Validation and Clinical Results of the FLQA-d, a Quality of Life Questionnaire for Patients with Chronic Skin Disease

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Abstract
Background: Quality of Life (QoL) has become an important outcome parameter in dermatology. Although various dermatology- specific questionnaires have been developed in the last years, many methodological questions on how to evaluate QoL in skin diseases are still unanswered. We previously published the concept of a modular QoL instrument called Freiburg Life Quality Assessment (FLQA) with variants for the use in chronic venous insufficiency, leg ulcer and allergies. Objective: To develop, validate and test a new FLQA variant for the use in chronic skin diseases that includes disease-specific as well as generic components. Methods: An open survey was performed, asking 46 patients with atopic dermatitis, psoriasis and urticaria about the most important psychosocial and physical implications of their disease. The resulting list of answers was further reduced by an expert panel and combined with generic QoL items derived from previously validated variants of the FLQA. The resulting questionnaire (FLQA-d) includes 53 items referring to 6 dimensions of QoL. This questionnaire was validated on 747 patients with chronic skin diseases at admission to hospital. Results: Clinically, patients with atopic dermatitis showed significantly greater reductions of QoL than patients with psoriasis, urticaria and other dermatoses. Regarding the FLQA-d validation, satisfactory results were found with respect to internal consistency, distribution characteristics, test-retest reliability, responsiveness, convergent (construct) validity and discriminant validity. The number of missing data was low. Conclusion: The FLQA-d is a valid and easy-to-use instrument for the evaluation of QoL in chronic dermatoses.

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