Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires

Cláudia Chaves; Renata Puppin Zandonadi; António Raposo; Eduardo Yoshio Nakano; Fernando Ramos; Priscila Farage; Edite Teixeira-Lemos

doi:10.3389/fimmu.2024.1372369

Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires

Front Immunol. 2024 Mar 4:15:1372369. doi: 10.3389/fimmu.2024.1372369. eCollection 2024.

Authors

Cláudia Chaves¹, Renata Puppin Zandonadi², António Raposo³, Eduardo Yoshio Nakano⁴, Fernando Ramos^{5

6}, Priscila Farage⁷, Edite Teixeira-Lemos⁸

Affiliations

¹ ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, Viseu, Portugal.
² Faculty of Health Sciences, Nutrition Department, University of Brasília, Brasília, Brazil.
³ CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal.
⁴ Department of Statistics, University of Brasília, Brasília, Brazil.
⁵ Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
⁶ Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), Porto, Portugal.
⁷ Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil.
⁸ CERNAS Research Centre, Polytechnic University of Viseu, Viseu, Portugal.

Abstract

Objective: This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals.

Methods: This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire).

Results: A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research.

Conclusion: Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.

Keywords: Portugal; celiac disease; gluten-free diet; quality of life; questionnaire.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Celiac Disease*
Cross-Sectional Studies
Humans
Portugal
Quality of Life*
Surveys and Questionnaires

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work is funded by National Funds through the FCT-Foundation for Science and Technology, I.P., within the scope of the projects Ref^a UIDB/05507/2020 and UIDB/00681/202. The study was also supported by FAPDF N° 539/2022 and the Brazilian National Council for Scientific and Technological Development (CNPq -N° 302602/2021-6).