Background
Methods
Original HAQL questionnaires
Study design
Evaluation of the French version of the HAQL
Validity
Reliability
Methodology to propose a new structure
Results
Response rates
Dropout analysis
Face validity
Validity of the original structure
Proposition of a new structure
-
Dimensions 2 “Constipating diet” and 3 “Presence of diarrhea” were grouped into one dimension, since they are closely related and for adolescents, the items in Dimension 2 correlated more strongly with Dimension 3 than with their own dimension. For adults Dimension 2 did not have satisfactory validity properties either.
-
Dimensions 7 “Emotional functioning” and 8 “Body image” were grouped into one dimension, since the items in Dimension 8 correlated more strongly with Dimension 7 than with Dimension 8 for both adults and adolescents and the dimensions are close.
-
Items “loss of feces during emotional moments” and “going to the toilet while having no urge” corresponding to item numbers 43 and 31 respectively for adolescents and 46 and 34 for adults, were removed. Also, items “amorous feelings” and “fantasize about making love” corresponding to item numbers 17 and 18 for adolescents were removed. These items had especially bad divergent as well as convergent validity properties and there was no clear indication that they could be moved to another dimension.
-
Item 9 “important to be in neighborhood of a toilet” was moved from dimension “Fecal continence” to “Emotional functioning” for both adults and adolescents. This decision was based on that Item 9 correlated strongly with Dimension “Emotional functioning” for both age groups, while it reached neither convergent, nor divergent validity in its former dimension.
HAQL dimensions | N | % missing | Min | Max | Mean | Sd | Internal consistency Cronbach’s α coefficient | Test-retest concordance Intraclass correlation | Patient-proxy concordance Intraclass correlation |
---|---|---|---|---|---|---|---|---|---|
Overall scale | 51 | 26% | 309 | 800 | 620.86 | 135.29 | 0.95 | 0.91 | – |
Adults | |||||||||
1 - Laxative Diet | 68 | 1% | 17 | 100 | 85.50 | 24.09 | 0.78 | 0.66 | – |
2 - Presence of Diarrhea | 59 | 14% | 0 | 100 | 77.69 | 22.85 | 0.76 | 0.90 | – |
3 - Fecal Continence | 58 | 16% | 6 | 100 | 82.88 | 21.83 | 0.88 | 0.86 | – |
4 - Urinary Continence | 69 | 0% | 0 | 100 | 91.17 | 18.79 | 0.91 | 0.75 | – |
5 - Social Functioning | 59 | 14% | 0 | 100 | 78.20 | 30.42 | 0.89 | 0.86 | – |
6 - Emotional Functioning and Body Image | 69 | 0% | 3 | 100 | 64.01 | 28.00 | 0.93 | 0.88 | – |
