Dermatology research and practice · 2026
An Amharic Version of the Children's Dermatology Life Quality Index (CDLQI): Cross-Cultural Adaptation and Psychometric Evaluation.
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Wendimu Debisa Eshatu, Alemu Abebaw Yeshambel, Daba Derese Bekele, Lambert Saba Maria, Nigusse Tedros, Jira Sagni Chali, Aragaw Yematawork Kebede, Zewdu Feleke Tilahun, Bedaso Wosen Ketema, Kassa Fikregabrail Aberra, Damte Demekech, Cherkose Teklu, Mohammed Amel Beshir, Mohammed Fewzia Shikur, Doni Shimelis Nigussie, Marks Michael, Gadisa Endalamaw, Walker Stephen L, Hailemichael Yohannes
Аннотация
BACKGROUND: Skin diseases are associated with reduced health-related quality of life (HRQoL) of children and their families. The Children's Dermatology Life Quality Index (CDLQI) questionnaire is a skin disease-specific measure of HRQoL in children. Our study aimed to translate the CDLQI into Amharic, culturally adapt, and evaluate the validity and reliability of the translation.
METHODS: This study was embedded within a larger hospital-based cohort study of cutaneous leishmaniasis (CL). Forward-backward translation procedures were conducted, followed by assessment of content and face validity. The psychometric properties were evaluated through reliability (internal consistency and interrater reliability), construct validity (including known-group, convergent, and discriminant validity), and responsiveness to change. Cronbach's alpha, intraclass correlation coefficient (ICC), Mann-Whitney U test, Kruskal-Wallis test, confirmatory factor analysis (CFA), and Wilcoxon paired rank test were used to assess internal consistency, interrater reliability, known-group validity, construct validity, and responsiveness to change validity, respectively.
RESULTS: The CDLQI showed acceptable content validity with a modified kappa between 0.7 and 0.9. In a pilot testing, children reported that the items in the translated Amharic version of the CDLQI were unambiguous. Among 188 enrolled participants, 129 (68.62%) were diagnosed with CL and 59 (31.38%) with other skin conditions. The median CDLQI score was 7 (IQR = 10). The overall Cronbach's alpha and ICC were 0.82 and 0.92, respectively. The median CDLQI score showed statistically significant differences between "mild" vs. "severe" and "moderate" vs. "severe" CL cases (p < 0.001), as well as between the number of lesions (single vs. multiple) (p = 0.034) and lesion size (< 40 mm vs. ≥ 40 mm) (p < 0.001). CFA showed acceptable convergent validity with most items loading strongly (0.50-0.74), and Heterotrait-Monotrait ratio values ranging from 0.614 to 0.744. The CDLQI median score significantly decreased from Day 1 (median = 9) to Day 90 (median = 4; p < 0.001).
CONCLUSIONS: Our Amharic version of the CDLQI showed acceptable validity and reliability, supporting its use in clinical practice and research to assess the HRQoL of Amharic-speaking children with skin conditions in Ethiopia.
METHODS: This study was embedded within a larger hospital-based cohort study of cutaneous leishmaniasis (CL). Forward-backward translation procedures were conducted, followed by assessment of content and face validity. The psychometric properties were evaluated through reliability (internal consistency and interrater reliability), construct validity (including known-group, convergent, and discriminant validity), and responsiveness to change. Cronbach's alpha, intraclass correlation coefficient (ICC), Mann-Whitney U test, Kruskal-Wallis test, confirmatory factor analysis (CFA), and Wilcoxon paired rank test were used to assess internal consistency, interrater reliability, known-group validity, construct validity, and responsiveness to change validity, respectively.
RESULTS: The CDLQI showed acceptable content validity with a modified kappa between 0.7 and 0.9. In a pilot testing, children reported that the items in the translated Amharic version of the CDLQI were unambiguous. Among 188 enrolled participants, 129 (68.62%) were diagnosed with CL and 59 (31.38%) with other skin conditions. The median CDLQI score was 7 (IQR = 10). The overall Cronbach's alpha and ICC were 0.82 and 0.92, respectively. The median CDLQI score showed statistically significant differences between "mild" vs. "severe" and "moderate" vs. "severe" CL cases (p < 0.001), as well as between the number of lesions (single vs. multiple) (p = 0.034) and lesion size (< 40 mm vs. ≥ 40 mm) (p < 0.001). CFA showed acceptable convergent validity with most items loading strongly (0.50-0.74), and Heterotrait-Monotrait ratio values ranging from 0.614 to 0.744. The CDLQI median score significantly decreased from Day 1 (median = 9) to Day 90 (median = 4; p < 0.001).
CONCLUSIONS: Our Amharic version of the CDLQI showed acceptable validity and reliability, supporting its use in clinical practice and research to assess the HRQoL of Amharic-speaking children with skin conditions in Ethiopia.