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

J Allergy Clin Immunol Pract. 2022 Jun;10(6):1527-1533.e3. doi: 10.1016/j.jaip.2022.02.023. Epub 2022 Mar 5.

Authors

Rebecca C Knibb¹, Aarnoud P Huissoon², Richard Baretto², Anjali Ekbote², Sham Onyango-Odera³, Cassandra Screti⁴, Kristina L Newman⁵, Mamidipudi T Krishna⁶

Affiliations

¹ School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK. Electronic address: r.knibb@aston.ac.uk.
² Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
³ Research and Development, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
⁴ School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK.
⁵ School of Psychology, Nottingham Trent University, Nottingham, United Kingdom.
⁶ Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Immunology & Immunotherapy, University of Birmingham, Birmingham, United Kingdom.

PMID: 35259537
DOI: 10.1016/j.jaip.2022.02.023

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.

Publication types

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

MeSH terms

Adult
Anaphylaxis* / diagnosis
Humans
Psychometrics
Quality of Life* / psychology
Reproducibility of Results
Surveys and Questionnaires