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• W2079449807 abstract "To contribute to the application of the Childhood Atopic Dermatitis Impact Scale (CADIS), 135 Italian parents of children with atopic dermatitis (AD) aged birth to 6 years completed: CADIS, Infants Dermatitis Quality of Life Index (IDQOL) or Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact 10-item questionnaire (DFI). A subsample of 66 caregivers completed the CADIS again, 48hours later. Disease severity was measured with the Severity Scoring of Atopic Dermatitis (SCORAD) index. Exploratory factor analyses almost replicated the general factor structure of the original CADIS, established on a US sample. However, some differences emerged, probably due to cultural differences. A reduced version of the original CADIS was also obtained, based on the exploratory factor analyses, to facilitate use in clinical settings. The original and the shorter versions were tested for reliability: overall Cronbach's α and test–retest reliability for the child- and parent-related scales were acceptable. Regarding concurrent validity, estimates showed the CADIS to correlate adequately with SCORAD, IDQOL-CDLQI, and DFI. Multiple comparison tests for discriminant validity revealed significant differences between extreme groups based on AD severity for all five domains of CADIS. The original CADIS showed adequate validity and reliability in Italy as well, and the shorter version showed promising psychometric properties. To contribute to the application of the Childhood Atopic Dermatitis Impact Scale (CADIS), 135 Italian parents of children with atopic dermatitis (AD) aged birth to 6 years completed: CADIS, Infants Dermatitis Quality of Life Index (IDQOL) or Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact 10-item questionnaire (DFI). A subsample of 66 caregivers completed the CADIS again, 48hours later. Disease severity was measured with the Severity Scoring of Atopic Dermatitis (SCORAD) index. Exploratory factor analyses almost replicated the general factor structure of the original CADIS, established on a US sample. However, some differences emerged, probably due to cultural differences. A reduced version of the original CADIS was also obtained, based on the exploratory factor analyses, to facilitate use in clinical settings. The original and the shorter versions were tested for reliability: overall Cronbach's α and test–retest reliability for the child- and parent-related scales were acceptable. Regarding concurrent validity, estimates showed the CADIS to correlate adequately with SCORAD, IDQOL-CDLQI, and DFI. Multiple comparison tests for discriminant validity revealed significant differences between extreme groups based on AD severity for all five domains of CADIS. The original CADIS showed adequate validity and reliability in Italy as well, and the shorter version showed promising psychometric properties. atopic dermatitis Childhood Atopic Dermatitis Impact Scale Children's Dermatology Life Quality Index Dermatitis Family Impact 10-item questionnaire Infants Dermatitis Quality of Life Index quality of life Severity Scoring of Atopic Dermatitis Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in childhood, affecting 10–20% of children in Europe (Hanifin, 2002Hanifin J.M. Epidemiology of atopic dermatitis.Immunol Allergy Clin N Am. 2002; 22: 1-24Abstract Full Text Full Text PDF Scopus (247) Google Scholar) and 17% in the United States (Laughter et al., 2000Laughter D. Istvan J.A. Tofte S.J. et al.The prevalence of atopic dermatitis in Oregon schoolchildren.J Am Acad Dermatol. 2000; 43: 649-655Abstract Full Text Full Text PDF PubMed Scopus (341) Google Scholar). Adverse consequences of this disorder on children, like distress, irritability, behavioral problems, and sleep dysfunctions, have been well-documented (Beattie and Lewis-Jones, 2006Beattie P.E. Lewis-Jones M.S. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases.Br J Dermatol. 2006; 155: 145-151Crossref PubMed Scopus (388) Google Scholar; Chamlin, 2006Chamlin S.L. The psychosocial burden of childhood atopic dermatitis.Dermatol Ther. 2006; 19: 104-107Crossref PubMed Scopus (91) Google Scholar; Ricci et al., 2007Ricci G. Bendandi B. Bellini F. et al.Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score.Pediatr Allergy Immunol. 2007; 18: 245-249Crossref PubMed Scopus (88) Google Scholar). It has also been shown that with worsening disease severity, the negative impact on child's quality of life (QoL) increases (Ben-Gashir et al., 2004Ben-Gashir M.A. Seed P.T. Hay R.J. Quality of life and disease severity are correlated in children with atopic dermatitis.Br J Dermatol. 2004; 150: 284-290Crossref PubMed Scopus (158) Google Scholar; Beattie and Lewis-Jones, 2006Beattie P.E. Lewis-Jones M.S. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases.Br J Dermatol. 2006; 155: 145-151Crossref PubMed Scopus (388) Google Scholar; Zuberbier et al., 2006Zuberbier T. Orlow S.J. Paller A.S. et al.Patient perspectives on the management of atopic dermatitis.J Allergy Clin Immunol. 2006; 118: 226-232Abstract Full Text Full Text PDF PubMed Scopus (232) Google Scholar; Mozaffari et al., 2007Mozaffari H. Pourpak Z. Pourseyed S. et al.Quality of life in atopic dermatitis patients.J Microbiol Immunol Infect. 2007; 40: 260-264PubMed Google Scholar). The onset of the disease in the first years of life (Kay et al., 1994Kay J. Gawkrodger D.J. Mortimer M.H. et al.The prevalence of childhood atopic eczema in a general population.J Am Acad Dermatol. 1994; 30: 35-39Abstract Full Text PDF PubMed Scopus (412) Google Scholar) implies an impact on the emotional, economical, physical, and social well-being of the whole family (Balkrishnan et al., 2003Balkrishnan R. Housman T.S. Grummer S. et al.The family impact of atopic dermatitis in children: the role of the parent caregiver.Pediatr Dermatol. 2003; 20: 5-10Crossref PubMed Scopus (41) Google Scholar; Mozaffari et al., 2007Mozaffari H. Pourpak Z. Pourseyed S. et al.Quality of life in atopic dermatitis patients.J Microbiol Immunol Infect. 2007; 40: 260-264PubMed Google Scholar; Chamlin and Chren, 2010Chamlin S.L. Chren M.M. Quality-of-life outcomes and measurement in childhood atopic dermatitis.Immunol Allergy Clin N Am. 2010; 30: 281-288Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar). Taking care of a child with AD, in fact, entails an extra work for parents, tied to the daily care and treatment of the child (Elliott and Luker, 1997Elliott B.E. Luker K. The experiences of mothers caring for a child with severe atopic eczema.J Clin Nurs. 1997; 6: 241-247Crossref PubMed Scopus (63) Google Scholar); many studies have evidenced how the whole family is influenced in terms of lower social support, higher stress tied to one's own parental role, and greater difficulties in managing discipline (Daud et al., 1993Daud L.R. Garralda M.E. David T.J. Psychosocial adjustment in preschool children with atopic eczema.Arch Dis Child. 1993; 69: 670-676Crossref PubMed Scopus (181) Google Scholar; Ricci et al., 2007Ricci G. Bendandi B. Bellini F. et al.Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score.Pediatr Allergy Immunol. 2007; 18: 245-249Crossref PubMed Scopus (88) Google Scholar; Monti et al., 2011Monti F. Agostini F. Gobbi F. Quality of life measures in Italian children with atopic dermatitis and their families.Ital J Pediatr. 2011; 37: 59Crossref PubMed Scopus (49) Google Scholar). Different scales have been developed to measure QoL in children with AD and their parents. A recent review on QoL instruments in AD (Rehal and Armstrong, 2011Rehal B. Armstrong A.W. Health outcome measures in atopic dermatitis: a systematic review of trends in disease severity and Quality-of-Life Instruments 1985–2010.PLoS One. 2011; 6: e17520Crossref PubMed Scopus (130) Google Scholar) underlines how, in the past 25 years, up to 14 instruments have been created and used in clinical trials on patients with AD, but the most frequently used have been: the Children's Dermatology Life Quality Index (CDLQI), DLQI, Infants Dermatitis Quality of Life Index (IDQOL), and Dermatitis Family Impact 10-item questionnaire (DFI). Specifically, the CDLQI (Lewis-Jones and Finlay, 1995Lewis-Jones M.S. Finlay A.Y. The Children's Dermatology life Quality Index (CDLQI), initial validation and practical use.Br J Dermatol. 