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02-09-2010 | Dermatology | Article

QoL tool devised for adolescents with skin disease


Free abstract

MedWire News: Researchers have devised a new 21-item instrument for assessing quality-of-life (QoL) in adolescents with skin disease, based on physical symptoms and psychosocial functioning.

The Skindex-Teen was completed by 200 adolescents and showed good validity, test-retest reliability, and responsiveness against clinical skin symptoms at 4 weeks.

"Accurate measurement of the multidimensional effects of skin disorders on quality of life allow the physician a better understanding of the experience of patients," say Aimee Smidt (University of New Mexico School of Medicine, Albuquerque, USA) and colleagues in the Archives of Dermatology.

Although many QoL instruments have been validated for use in adults with skin disease, fewer are available for use in children, and none are available for use in adolescents.

"This unique population requires age-specific questions addressing pertinent aspects of their lives, including participation in sports, peer activities, clothing choices, and development of self-image," Smidt et al say.

For the current study, 205 adolescents aged 12-17 years who had a skin condition completed the Skindex-Teen questionnaire and answered clinical questions at enrollment and again 4 weeks later.

Approximately half of respondents reported their skin condition as either poor (13%) or fair (33.5%), and most rated their general health as very good (31%) or excellent (40%).

The most common Skindex-Teen items mentioned were appearance; perception by others; itching, pain or discomfort; effect on apparel choice; feelings of anger or frustration; chronicity of condition; need for medications or treatment; and effect on self-esteem or self-image.

Factor analysis suggested two broad domains on the Skindex-Teen test -namely, physical symptoms (five items) and psychosocial functioning (16 items).

All item-scale reliabilities were greater than 0.4 and test-retest reliability was supported by acceptable intraclass correlation coefficients for the total score, physical symptoms scale score, and psychosocial functioning scale score, respectively.

At 4 weeks, 13.9% of patients reported worsening of their skin condition, 19.6% reported it had remained unchanged, and 36.5% reported improvement.

Significant mean differences were present between the improved and worsened groups for the psychosocial functioning scale and total scores - demonstrating test responsiveness.

"We hope this instrument will prove useful for clinical and research applications in measuring and understanding the quality-of-life effects of skin disease in the adolescent population," Smidt and colleagues conclude.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Andrew Czyzewski