S Nochaiwong1,2, C Ruengorn1,2, R Awiphan1, S Panyathong3, K Noppakun4, W Chongruksut5, S Chiewchanvit6. 1. Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand. 2. Pharmacoepidemiology and Statistics Clinic, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand. 3. Kidney Center, Nakornping Hospital, Chiang Mai, 50180, Thailand. 4. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. 5. Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. 6. Division of Dermatology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Abstract
BACKGROUND: Dialysis patients with uraemic pruritus (UP) have significantly impaired quality of life. To assess the therapeutic effect of UP treatments, a well-validated comprehensive and multidimensional instrument needed to be established. OBJECTIVES: To develop and validate a multidimensional scale assessing UP in patients on dialysis: the Uraemic Pruritus in Dialysis Patients (UP-Dial). METHODS: The development and validation of the UP-Dial instrument were conducted in four phases: (i) item generation, (ii) development of a pilot questionnaire, (iii) refinement of the questionnaire with patient recruitment and (iv) psychometric validation. Participants completed the UP-Dial, the visual analogue scale (VAS) of UP, the Dermatology Life Quality Index (DLQI), the Kidney Disease Quality of Life-36 (KDQOL-36), the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI) between 15 May 2012 and 30 November 2015. RESULTS: The 27-item pilot UP-Dial was generated, with 168 participants completing the pilot scale. After factor analysis was performed, the final 14-item UP-Dial encompassed three domains: signs and symptoms, psychosocial, and sleep. Face and content validity were satisfied through the item generation process and expert review. Psychometric analysis demonstrated that the UP-Dial had good convergent and discriminant validity. The UP-Dial was significantly correlated [Spearman rank coefficient, 95% confidence interval (CI)] with the VAS-UP (0·76, 0·69-0·83), DLQI (0·78, 0·71-0·85), KDQOL-36 (-0·86, -0·91 to -0·81), PSQI (0·85, 0·80-0·89) and BDI (0·70, 0·61-0·79). The UP-Dial revealed excellent internal consistency (Cronbach's α 0·90, 95% CI 0·87-0·92) and reproducibility (intraclass correlation 0·95, 95% CI 0·90-0·98). CONCLUSIONS: The UP-Dial is valid and reliable for assessing UP among patients on dialysis. Future research should focus on the cross-cultural adaptation and translation of the scale to other languages.
BACKGROUND: Dialysis patients with uraemic pruritus (UP) have significantly impaired quality of life. To assess the therapeutic effect of UP treatments, a well-validated comprehensive and multidimensional instrument needed to be established. OBJECTIVES: To develop and validate a multidimensional scale assessing UP in patients on dialysis: the Uraemic Pruritus in Dialysis Patients (UP-Dial). METHODS: The development and validation of the UP-Dial instrument were conducted in four phases: (i) item generation, (ii) development of a pilot questionnaire, (iii) refinement of the questionnaire with patient recruitment and (iv) psychometric validation. Participants completed the UP-Dial, the visual analogue scale (VAS) of UP, the Dermatology Life Quality Index (DLQI), the Kidney Disease Quality of Life-36 (KDQOL-36), the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI) between 15 May 2012 and 30 November 2015. RESULTS: The 27-item pilot UP-Dial was generated, with 168 participants completing the pilot scale. After factor analysis was performed, the final 14-item UP-Dial encompassed three domains: signs and symptoms, psychosocial, and sleep. Face and content validity were satisfied through the item generation process and expert review. Psychometric analysis demonstrated that the UP-Dial had good convergent and discriminant validity. The UP-Dial was significantly correlated [Spearman rank coefficient, 95% confidence interval (CI)] with the VAS-UP (0·76, 0·69-0·83), DLQI (0·78, 0·71-0·85), KDQOL-36 (-0·86, -0·91 to -0·81), PSQI (0·85, 0·80-0·89) and BDI (0·70, 0·61-0·79). The UP-Dial revealed excellent internal consistency (Cronbach's α 0·90, 95% CI 0·87-0·92) and reproducibility (intraclass correlation 0·95, 95% CI 0·90-0·98). CONCLUSIONS: The UP-Dial is valid and reliable for assessing UP among patients on dialysis. Future research should focus on the cross-cultural adaptation and translation of the scale to other languages.
Authors: Jennifer E Flythe; Tandrea S Hilliard; Kourtney Ikeler; San Keller; Debbie S Gipson; Amanda C Grandinetti; Robert J Nordyke; Ronald D Perrone; Prabir Roy-Chaudhury; Mark Unruh; Melissa West; Fraser Bocell; Frank P Hurst Journal: Clin J Am Soc Nephrol Date: 2020-04-10 Impact factor: 8.237