7 - Physical symptoms | 59 | 14% | 0 | 100 | 60.85 | 23.77 | 0.86 | 0.83 | – |
8 - Sexual functioning | 61 | 12% | 0 | 100 | 81.18 | 29.52 | 0.94 | 0.78 | – |
Adolescents | |||||||||
Overall scale | 42 | 12% | 276 | 700 | 608.07 | 95.50 | 0.94 | 0.91 | 0.94 |
1 - Laxative Diet | 48 | 0% | 33 | 100 | 88.83 | 18.01 | 0.65 | 0.88 | 0.73 |
2 - Presence of Diarrhea | 43 | 10% | 17 | 100 | 83.35 | 25.09 | 0.88 | 0.73 | 0.92 |
3 - Fecal Continence | 43 | 10% | 28 | 100 | 85.70 | 18.92 | 0.85 | 0.92 | 0.86 |
4 - Urinary Continence | 48 | 0% | 58 | 100 | 97.60 | 7.29 | 0.78 | 0.93 | 0.71 |
5 - Social Functioning | 42 | 12% | 0 | 100 | 93.14 | 19.92 | 0.95 | 0.88 | 0.81 |
6 - Emotional Functioning and Body Image | 48 | 0% | 19 | 100 | 84.17 | 20.69 | 0.91 | 0.91 | 0.82 |
7 - Physical symptoms | 43 | 10% | 17 | 100 | 71.77 | 18.67 | 0.80 | 0.79 | 0.74 |
Validity
HAQL dimensions | Disease statusa
HD N = 8 ARM N = 60 | Clinical status | |||
---|---|---|---|---|---|
Autonomy statusa
Usual A. N = 56 Lower A. N = 9 | Soilingb
Grade 0 N = 33 Grade 1 N = 24 Grade 2 N = 4 Grade 3 N = 3 | Constipationb
Grade 0 N = 36 Grade 1 N = 7 Grade 2 N = 6 Grade 3 N = 7 | Voluntary bowel movementsb
Grade 0 N = 30 Grade 1 N = 18 Grade 2 N = 9 | ||
Overall scale | 621 ± 135
p = 0.55 | 621 ± 135
p = 0.27 |
Grade 0: 706 ± 80
Grade 1: 594 ± 129
Grade 2 or 3: 473 ± 112
p
< 0.0001
|
Grade 0 or 1 or 2: 639 ± 135
Grade 3: 462 ± 136
p
= 0.0121
|
Grade 0: 691 ± 103
Grade 1 or 2: 544 ± 142
p
= 0.0005
|
1- Laxative Diet | 86 ± 24
p = 0.32 |
Usual A.: 83 ± 26
Lower A.: 98 ± 6
p
= 0.0004
| 86 ± 24
p = 0.12 |
Grade 0: 92 ± 18
Grade 1 or 2 or 3: 69 ± 30
p
= 0.0025
| 86 ± 24
p = 0.69 |
2- Presence of Diarrhea | 78 ± 23
p = 0.34 | 78 ± 23
p = 0.85 |
Grade 0 : 88 ± 16
Grade 1: 76 ± 21
Grade 2 or 3: 57 ± 31
p
= 0.0021
| 78 ± 23
p = 0.80 |
Grade 0: 90 ± 13
Grade 1: 73 ± 17
Grade 2: 35 ± 29
p
< 0.0001
|
3- Fecal Continence | 83 ± 22
p = 0.15 | 83 ± 22
p = 0.81 |
Grade 0: 97 ± 7
Grade 1: 82 ± 16
Grade 2 or 3: 47 ± 27
p
< 0.0001
| 83 ± 22
p = 0.57 |
Grade 0: 94 ± 12
Grade 1 or 2: 72 ± 21
p
< 0.0001
|
4- Urinary Continence | 91 ± 19
p = 0.93 | 91 ± 19
p = 0.19 | 91 ± 19
p = 0.24 | 91 ± 19
p = 0.15 | 91 ± 19
p = 0.31 |
5- Social Functioning | 78 ± 30
p = 0.83 | 78 ± 30
p = 0.11 |
Grade 0 or 1: 85 ± 25
Grade 2 or 3: 29 ± 25
p
< 0.0001
| 78 ± 30
p = 0.06 |
Grade 0: 91 ± 15
Grade 1 or 2: 62 ± 38
p
= 0.0028
|
6- Emotional Functioning and Body Image | 64 ± 28
p = 0.50 |
Usual A.: 68 ± 26
Lower A.: 39 ± 27
p
= 0.0128
|
