Aim: The present study aimed to assess the reliability and validity of Persian version of patient assessment of constipation: quality of life (PAC-QOL) questionnaire in Iranian patients.
Background: Chronic constipation has significant effects on daily living, wellbeing and individuals' quality of life (QOL). Validated tools can help us to assessing QOL in affected ones and facilitating clinical management of them.
Methods: The English version of Patient Assessment of Constipation: Quality of Life (PAC-QOL) was translated into the Persian language and was confirmed by back-translation. One hundred and forty patients with functional constipation, according Rome III criteria, completed the questionnaires .The questionnaires were analyzed using Cronbach's Alpha internal consistency score to determine the reliability. Twenty medical experts were then asked to evaluate the PAC-QOL and the results were used to calculate the Content Validity Ratio (CVR) and Content Validity Index (CVI).
Results: Due to obtained value for Cronbach`s ? (0.975) and also for the subscale of physical discomfort (0.930), psychosocial discomfort (0.975) and worries and concerns (0.915), the internal consistency is established. According to medical experts’ opinions, the value of CVR ranged from 0.5 to 0.8 and the value of CVI was 0.81.
Conclusion: The Persian version of PAC-QOL questionnaire is shown to have acceptable reliability and validity to be used for psychometric evaluation in Iranian patients complaining of functional constipation.
Keywords: Quality of life, Reliability, Validity, Persian, Constipation.
Irvine EJ, Ferrazzi S, Pare P, Thompson WG, Rance L. Health-related quality of life in functional GI disorders: focus on constipation and resource utilization. The American journal of gastroenterology. 2002 Aug 1;97(8):1986-93.
Wald A, Scarpignato C, Kamm MA, MUELLER‐LISSNER S, Helfrich I, Schuijt C, Bubeck J, Limoni C, Petrini O. The burden of constipation on quality of life: results of a multinational survey. Alimentary pharmacology & therapeutics. 2007 Jul 1;26(2):227-36.
Chassany O, Sagnier P, Marquis P, Fullerton S, Aaronson N. Patient-reported outcomes: the example of health-related quality of life—a European guidance document for the improved integration of health-related quality of life assessment in the drug regulatory process. Drug Information Journal. 2002;36(1):209-38.
Nomura H, Agatsuma T, Mimura T. Validity and reliability of the Japanese version of the Patient Assessment of Constipation Quality of Life questionnaire. Journal of gastroenterology. 2014 Apr 1;49(4):667-73.
Dubois D, Gilet H, Viala‐danten M, Tack J. Psychometric performance and clinical meaningfulness of the Patient Assessment of Constipation–Quality of Life questionnaire in prucalopride (RESOLOR®) trials for chronic constipation. Neurogastroenterology& Motility. 2010 Feb 1;22(2):e54-63.
Mueller-Lissner S, Kamm MA, Wald A, Hinkel U, Koehler U, Richter E, Bubeck J. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. The American journal of gastroenterology. 2010 Apr 1;105(4):897-903.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr 30;130(5):1480-91.
Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Diseases of the colon & rectum. 1996 Jun 1;39(6):681-5.
Jun DW, Park HY, Lee OY, Lee HL, Yoon BC, Choi HS, Hahm JS, Lee MH, Lee DH, Kee CS. A population-based study on bowel habits in a Korean community: prevalence of functional constipation and self-reported constipation. Digestive diseases and sciences. 2006 Aug 1;51(8):1471-7.
Pourhoseingholi A, Safaee A, Pourhoseingholi MA, Moghimi-Dehkordi B, Habibi M, Vahedi M, Zali MR. Prevalence and demographic risk factors of gastrointestinal symptoms in Tehran province. JPH. 2010;8(7):42-6.
Honarkar Z, Baladast M, Khorram Z, AkhondiSh AM, Masoodi M. An analysis of gastrointestinal symptoms in causalities of catastrophic earthquake of Bam, Iran. Shiraz E-Medical Journal. 2005;6(1):2.
Sorouri M, Pourhoseingholi MA, Vahedi M, Safaee A, Moghimi-Dehkordi B, Pourhoseingholi A, et al. Functional bowel disorders in Iranian population using Rome III criteria. Saudi J Gastroenterol. 2010;16(3):154–60.
Massarrat S, Saberi-Firoozi M, Soleimani A, Himmelmann GW, Hitzges M, Keshavarz H. Peptic ulcer disease, irritable bowel syndrome and constipation in two populations in Iran. Eur J GastroenterolHepatol. 1995;7(5):427–33.
Moghimi-Dehkordi B, Vahedi M, Pourhoseinghoi MA, Khoshkrood Mansoori B, Safaee A, Habibi M, Pourhoseingholi A , Zali MR. Economic burden attributable to functional bowel disorders in Iran: A cross-sectional population-based study. Journal of Digestive Diseases.2011; 12;384–392
Mohaghegh Shalmani H, Soori H, Khoshkrood Mansoori B, Vahedi M, Moghimi-Dehkordi B, Pourhoseingholi MA, Norouzinia M, Zali MR. Direct and indirect medical costs of functional constipation: a population-based study.Int J Colorectal Dis . 2011 Apr;26(4):515-22.
Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire. Scandinavian journal of gastroenterology. 2005 May;40(5):540-51.
Acquadro C, Jambon B, Ellis D, Marquis P. Language and translation issues. In: Spilker B, editor.Quality of Life and Parmacoeconomics in Clinical Trrials. Philadelphia: Lippincott- Raven Publishers; 1996. p. 575–85.
Acquadro C, Conway K, Giroudet C, Mear I. Linguistic Validation Manual for Health Outcome Assessments. Lyon: Mapi Institute; 2012.
De Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in Medicine.Cambridge: Cambridge University Press; 2011.
Gorsuch, Richard L. "Exploratory factor analysis: Its role in item analysis." Journal of personality assessment 68.3 (1997): 532-560.
Chronbach LJ. Coefficient alpha and the internal structure of tests.Phyc. 1951;16:297–334.