1995; 132: 942-949Crossref PubMed Scopus (721) Google Scholar) and the Infants’ Dermatitis Quality of Life Index (IDQOL; Lewis-Jones et al., 2001Lewis-Jones M.S. Finlay A.Y. Dykes P.J. The infants’ dermatitis quality of life index.Br J Dermatol. 2001; 144: 104-110Crossref PubMed Scopus (266) Google Scholar) are 10-item questionnaires for measuring QoL in children with AD from 4 to 16 years (with help from the parents for younger children) and in infants from birth to 4 years (to be completed by the parents), respectively. The DLQI (Finlay and Khan, 1994Finlay A.Y. Khan G.K. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use.Clin Exp Dermatol. 1994; 19: 210-216Crossref PubMed Scopus (3632) Google Scholar) is a 10-item questionnaire as well, but evaluates QoL in the routine clinical practice with adult patients, over 18 years of age. The DFI (Lawson et al., 1998Lawson V. Lewis-Jones M.S. Finlay A.Y. et al.The family impact of childhood atopic dermatitis: the Dermatitis Family Impact questionnaire.Br J Dermatol. 1998; 138: 107-113Crossref PubMed Scopus (319) Google Scholar) measures how the child's AD affects family life. Although all these instruments have shown good internal consistency, validity, sensitivity to change, and ease of use, they do not pay enough attention to the emotional effects of AD (Chamlin et al., 2005Chamlin S.L. Cella D. Frieden I.J. et al.Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families.J Invest Dermatol. 2005; 125: 1106-1111Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar). As the emotional burden of a chronic disease like AD has been found to be relevant in children and their parents (Chamlin et al., 2004Chamlin S.L. Frieden I.J. Williams M.L. et al.The effects of atopic dermatitis on young American children and their families.Pediatrica. 2004; 114: 607-611Crossref PubMed Scopus (242) Google Scholar; Al Robaee and Shahzad, 2010Al Robaee A.A. Shahzad M. Impairment quality of life in families of children with atopic dermatitis.Acta Dermatovenerol Croat. 2010; 18: 243-247PubMed Google Scholar), its understanding and the identification of those families for whom AD is associated with evident emotional effects are considered essential for promoting appropriate care. For this reason, the Childhood Atopic Dermatitis Impact Scale (CADIS; Chamlin et al., 2005Chamlin S.L. Cella D. Frieden I.J. et al.Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families.J Invest Dermatol. 2005; 125: 1106-1111Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar) was created, specifically developed from directed focus sessions with expert clinicians and parents of young children with AD (Chamlin et al., 2004Chamlin S.L. Frieden I.J. Williams M.L. et al.The effects of atopic dermatitis on young American children and their families.Pediatrica. 2004; 114: 607-611Crossref PubMed Scopus (242) Google Scholar), based on the existing knowledge about pediatric AD and QoL and on the following assumptions:(1)IDQOL, CDLQI, and DFI, even if very brief and easy to use, mainly assess physical symptoms and functioning, while emotional effects are assessed only through a few items;(2)IDQOL, CDLQI, and DFI were developed by the same group of physicians and are similar in format and design; for this reason, the combined use of these questionnaires may limit the diversity and the variety of characteristics that are used when assessing QoL in patients with AD (Rehal and Armstrong, 2011Rehal B. Armstrong A.W. Health outcome measures in atopic dermatitis: a systematic review of trends in disease severity and Quality-of-Life Instruments 1985–2010.PLoS One. 2011; 6: e17520Crossref PubMed Scopus (130) Google Scholar);(3)there is not a unique instrument capable of assessing both the child's and the family's QoL, at the same time, in relation to the impact of AD. The CADIS measures the multidimensional effects of AD on QoL in both parents and their children, aged from birth to 6 years, showing good psychometrical properties (Chamlin et al., 2005Chamlin S.L. Cella D. Frieden I.J. et al.Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families.J Invest Dermatol. 