The Portuguese version of the RhinoQOL Questionnaire: validation and clinical application<b><sup>,</sup></b>

Cerejeira, Rui; Veloso-Teles, Rafaela; Lousan, Nuno; Moura, Carla Pinto

doi:10.1016/j.bjorl.2015.08.015

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Brazilian Journal of Otorhinolaryngology

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (6) • Nov-Dec 2015 • https://doi.org/10.1016/j.bjorl.2015.08.015 copy

The Portuguese version of the RhinoQOL Questionnaire: validation and clinical application^☆ ☆ Please cite this article as: Cerejeira R, Veloso-Teles R, Lousan N, Pinto Moura C. The Portuguese version of the RhinoQOL Questionnaire: validation and clinical application. Braz J Otorhinolaryngol. 2015;81:630-5. ^,^{^☆☆} ☆☆ Instituição: Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

Rhinosinusitis constitutes an important health problem, with significant interference in personal, professional, and social functioning. This study presents the validation process of the Portuguese version of the RhinoQOL, to be used as a routine procedure in the assessment of patients with chronic rhinosinusitis.

OBJECTIVE:

To demonstrate that the Portuguese version of the RhinoQOL is as valid as the English version to measure symptoms and health-related quality of life in chronic rhinosinusitis.

METHODS:

The Portuguese version of the RhinoQOL was administered consecutively to 58 patients with chronic rhinosinusitis with and without nasal polyps, assessed for endoscopic sinus surgery. A follow-up survey was completed three months after surgery. Statistical analysis was performed to determine its psychometric properties.

RESULTS:

Face and content validity were confirmed by similar internal consistency as the original questionnaire for each sub-scale, and strong correlation between individual items and total score. The questionnaire was easy and quick to administer (5.5 min). At three months, there was a significant decrease from baseline for all sub-scale scores, indicating clinical improvement, with an effect size considered as large.

CONCLUSION:

This study provides a questionnaire that is equivalent to the original English version, with good responsiveness to change, which can be especially valuable to measure the outcome of surgery.

Keywords:
Quality of life; Questionnaires; Sinusitis; Natural orifice endoscopic surgery

	Instrument	Items	Domains	Authors
RSOM-31	Rhinosinusitis Outcome Measurement	31	7	Piccirillo²
SNOT-16	Sinonasal Outcome Test	16	1	Anderson et al.³
SNOT-20	Sinonasal Outcome Test	20	1	Piccirillo et al.⁴
SNOT-22	Sinonasal Outcome Test	22	1	Hopkins et al.^{5 and 6}
RSDI	Rhinosinusitis Disability Index	30	3	Benninger, Senior⁷
RhinoQOL	Rhinosinusitis Quality of Life Survey Instrument	17	3	Atlas et al.^{8 and 9}

	CRSwNP	CRSsNP	Total
Male	20	10	30
Female	18	10	28

Sex	n	Frequency scale		Impact scale		Bothersomeness scale
		Mean	SD	Mean	SD	Mean	SD
Male	30	14.71	5.01	17.60	4.66	13.07	6.31
Female	28	12.93	4.24	22.71	9.97	15.46	6.41
Significance (a = 0.05)		0.149		0.018		0.157

	n	Frequency scale		Impact scale		Bothersomeness scale
		Mean	SD	Mean	SD	Mean	SD
CRSwNP	38	14.79	5.10	19.37	6.72	14.95	7.15
CRSsNP	20	11.90	3.02	21.40	10.18	12.85	4.56
Significance (a = 0.05)		0.009		0.428		0.180

	n	Mean	SD	Significance (a = 0.05)
CRSwNP	38	15.89	3.965	<0.001
CRSsNP	20	9.00	3.112	<0.001

Sub-scale of RhinoQOL	Item	Spearman	Significance
Frequency	1	0.489	<0.001
	2	0.605	<0.001
	3	0.907	<0.001
	4	0.838	<0.001
	5	0.763	<0.001

Impact	1	0.739	<0.001
	2	0.689	<0.001
	3	0.676	<0.001
	4	0.643	<0.001
	5	0.390	0.002
	6	0.844	<0.001
	7	0.834	<0.001
	8	0.663	<0.001
	9	0.653	<0.001

Bothersomeness	1	0.675	<0.001
	2	0.670	<0.001
	3	0.829	<0.001

RhinoQOL sub-scales	Baseline			Three-month follow-up			p-Value
	n	Mean	SD	n	Mean	SD
Frequency	58	13.79	4.67	58	8.79	2.19	<0.001
Impact	58	20.07	8.05	58	12.95	4.35	<0.001
Bothersomeness	58	14.22	6.42	58	5.31	3.81	<0.001

RhinoQOL sub-scales	(Mean_baseline - Mean_3month)/SD_baseline			Improvement in QOL
	Total	CRSwNP	CRSsNP
Frequency	1.07	1.19	0.99	Large
Impact	0.88	0.95	0.83	Large
Bothersomeness	1.39	1.31	1.77	Large

	RhinoQOL (original)⁹	RhinoQOL-pv
Cronbach's a [Frequency]	0.68	0.77
Cronbach's a [Impact]	0.89	0.88
Cronbach's a [Bothersomeness]	0.57	0.56

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail:r.cerejeira@netcabo.pt(R. Cerejeira).