An Amharic Version of the Children's Dermatology Life Quality Index (CDLQI): Cross-Cultural Adaptation and Psychometric Evaluation.

Authors

Debisa Eshatu Wendimu, Abebaw Yeshambel Alemu, Derese Bekele Daba, Saba Maria Lambert, Tedros Nigusse, Sagni Chali Jira, Yematawork Kebede Aragaw, Feleke Tilahun Zewdu, Wosen Ketema Bedaso, Fikregabrail Aberra Kassa, Demekech Damte, Teklu Cherkose, Amel Beshir Mohammed, Fewzia Shikur Mohammed, Shimelis Nigussie Doni, Michael Marks, Endalamaw Gadisa, Stephen L Walker, Yohannes Hailemichael

Published in

Dermatology research and practice. Volume 2026. Pages 4076478. Epub Sep 29, 2026.

Abstract

Skin diseases are associated with reduced health-related quality of life (HRQoL) of children and their families. The Children's Dermatology Life Quality Index (CDLQI) questionnaire is a skin disease-specific measure of HRQoL in children. Our study aimed to translate the CDLQI into Amharic, culturally adapt, and evaluate the validity and reliability of the translation.
This study was embedded within a larger hospital-based cohort study of cutaneous leishmaniasis (CL). Forward-backward translation procedures were conducted, followed by assessment of content and face validity. The psychometric properties were evaluated through reliability (internal consistency and interrater reliability), construct validity (including known-group, convergent, and discriminant validity), and responsiveness to change. Cronbach's alpha, intraclass correlation coefficient (ICC), Mann-Whitney U test, Kruskal-Wallis test, confirmatory factor analysis (CFA), and Wilcoxon paired rank test were used to assess internal consistency, interrater reliability, known-group validity, construct validity, and responsiveness to change validity, respectively.
The CDLQI showed acceptable content validity with a modified kappa between 0.7 and 0.9. In a pilot testing, children reported that the items in the translated Amharic version of the CDLQI were unambiguous. Among 188 enrolled participants, 129 (68.62%) were diagnosed with CL and 59 (31.38%) with other skin conditions. The median CDLQI score was 7 (IQR = 10). The overall Cronbach's alpha and ICC were 0.82 and 0.92, respectively. The median CDLQI score showed statistically significant differences between "mild" vs. "severe" and "moderate" vs. "severe" CL cases (p < 0.001), as well as between the number of lesions (single vs. multiple) (p = 0.034) and lesion size (< 40 mm vs. ≥ 40 mm) (p < 0.001). CFA showed acceptable convergent validity with most items loading strongly (0.50-0.74), and Heterotrait-Monotrait ratio values ranging from 0.614 to 0.744. The CDLQI median score significantly decreased from Day 1 (median = 9) to Day 90 (median = 4; p < 0.001).
Our Amharic version of the CDLQI showed acceptable validity and reliability, supporting its use in clinical practice and research to assess the HRQoL of Amharic-speaking children with skin conditions in Ethiopia.

PMID:
42819551
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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