2005; 125: 1106-1111Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar) and provides a patient-centered measurement of AD severity that should prove useful in clinical research (Chamlin et al., 2007Chamlin S.L. Lai J.S. Cella D. et al.Childhood Atopic Dermatitis Impact Scale: reliability, discriminative and concurrent validity, and responsiveness.Arch Dermatol. 2007; 143: 768-772Crossref PubMed Scopus (52) Google Scholar). However, two aspects could be addressed to improve the characteristics of this recent and promising tool: the performance of this instrument in cultures other than the United States, and the possibility of reducing the length of the questionnaire to make it easier to use in clinical settings. This study analyzed the structure of the CADIS and its validity and reliability in a sample of Italian parents of children with AD aged birth to 6 years, with a twofold purpose:(1)to assess whether it is actually applicable to a reality that is culturally different from the United States;(2)to assess whether it is possible to reduce the number of items while maintaining appropriate psychometric characteristics. In all, 135 parents of children with AD participated in the study. Children were aged 2–72 months (53% female) and were diagnosed with mild, moderate, or severe AD based on the SCORAD index (European Task Force on Atopic Dermatitis, 1993European Task Force on Atopic DermatitisSeverity scoring of atopic dermatitis: the SCORAD index: consensus report of the European task force on atopic dermatitis.Dermatology. 1993; 186: 23-31Crossref PubMed Scopus (1858) Google Scholar). Parents were aged 23–48 years (80% female). Detailed sample characteristics are presented in Table 1.Table 1Characteristics of children and caregivers (N=135)Frequency, N (%)1Percentages do not always add up to 100 because of missing values.Children Gender Female71 (53) Male62 (46)Mean age33 (SD=23; range 2–72 months)Other diseases18 (13) Allergies6 (4) Asthma6 (4) Angioma3 (2) Other3 (2)Siblings65 (48)Sibling's disease21 (16) Asthma1 (1) Dermatitis14 (10) Dermatitis and asthma2 (2) Other4 (3)School Nursery21 (16) Kindergarten38 (28) Primary school16 (12) No58 (43)Mean age at AD diagnosis14 (SD=23; range 2–72 months)Mild AD (total SCORAD <25)55 (41)Moderate AD (total SCORAD 25–50)52 (39)Severe AD (total SCORAD >50)20 (15)Caregivers Gender Female108 (80) Male25 (19)Mean age36 (SD=5; range 23–48 years)Marital status Single19 (14) Married107 (80) Separated6 (4)Occupation Student2 (2) Housewife19 (4) Unemployed7 (5) Employed105 (78)Mean absence from work0.6 (SD=2; range 0–15 days)Diseases56 (41) AD13 (10) Allergies18 (13) Asthma3 (2) Dermatitis5 (4) Other17 (13)Economic costs Low28 (21) Adequate45 (33) High60 (44)Abbreviations: AD, atopic dermatitis; SCORAD, Severity Scoring of Atopic Dermatitis.1 Percentages do not always add up to 100 because of missing values. Open table in a new tab Abbreviations: AD, atopic dermatitis; SCORAD, Severity Scoring of Atopic Dermatitis. Of all participants, 66 parents (49%) completed the CADIS again, after 2 days, and returned it by mail. Although this response rate is below the mean of mail surveys published in medical journals (which is approximately 60%; Asch et al., 1997Asch D.A. Jedrziewski M.K. Christakis N.A. Response rates to mail surveys published in medical journals.J Clin Epid. 1997; 50: 1129-1136Abstract Full Text PDF PubMed Scopus (1798) Google Scholar), socio-demographic characteristics of responders did not significantly differ from those of non-responders. Therefore, the extent of the non-respondent bias could be considered limited. The 45 items of the CADIS were treated as elements of two different scales based on the procedure followed by Chamlin et al., 2005Chamlin S.L. Cella D. Frieden I.J. et al.Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families.J Invest Dermatol. 