Development And Performance Test Of Chinese Version Of Quality Of Life In Patients With Keloid

Background:Keloid is pathological scar, which grows beyond the boundaries of original wound. Patients suffer from tingling pain, pruritus, and other symptoms, as well as disfiguration. With undecided pathogenesis, keloid is resistant to therapy. The lengthy natural history and high recurrence rate exacerbate its enervating effect. Therefore, keloid can impair patients’life quality in multitude aspects. Effective Measuring instruments can bring substantial advantages to clinical routine, therapy evaluation, and patient’s follow-up. Nowadays, most mainstream scar assessment scales fail to include patients’objective judgment of disease. A Chinese keloid-specific quality of life (QoL) measuring instrument is yet to be developed.Objective:This study was designed to develop a Chinese version of keloid-specific QoL questionnaire, and to test its reliability and validity in Chinese keloid patients. QoL questionnaire score was analyzed to verify possible relationships with demographic and clinical features of keloid patients.Method:Based on the original questionnaire, a Chinese version was created through rigorous protocol of translation and localization. Keloid patients visiting the plastic surgery clinic of Peking Union Medical College Hospital were inducted into the study. Reliability of the questionnaire was tested as internal consistency and test-retest reliability, while the construct validity was examined using factor analysis. Gender, age, and clinical features such as the duration, position, family history and recurrence of keloid were calculated with the QoL score. POSAS score was inspected with QoL score to demonstrate plausible consistency.Result:A total of 81 keloid patients were taken into the study. The male:female sex ratio is 1:1.22, and the average age is 28.5±13.5 years. Average of disease duration is 4.5±5.8 years.29.6% of patients have positive family history, and 42% suffered from recurrence. The Cronbach’s a is 0.815 and 0.741 for physical and psychological scales respectively, indicating considerable reliability. The test-retest reliability is well since the intraclass correlation coefficient for all items exceeds 0.7. Factor analysis detects similar structure in both Chinese and the original version of questionnaire. There are no significant differences in QoL scores between patients of different age, gender, family history, or recurrence status. Poorer QoL is associated with long duration of disease (> 10 years) and keloids in visible positions. Both patient and observer scale show poor consistency with QoL score, however, the scores of pain and pruritus is moderately consistent with the physical scale of QoL questionnaire.Conclusion:The Chinese version of keloid QoL questionnaire demonstrates substantial reliability and validity in Chinese keloid patients. Lower QoL score is related to positive family history and 10 years or longer duration of disease. QoL score shows substandard consistency with POSAS grade.