in Ophthalmology in 2005.

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    Marta Sacchetti, MD, is a PhD student of Ocular Immunology at the University of Rome “Campus Bio-Medico”. She received her medical degree from University of Rome “Tor Vergata” where she completed her residency program in Ophthalmology in 2005.

    Ilaria Baiardini currently a psychologist and psychotherapist, is a PhD student at the University of Turin, Italy. Dr Baiardini field of interest is about the Patient Reported Outcomes in allergic and respiratory diseases.

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