2005; 125: 1106-1111Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar: a 16-item scale related to the impact of AD on the child's QoL, and a 29-item scale measuring the impact of the child's AD on the QoL of the family. Kaiser–Meyer–Olkin and Bartlett's test of sphericity for both child- and parent-related items indicated that the data set characteristics were adequate for performing factor analysis. For child-related items, the two extracted factors accounted for 43.9% of the total variance. All seven items originally belonging to the Child Symptoms scale loaded on the first factor, with item 10 cross-loading on both factors. It was attributed to the second factor, based on higher factor loading. Of the nine items originally belonging to the Child Activity Limitations and Behavior scale, four items (items 2, 21, 29, and 41) loaded on the second factor, two (items 27 and 34) loaded on the first factor, one (item 22) loaded on both factors, while items 24 and 43 did not reach an acceptable loading on any factor, hence they were eliminated. The cross-loading item was included in the second factor, based on higher loading value. The content of the eight items that formed the first factor reflected the child's AD symptoms, whereas the six items of the second factor described the child's activity limitations and behavior, almost replicating the original item dimensionality. Factor loadings of the retained items ranged from 0.33 to 0.88 for Child Symptoms, and from 0.40 to 0.81 for Child Activity Limitations and Behavior. A subsequent examination of the rotated factor matrix led to the elimination of one item of the Child Symptoms scale (item 27) and one item of the Child Activity Limitations and Behavior scale (item 10), based on inadequate factor loadings. Child-related scales are shown in Table 2.Table 2Exploratory factor analysis for child-related itemsItemsFactors and loadingsChild SymptomsChild Activity Limitations and Behavior9. My child scratches or rubs his/her skin.0.88-0.1917. My child seems to be restless or hyperactive because of this skin condition.0.820.0514. My child's skin seems to be painful or irritated.0.82-0.226. This skin condition makes my child fussy or irritable.0.820.071. This skin condition affects how well my child sleeps.0.71-0.0312. My child seems to cry more because of this skin condition.0.630.2334. My child misbehaves more because of this skin condition.0.520.0627. Certain fabrics or clothes seem to bother my child's skin.1Item excluded from the short version.0.330.102. Because of this skin condition, I limit my child's outdoor activities such as playing at parks or beaches.-0.180.8229. It is difficult to discipline my child because of this skin condition.0.110.5921. Taking a bath makes my child uncomfortable.-0.110.5441. Children seem to avoid touching or playing with my child because of this skin condition.-0.060.5422. My child's itching or scratching affects his/her play.0.330.5210. This skin condition makes my child feel frustrated.1Item excluded from the short version.0.360.4043. My child dislikes having creams or ointments applied to his or her skin.0.280.3024. My child scratches his/her skin to get attention0.100.23Cronbach's alpha0.880.79Cronbach's alpha—short version0.890.74Note: Extraction method: principal axis factoring with Promax rotation.Items in bold indicate the item's primary factor.1 Item excluded from the short version. Open table in a new tab Note: Extraction method: principal axis factoring with Promax rotation. Items in bold indicate the item's primary factor. The total percentage of variance explained by the three extracted factors was 43.7%. Of the 17 items originally belonging to the Parent Emotions scale, 15 loaded exclusively on the first factor, one (item 18) loaded on the second factor, and one (item 16) did not reach an acceptable loading on any factor, hence it was eliminated. Of the nine items originally belonging to the Family and Social Function scale, six loaded on the second factor, one (item 30) loaded on the third factor, and one (item 11) cross-loaded on two factors and was included in the third factor, based on higher loading value. Item 20 did not reach an acceptable loading on any of the three factors, hence it was eliminated. All the three items belonging to the Sleep scale loaded on the third factor, with the addition of items 11 and 30. Items in the first and second factors described the parents’ emotions, and family functioning, respectively, as in the original CADIS, while items in the third factor did not only describe sleep-related issues, as in the original CADIS, but rather