Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)

Abstract

The aims of this study were to translate and culturally adapt the UK English Audit of Diabetes-Dependent Quality of Life version 19 (ADDQOL-19) into Bulgarian and explore the psychometric properties of the ADDQoL-19 BUL. The formalized linguistic procedure was used to develop the Bulgarian version of the ADDQoL-19 BUL. The ADDQoL was assessed for the following: internal consistency (Cronbach's alpha); test--retest reliability (intraclass correlation coefficient (ICC)); factor structure and known-groups validity (insulin requiring vs. non-insulin requiring, with vs. without diabetes-related complications, overweight/obese vs. not overweight/obese). A total of 423 adults with type 2 diabetes mellitus (T2DM) participated in the study. The mean age was 59.92 years (standard deviation (SD) 11.60, range 28–88 years), and 52.6% were male. Internal consistency (α = 0.922) and the 3-week test–retest stability (intraclass correlation = 0.99) were high. Confirmatory factor analysis indicated that the one-factor structure of the ADDQoL-19 fits moderately (χ2 = 230.63, df = 136, p < 0.001, SRMR (Standardized Root Mean Square Residual) of 0.05, RMSEA (Root Mean Square Error of Approximation) of 0.06, CFI (Comparative Fit Index) of 0.95). Standardized coefficients showed that all domains loaded 0.4, except for one item. The total score was negatively associated with HbA1c (r = −0.10; p < 0.05), indicating that lower scores were related to poorer glycaemic control. In conclusion, the Bulgarian version of the ADDQoL-19 has good psychometric properties and provides clinicians and researchers with a useful tool for comprehensive assessment of the quality of life in adults with diabetes mellitus.

Keywords

• Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)
• Quality of Life (QoL)
• Type 2 Diabetes Mellitus
• Patient-Reported Outcomes Measure (PROMs)
• Bulgaria