Health-related quality of life in Swiss adolescents with asthma. Validation of the AAQOL-D and comparison with Australian adolescents.
PRINCIPLES: The Adolescent Asthma Quality of Life Questionnaire (AAQOL) is the only asthma-specific quality-of-life questionnaire to date for use specifically in adolescents. The aim of this study was translation of the AAQOL into German, revalidation of the German version (AAQOL-D) and comparison of health-related quality of life (HRQOL) in Swiss and Australian adolescents. METHODS: 60 adolescents with frequent episodic or persistent asthma aged 12-17 years were recruited. The standardised method consisted of (1) translation of the AAQOL; (2) additional item selection via semistructured interviews (n = 11); (3) item reduction and re-validation (n = 56). For item reduction the clinical impact method was applied. RESULTS: The same 32 items were identified as relevant for the AAQOL-D as in the original version (AAQOL). Internal consistency for the 6 dimensions and the total score was high (alpha = 0.76-0.87). Despite consideration of psychosocial aspects relevant to adolescents, high correlation with the Pediatric Asthma Quality of Life Questionnaire was confirmed for the AAQOL-D (rho = 0.85; p <0.0001). Correlation with a health status thermometer consisted in rho = 0.74 (p <0.0001). There was moderate correlation with clinical parameters of asthma severity (rho = 0.51-0.73; p < or = 0.0002), not however with frequency of medication (rho = 0.22; p = 0.13). Comparison of Swiss and Australian adolescents showed that Swiss adolescents were more bothered by cigarette smoke and the need to avoid places where cigarettes were smoked. CONCLUSIONS: The AAQOL-D is a valid multidimensional instrument in German for assessing HRQOL of adolescents with asthma. HRQOL of Swiss adolescents with asthma may be enhanced by implementing non-smoking policies promoting smoke-free environments.