Grade 0: 78 ± 22
Grade 1: 58 ± 26
Grade 2 or 3: 25 ± 17
p
< 0.0001
| 64 ± 28
p = 0.12 |
Grade 0: 78 ± 21
Grade 1 or 2: 54 ± 29
p
= 0.0048
|
7- Physical symptoms | 61 ± 24
p = 0.21 |
Usual A.: 64 ± 24
Lower A.: 47 ± 19
p
= 0.0441
|
Grade 0 : 72 ± 20
Grade 1: 56 ± 23
Grade 2 or 3: 33 ± 20
p
= 0.0001
|
Grade 0: 69 ± 25
Grade 1 or 2 or 3: 47 ± 20
p
= 0.0043
|
Grade 0: 72 ± 21
Grade 1 or 2: 53 ± 23
p
= 0.0127
|
8- Sexual functioning | 81 ± 30
p = 0.80 | 81 ± 30
p = 0.22 |
Grade 0: 94 ± 15
Grade 1: 70 ± 36
Grade 2 or 3: 47 ± 27
p
= 0.0003
|
Grade 0: 87 ± 24
Grade 1 or 2 or 3: 67 ± 36
p
= 0.0320
| 81 ± 30
p = 0.19 |
Dimensions | Disease statusa
HD N = 16 ARM N = 34 | Clinical status | |||
---|---|---|---|---|---|
Autonomy status a
Usual A. N = 37 Lower A. N = 9 | Soiling b
Grade 0 N = 22 Grade 1 N = 18 Grade 2 N = 3 Grade 3 N = 3 | Constipation b
Grade 0 N = 28 Grade 1 N = 3 Grade 2 N = 5 Grade 3 N = 5 | Voluntary bowel movements b
Grade 0 N = 25 Grade 1 N = 4 Grade 2 N = 2 Grade 3 N = 3 | ||
Overall scale | 608 ± 96
p = 0.95 |
Usual A.: 628 ± 65
Lower A.: 484 ± 130
p
= 0.0261
|
Grade 0: 650 ± 39
Grade 1 or 2 or 3: 564 ± 109
p
= 0.0224
|
Grade 0 or 1 or 2: 616 ± 85
Grade 3: 479 ± 137
p
= 0.0134
|
608 ± 96
p
= 0.0127
|
1- Laxative Diet | 89 ± 18
p = 0.73 |
Usual A.: 92 ± 16
Lower A.: 71 ± 21
p
= 0.0288
| 89 ± 18
p = 0.29 |
Grade 0: 94 ± 11
Grade 1 or 2 or 3: 72 ± 23
p
= 0.0008
| 89 ± 18
p = 0.21 |
2- Presence of Diarrhea | 83 ± 25
p = 0.63 | 84 ± 25
p = 0.18 | 84 ± 25
p = 0.31 | 84 ± 25
p = 0.94 | 84 ± 25
p = 0.44 |
3- Fecal Continence | 86 ± 19
p = 0.59 |
Usual A.: 90 ± 16
Lower A.: 62 ± 16
P
= 0.0008
|
Grade 0: 97 ± 6
Grade 1: 83 ± 16
Grade 2: 67 ± 11
Grade 3: 43 ± 17
p
< 0.0001
|
Grade 0 or 1: 85 ± 19
Grade 2 or 3: 69 ± 19
p
= 0.0067
|
Grade 0: 89 ± 18
Grade 1 or 2 or 3: 67 ± 13
p
= 0.0141
|
4- Urinary Continence | 98 ± 7
p = 0.52 | 98 ± 7
p = 0.17 | 98 ± 7
p = 0.47 | 98 ± 7
p = 0.08 | 98 ± 7
p = 0.06 |
5- Social Functioning | 93 ± 20
p = 0.55 | 93 ± 20
p = 0.14 | 93 ± 20
p = 0.53 |
Grade 0 or 1 or 2: 97 ± 12
Grade 3: 61 ± 45
p
= 0.0207
|
93 ± 20
P
= 0.0009
|
6- Emotional Functioning and Body Image | 84 ± 21
p = 0.84 |
Usual A.: 89 ± 14
Lower A.: 54 ± 24
p
= 0.0042
|
Grade 0: 96 ± 6
Grade 1 or 2 or 3: 72 ± 23
p
= 0.0004
|
Grade 0 or 1 or 2: 87 ± 18
Grade 3: 53 ± 28
p
= 0.0020
|
84 ± 21
p
= 0.0078
|
7- Physical symptoms | 72 ± 19
p = 0.58 | 72 ± 19
p = 0.10 |
Grade 0 or 1 or 2: 85 ± 21
Grade 3: 68 ± 16
p
= 0.0092
|
Grade 0 or 1 or 2: 73 ± 16
Grade 3: 48 ± 21
p
= 0.0129
| 72 ± 19
p = 0.06 |