obstacles to marital intimacy due to the child's AD. A subsequent examination of the pattern matrix led to the elimination of three items (items 19, 42, and 44) of the Parent Emotions scale, one item (item 18) of the Family and Social Function scale, and two items (items 11 and 30) of the last factor, based on loadings below the selected cutoff value. Parent-related scales are shown in Table 3.Table 3Exploratory factor analysis for parent-related itemsItemsFactors and loadingsParent EmotionsFamily and Social FunctionParent Sleep13. I worry that my child's skin condition will continue.0.73-0.20-0.0239. My child's skin condition makes me feel sad or depressed.0.72-0.010.0938. I worry that this skin condition will affect my child's self-esteem.0.710.12-0.2228. I worry that my child is exposed to things that may worsen this skin condition.0.70-0.19-0.0423. I feel helpless about my child's skin condition.0.68-0.250.2715. I am frustrated with my child's skin condition.0.680.030.0933. I worry that this skin condition will affect my child's ability to make friends.0.670.25-0.3025. I am bothered by the reaction of strangers to this skin condition.0.670.08-0.0432. I worry about the side effects from treatments for this skin condition.0.62-0.160.2637. I am angry that my child has this skin condition.0.60-0.030.0535. This skin condition has affected how confident I feel about my child's medical care.0.600.19-0.1426. I am disappointed that my child has this skin condition.0.60-0.01-0.0942. I blame myself or feel guilty that my child has this skin condition.1Item excluded from the short version.0.390.29-0.0619. I worry about the costs of my child's skin condition1Item excluded from the short version.0.370.230.1344. I am embarrassed by the way my child's skin looks.1Item excluded from the short version.0.330.280.0920. My child's skin condition affects my spouse's or my work performance due to missed time and decreased productivity.0.300.290.2845. My child's skin condition makes it hard to do what I enjoy.-0.040.810.054. I am bothered that this skin condition affects our vacation plans.-0.320.800.097. I am bothered that my family stays home more because of this skin condition.-0.130.640.1540. My child's skin condition has affected my decision to have other children.0.110.60-0.125. This skin condition affects our social life.0.010.580.208. I am bothered that this skin condition affects our relationships with relatives.-0.010.53-0.2218. I am bothered by how much time is needed to care for my child's skin condition.1Item excluded from the short version.0.270.430.1216. I/we avoid taking photos of my child because of this skin condition.0.190.290.0431. My child sleeps in my bed because of this skin condition.-0.240.010.903. My child's skin condition affects how well my spouse and I sleep.0.020.040.7036. I am bothered by my child sleeping in my bed.-0.030.010.5111. I worry about leaving my child with others (babysitters, relatives) because of this skin condition.1Item excluded from the short version.0.33-0.080.4330. My child's skin condition has strained my relationship with spouse or partner.1Item excluded from the short version.0.210.200.40Cronbach's alpha0.900.820.77Cronbach's alpha—short version0.890.810.72Note: Extraction method: principal axis factoring with Promax rotation.Items in bold indicate the item's primary factor.1 Item excluded from the short version. Open table in a new tab Note: Extraction method: principal axis factoring with Promax rotation. Items in bold indicate the item's primary factor. CADIS subscales showed acceptable internal consistency estimates (0.77–0.90) with Cronbach's α coefficients and corrected item–total correlations in the 0.32 to 0.81 range. α-Value for the total CADIS was 0.95. This high α-value may be indicative of item redundancy. The reduced version of the CADIS also showed good reliability, with α coefficients between 0.72 and 0.89 and corrected item–total correlations in the 0.33 to 0.83 range. α-Value for the total 33-item CADIS was 0.90. The lower α-value of the total 33-item scale, compared to that of the longer CADIS, may be indicative of a reduction in item redundancy. Cronbach's α-values for child and parent-related