Introduction and rationale Patients with spina bifida often face challenges in different
areas. It is common to have a dedicated team of medical specialists for yearly follow-up.
This team includes paediatricians, neurosurgeons, orthopaedics, urologists and
rehabilitation specialists. Patients with spina bifida may experience symptoms in each of
these areas which will have an impact of these patient's quality of life. From the
urologist perspective urinary incontinence and faecal incontinence have a high impact on
quality of life.
Questionnaires to evaluate quality of life in patients with spina bifida do not
incorporate these specific symptoms. The QUAlity of Life Assessment in Spina bifida in
Children (QUALAS-C), QUAlity of Life Assessment in Spina bifida in Teenagers (QUALAS-T)
and The QUAlity of Life Assessment in Spina bifida in Adults (QUALAS-A) have been
developed to take these symptoms into account when assessing quality of life. These
questionnaires are validated in the United States. For children aged 8-12 years the
QUALAS-C version is available. For children between 13-17 years of age the QUALAS-T
version is available. For adults the QUALAS-A version is available.
Currently, no versions of the QUALAS-C, QUALAS-T, QUALAS-A questionnaires are available
in Dutch.
With the QUALAS-C, QUALAS-T and QUALAS-A the investigators will be able to assess spina
bifida related quality of life and monitor the development over time. This will enable
clinicians to offer improved standardized care.
Objective(s) The aim of this study is to validate the QUALAS questionnaire for children,
teenagers and adults in Dutch.
Methods This is a multicenter prospective cohort validation study of the QUALAS
questionnaire. This is a spina bifida related quality of life questionnaire. The
investigators will validate the QUALAS using the validated KIDSCREEN-27 for children 8-17
years of age and the World Health Organization Quality of Life instrument (WHOQOL-BREF)
and (International Consultation on Incontinence Questionnaire) ICIQ for adults
questionnaires to determine spina bifida related quality of life in a standardized
manner.
All patients are subject to treatment at the department of Paediatric Urology in Erasmus
MC-Sophia or University Medical Center Groningen. Participation in this study will not
interfere with their treatment.
For this study two different phases are distinguished:
Phase 1: The QUALAS will be translated following a standardized translation process.
This includes three forward translations by Dutch native speakers, one backward
translation by a English native speaker and face-to-face testing in the target
population.
Phase 2: Children of 8 years and older and adults are asked to fill out the
questionnaires, QUALAS and KIDSCREEN for children 8-17 years of age and the
WHOQOL-BREF and ICIQ for adults, and repeat filling out the QUALAS questionnaire one
week later. The team asks all parents to fill out the questionnaire in order to
secure a constant answer during the study. Children of 8 years and older and adults
in the control group are asked to fill out the QUALAS and KIDSCREEN-27 for children
8-17 years of age and the WHOQOL-BREF and ICIQ for adults. Internal consistency,
criterion validity, construct validity an reproducibility will be determined.