Validation of Sinhala version of the Chronic Liver Disease Questionnaire (CLDQ) and evaluation of health related quality of fife among patients with cirrhosis in Sri Lanka

Abstract

AIMS: Our aim was to validate a Sinhala version of the CLDQ (sCLDQ) and to test its correlation with the degree of liver dysfunction in a cohort of Sri Lankan cirrhotics. METHODS: A standard method was used to translate the CLDQ to Sinhala. Pilot testing was done and relevant cultural and language adaptations made. The final version was self-administered to stable chronic liver disease (CLD) patients, together with the WHO Quality of Life-BREF (WHOQOL-BREF) validated Sinhala version, for comparison. The sCLDQ was re-administered 4 weeks later to test internal consistency and reliability. The validation was assessed using Cronabach's alpha, intraclass correlation coefficient (ICC) and Pearson's correlation coefficient. ANOVA and Pearson's correlation were used to test correlation with the degree of liver dysfunction. RESULTS: Validation was done with 48 subjects, mean age 55.6 (SD 10) years; male 79%. Item total correlations of sCLDQ varied from 0.30-0.82. Overall Cronabach's alpha was 0.92. Re-administration of sCLDQ yielded an ICC of 0.54 (p=0.02). There was a significant correlation between sCLDQ and WHOQOL-BREF (r=0.34; p=0.03). Validated sCLDQ xvas administered to a different cohort of 202 cirrhotics with mean age of 55.3 years (SD 10,5); male 77%; mean duration of cirrhosis 2.7 years (SD 2.9) years. Higher Child class (F=0.000; p-0.017) and hyponatraemia (r=0.2I3; p=0.005) were associated with worse sCLDQ scores. There was no significant association between sCLDQ score and MELD (r=-0.128, p=0.072). CONCLUSIONS: The sCLDQ is a reliable and valid tool to assess QOL of Sri Lankan cirrhotics and it correlates with known indices of disease severity.