items are displayed in Tables 2 and 3. Temporal stability was explored in a subsample of 66 parents who were asked to complete the CADIS again after 48hours. Spearman's ρ coefficients indicated acceptable test–retest reliability with correlations of 0.92 for the 41-item CADIS, 0.90 and 0.80 for Child Symptoms and Child Activity Limitations and Behavior, respectively (for all ρ values, P≤0.001). For the three parent-related scales, test–retest reliability estimates were 0.73 (Family and Social Function) and 0.87 (Parent Emotions and Parent Sleep) (for all ρ values, P≤0.001). The 33-item CADIS showed test–retest coefficients of 0.91 (total scale), 0.91 (Child Symptoms), and 0.78 (Activity Limitations and Behavior) for the child-related scales, and 0.85 (Parent Emotions), 0.67 (Family and Social Function), and 0.87 (Parent Sleep) for the parent-related scales, respectively (for all ρ values P≤0.001). Concurrent validity evaluation demonstrated both the 41- and 33-item CADIS to be significantly correlated with SCORAD, IDQOL-CDLQI, and DFI scores. Spearman's correlations with the SCORAD ranged between 0.27 and 0.58 for the long CADIS and between 0.24 and 0.57 for the 33-item CADIS, with lower correlations with the objective SCORAD and higher correlations with the subjective SCORAD. For the long CADIS, correlation coefficients ranged between 0.40 and 0.75 with the IDQOL, between 0.38 and 0.62 with the CDLQI, and between 0.51 and 0.68 with the DFI. For the 33-item CADIS, correlations ranged between 0.32 and 0.74 with the IDQOL, 0.37 and 0.63 for the CDLQI, and 0.46 and 0.66 with the DFI. Correlation coefficients for both CADIS versions are presented in Table 4.Table 4CADIS concurrent validity estimates with Spearman's ρ correlation coefficientObjective SCORADSubjective SCORADTotal SCORADIDQOL1N=102 (children aged 0–4 years).CDLQI2N=33 (children aged >4 years).DFI3N=126 (children aged >6 months).41-Item CADIS domain Child Symptoms0.370.580.440.750.600.62 Child Activity Limitations0.310.440.360.620.540.51 Parent Emotions0.300.510.360.620.380.58 Family and Social Function0.270.310.320.400.620.55 Parent Sleep0.310.400.360.620.530.61 Total 41-item CADIS0.380.570.440.740.580.6833-Item CADIS domain Child Symptoms0.390.570.450.740.610.61 Child Activity Limitations0.300.380.340.590.530.46 Parent Emotions0.300.520.350.630.370.58 Family and Social Function0.240.240.280.320.630.49 Parent Sleep0.300.350.350.550.520.53 Total 33-item CADIS0.380.560.440.740.560.66Abbreviations: CADIS, Childhood Atopic Dermatitis Impact Scale; CDLQI, Children's Dermatology Life Quality Index; DFI, Dermatitis Family Impact 10-item questionnaire; IDQOL, Infants Dermatitis Quality of Life Index; SCORAD, Severity Scoring of Atopic Dermatitis.All correlations are significant for P≤0.01 (two-tailed).1 N=102 (children aged 0–4 years).2 N=33 (children aged >4 years).3 N=126 (children aged >6 months). Open table in a new tab Abbreviations: CADIS, Childhood Atopic Dermatitis Impact Scale; CDLQI, Children's Dermatology Life Quality Index; DFI, Dermatitis Family Impact 10-item questionnaire; IDQOL, Infants Dermatitis Quality of Life Index; SCORAD, Severity Scoring of Atopic Dermatitis. All correlations are significant for P≤0.01 (two-tailed). In summary, a greater impact of AD on the QoL of children and their families (measured with CADIS) was associated with a more severe AD (measured with the SCORAD Index), a lower dermatological QoL in children and infants (measured with IDQOL or CDLQI), and a higher impairment of family life (measured with the DFI). According to the total SCORAD scores at baseline, children were classified into three groups depending on their AD severity: mild (n=55; 41%), moder" @default.
• W2079449807 created "2016-06-24" @default.
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• W2079449807 creator A5019462333 @default.
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• W2079449807 date "2012-11-01" @default.
• W2079449807 modified "2023-09-26" @default.
• W2079449807 title "Italian Validation of the Childhood Atopic Dermatitis Impact Scale: A Contribution to Its Clinical Application" @default.
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