Development and validation of Skindex-Teen, a quality-of-life instrument for adolescents with skin disease.
OBJECTIVE
To develop and validate a quality-of-life index for adolescents with skin disease.


METHODS
Prospective, longitudinal cohort study taking place from July 15, 2005, through February 29, 2008.


METHODS
Academic pediatric dermatology practice.


METHODS
A total of 205 patients between the ages of 12 and 17 years with a skin condition.


METHODS
Participants completed the Skindex-Teen questionnaire, reported sociodemographic data, and answered clinical questions at enrollment. Four weeks later, they completed Skindex-Teen and responded to clinical questions again. Forty patients also completed Skindex-Teen 48 hours after baseline.


RESULTS
Of 205 patients, 200 (97.6%) completed all enrollment materials; 125 (62.5%) of these returned follow-up materials, of which 115 (57.5%) were complete. Twenty-three of 40 participants (57.5%) completed the 48-hour-after-initial-answers materials. The mean (SD) age of the patients was 15.3 (1.4) years (range, 12.9-18.0 years). Approximately half reported their skin condition as poor (26 [13.0%]) or fair (67 [33.5%]); most rated their general health as very good (62 [31.0%]) or excellent (80 [40.0%]). The dimensionality of the items was evaluated using factor analysis; results suggested 2 factors, termed physical symptoms (5 items) and psychosocial functioning (16 items). Both scales demonstrated excellent internal consistency. All item-scale reliabilities were greater than 0.4. Fit of items to the measurement model was supported by Rasch analysis. Test-retest reliability was supported by intraclass correlation coefficients (0.82-0.94) for total scores, physical symptoms, and psychosocial functioning scales. At 4 weeks, 16 (13.9%) reported worsening of their skin condition, 57 (19.6%) reported it had remained unchanged, and 42 (36.5%) reported improvement. Significant mean differences were present between the improved and worsened groups for the psychosocial functioning scale and total scores.


CONCLUSIONS
These data provide evidence of construct, content, and face validity for Skindex-Teen, a new quality-of-life instrument for adolescents with skin disease. Test-retest reliability was verified, and responsiveness at 4 weeks was shown for total scores and the psychosocial functioning scale scores.
Smidt
Aimee C
AC
University of New Mexico School of Medicine, Departments of Dermatology and Pediatrics, 1021 Medical Arts Ave. NE, Albuquerque, NM 87131, USA. asmidt@salud.unm.edu
Lai
Jin-Shei
JS
Cella
David
D
Patel
Sapna
S
Mancini
Anthony J
AJ
Chamlin
Sarah L
SL
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000523:psychology*; D012919:Social Behavior; D011795:Surveys and Questionnaires