Korean J Transplant.  2019 Dec;33(4):135-145. 10.4285/jkstn.2019.33.4.135.

Development and validation of the Kidney Transplantation and Quality of Life, a Korean questionnaire to assess the general quality of life and other health issues associated with medication change in kidney transplant recipients

• Rhu J
• Lee KW
• Chung YJ
• Park JB
• Choi JY
• Kim SJ
• Jung JS
• Kim S

• KMID: 2468164
• DOI: http://doi.org/10.4285/jkstn.2019.33.4.135

Abstract

BACKGROUND
This study aimed to develop and validate the Kidney Transplantation and Quality of Life (KTQoL) questionnaire to evaluate the quality of life (QoL) in Korean kidney transplantation (KT) patients. During the validation, the KTQoL was used to compare the QoL of KT patients before and after conversion from twice-daily to a once-daily regimen of tacrolimus.
METHODS
Construct and content validity of the 24-item KTQoL was evaluated using factor analysis and a panel of experts, respectively. The questionnaire was validated in 50 KT patients, conducted before and after conversion from twice-daily to once-daily tacrolimus. Internal consistency was evaluated based on Cronbach's alpha coefficient.
RESULTS
The KTQoL showed high internal consistency (Cronbach's alpha 0.71 to 0.88). Besides the Concerns category, both the general and specific QoL of KT patients were relatively good (≥70% of positive responses) and did not change markedly after conversion to the once-daily regimen (42.9±8.8 vs. 43.6±8.6, P=0.740). After conversion, men scored better than women in total KTQoL, Specific QoL, and Symptoms, while employed patients had better Daily Life scores and showed greater improvement in Daily Life scores compared with unemployed patients.
CONCLUSIONS
The KTQoL seems to be a reliable instrument to evaluate general and specific QoL in Korean KT patients. Most patients evaluated their QoL positively. Conversion to once-daily tacrolimus had no significant effect on QoL in the total sample of KT patients. The QoL of men and/or employed persons might improve more after conversion to once-daily tacrolimus.

Keyword

Medication adherence; Kidney transplantation; Quality of life; Validation studies; Surveys; Surveys and questionnaires; Psychometrics

MeSH Terms

Female
Humans
Kidney Transplantation*
Kidney*
Male
Medication Adherence
Psychometrics
Quality of Life*
Surveys and Questionnaires
Tacrolimus
Transplant Recipients*
Tacrolimus

Figure

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  Fig. 1 Subject distribution. In total, six patients participated in the in-depth interview, of whom three were randomly chosen to be invited to the focus group meeting. For the quantitative research phase, 50 patients were screened and enrolled. All except four patients completed two site visits to answer the questionnaire. The analysis included all available data.

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  Fig. 2 Scatter plot of loading values from factor analysis. Each item was plotted based on the factor loading value ×100 for each factor. If the estimated loadings were >0.4 or <–0.4, the items associated with these loadings were identified as significant (blue or orange dots). Items plotted with gray dots were removed from the questionnaire. Items plotted with orange dots were treated with the reverse scoring method (plotted by –1×the original loading value×100).

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  Fig. 3 Distribution of quality of life (QoL) scores. The middle line in the box indicates median, + sign indicates mean, and whiskers indicate 5th and 95th percentiles. b.i.d., twice daily; q.d., once daily.

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