Development and Validation of the Anaphylaxis Quality of Life Scale for Adults

Rebecca C. Knibb; Aarnoud P. Huissoon; Richard Baretto; Anjali Ekbote; Sham Onyango-Odera; Cassandra Screti; Kristina L. Newman; Mamidipudi T. Krishna

doi:10.1016/j.jaip.2022.02.023

Development and Validation of the Anaphylaxis Quality of Life Scale for Adults

Rebecca C. Knibb^*, Aarnoud P. Huissoon, Richard Baretto, Anjali Ekbote, Sham Onyango-Odera, Cassandra Screti, Kristina L. Newman, Mamidipudi T. Krishna

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. Objective: The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). Methods: All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). Results: The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α = 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). Conclusions: The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.

Original language	English
Pages (from-to)	1527-1533.e3
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	10
Issue number	6
Early online date	5 Mar 2022
DOIs	https://doi.org/10.1016/j.jaip.2022.02.023
Publication status	Published - Jun 2022

Bibliographical note

© 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Funding: The project was paid for by a grant from the Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Keywords

Adults
Anaphylaxis
Quality of life
Scale

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10.1016/j.jaip.2022.02.023Licence: CC BY 4.0

Development and validation of the Anaphylaxis Quality of Life Scale for Adults
© 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Accepted author manuscript, 1.04 MBLicence: CC BY 4.0

Cite this

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title = "Development and Validation of the Anaphylaxis Quality of Life Scale for Adults",

abstract = "Background: Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. Objective: The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). Methods: All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). Results: The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α = 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). Conclusions: The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.",

keywords = "Adults, Anaphylaxis, Quality of life, Scale",

author = "Knibb, {Rebecca C.} and Huissoon, {Aarnoud P.} and Richard Baretto and Anjali Ekbote and Sham Onyango-Odera and Cassandra Screti and Newman, {Kristina L.} and Krishna, {Mamidipudi T.}",

note = "{\textcopyright} 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/). Funding: The project was paid for by a grant from the Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.",

year = "2022",

month = jun,

doi = "10.1016/j.jaip.2022.02.023",

language = "English",

volume = "10",

pages = "1527--1533.e3",

journal = "Journal of Allergy and Clinical Immunology: In Practice",

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T1 - Development and Validation of the Anaphylaxis Quality of Life Scale for Adults

AU - Knibb, Rebecca C.

AU - Huissoon, Aarnoud P.

AU - Baretto, Richard

AU - Ekbote, Anjali

AU - Onyango-Odera, Sham

AU - Screti, Cassandra

AU - Newman, Kristina L.

AU - Krishna, Mamidipudi T.

N1 - © 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/). Funding: The project was paid for by a grant from the Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

PY - 2022/6

Y1 - 2022/6

N2 - Background: Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. Objective: The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). Methods: All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). Results: The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α = 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). Conclusions: The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.

AB - Background: Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. Objective: The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). Methods: All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). Results: The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α = 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). Conclusions: The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.

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KW - Anaphylaxis

KW - Quality of life

KW - Scale

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JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

IS - 6

ER -

Development and Validation of the Anaphylaxis Quality of Life Scale for Adults

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