Special article
Adaptation and Validation of the Spanish Version of the Actinic Keratosis Quality of Life Questionnaire
Adaptación y validación de la versión española del cuestionario Actinic Keratosis Quality of Life (AKQoL)
Leído
5379
Vecesse ha leído el artículo
1962
Total PDF
3417
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219016300865" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.05.016" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "1391" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2016;107:474-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 802 "formatos" => array:3 [ "EPUB" => 42 "HTML" => 560 "PDF" => 200 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731016300266" "issn" => "00017310" "doi" => "10.1016/j.ad.2016.03.003" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "1391" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2016;107:474-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 316 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 251 "PDF" => 62 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo especial</span>" "titulo" => "Adaptación y validación de la versión española del cuestionario <span class="elsevierStyleItalic">Actinic Keratosis Quality of Life</span> (AKQoL)" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "474" "paginaFinal" => "481" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Adaptation and validation of the Spanish version of the Actinic Keratosis Quality of Life questionnaire" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3813 "Ancho" => 2420 "Tamanyo" => 366318 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Etapas para la traducción, la adaptación cultural y la validación del cuestionario AKQoL en español.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isabel Longo Imedio, Carlos Serra-Guillén" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Isabel" "apellidos" => "Longo Imedio" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Serra-Guillén" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219016300865" "doi" => "10.1016/j.adengl.2016.05.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016300865?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016300266?idApp=UINPBA000044" "url" => "/00017310/0000010700000006/v1_201606280028/S0001731016300266/v1_201606280028/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219016300695" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.05.001" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "1318" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Actas Dermosifiliogr. 2016;107:482-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1008 "formatos" => array:3 [ "EPUB" => 56 "HTML" => 731 "PDF" => 221 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Consensus Document</span>" "titulo" => "Clinical Pathway for Patients With Acute or Chronic Urticaria: A Consensus Statement of the Andalusian Section of the Spanish Academy of Dermatology and Venereology (AEDV)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "482" "paginaFinal" => "488" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Proceso de atención al paciente con urticaria aguda y crónica. Documento de consenso de la sección territorial andaluza de la Academia Española de Dermatología y Venereología" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3705 "Ancho" => 3254 "Tamanyo" => 695736 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the urticaria patient's pathway through the different parts of the health care system. CMU refers to clinical management unit; UAS7, Urticaria Activity Score 7; DQLI, Dermatology Quality of Life Index.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Ruiz-Villaverde, D. Moreno-Ramírez, M. Galán-Gutierrez, M. de Troya, V. Reyes-Alcázar, M. Alcalde, E.I. García, M. Linares, L. Martínez, Á. Pulpillo, C. Suárez, A. Vélez, E. García-Lora, A. Torres" "autores" => array:14 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Moreno-Ramírez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Galán-Gutierrez" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "de Troya" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Reyes-Alcázar" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Alcalde" ] 6 => array:2 [ "nombre" => "E.I." "apellidos" => "García" ] 7 => array:2 [ "nombre" => "M." "apellidos" => "Linares" ] 8 => array:2 [ "nombre" => "L." "apellidos" => "Martínez" ] 9 => array:2 [ "nombre" => "Á." "apellidos" => "Pulpillo" ] 10 => array:2 [ "nombre" => "C." "apellidos" => "Suárez" ] 11 => array:2 [ "nombre" => "A." "apellidos" => "Vélez" ] 12 => array:2 [ "nombre" => "E." "apellidos" => "García-Lora" ] 13 => array:2 [ "nombre" => "A." "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015005578" "doi" => "10.1016/j.ad.2015.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015005578?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016300695?idApp=UINPBA000044" "url" => "/15782190/0000010700000006/v2_201704050141/S1578219016300695/v2_201704050141/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219016300890" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.05.019" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "1360" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Actas Dermosifiliogr. 2016;107:465-73" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1251 "formatos" => array:3 [ "EPUB" => 56 "HTML" => 827 "PDF" => 368 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots and Freckling. Part II. Other Skin Manifestations Characteristic of NF1. NF1 and Cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "465" "paginaFinal" => "473" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neurofibromatosis tipo 1: más que manchas café con leche, efélides y neurofibromas. Parte II. Actualización sobre otras manifestaciones cutáneas características de la enfermedad. NF1 y cáncer" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 83313 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hypopigmented lesions in a female patient with NF1.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Hernández-Martín, A. Duat-Rodríguez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Martín" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Duat-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731016000740" "doi" => "10.1016/j.ad.2016.01.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016000740?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016300890?idApp=UINPBA000044" "url" => "/15782190/0000010700000006/v2_201704050141/S1578219016300890/v2_201704050141/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Adaptation and Validation of the Spanish Version of the Actinic Keratosis Quality of Life Questionnaire" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "474" "paginaFinal" => "481" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Isabel Longo Imedio, Carlos Serra-Guillén" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Isabel" "apellidos" => "Longo Imedio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Carlos" "apellidos" => "Serra-Guillén" "email" => array:1 [ 0 => "cserraguillen@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatolgía, Instituto Valenciano de Oncología, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adaptación y validación de la versión española del cuestionario <span class="elsevierStyleItalic">Actinic Keratosis Quality of Life</span> (AKQoL)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3813 "Ancho" => 2420 "Tamanyo" => 369557 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart showing process used to translate, culturally adapt, and validate the Actinic Quality of Life Questionnaire (AKQoL) in Spanish.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The concept of health-related quality of life (HRQOL) encompasses various dimensions, such as perception of health, level of independence, and interaction between a person and his or her environment.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1–3</span></a> Although there is no widely accepted definition of HRQOL in the literature,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> the growing interest in this concept is undeniable. HRQOL assessment allows clinicians and researchers to evaluate the impact of disease on the well-being of patients and has become an important consideration when evaluating the outcomes of diverse medical interventions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the field of dermatology, concerns about aesthetic alterations, which are chronic in many cases, have led clinicians to use different tools to measure the impact of various skin diseases on their patients’ lives and their interaction with the environment.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Actinic keratosis (AK) is an incipient form of superficial squamous cell carcinoma (SCC) that typically presents as multiple lesions in areas of long-term exposure to UV radiation, generally from the sun but also from tanning devices. The condition is thus highly prevalent (affecting over 20% of individuals older than 60 years) and is associated with a risk of recurrence due to field cancerization (presence of subclinical lesions in photo-damaged skin underlying clinically evident lesions). Generally nonsurgical treatment is necessary to prevent progression to invasive forms of SCC.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> AK lesions present with varying grades of hyperkeratosis and manifest in multiple forms, ranging from slight scaling to highly adherent crusts. They frequently cause itching or a burning sensation.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Numerous scales are available to assess the impact of dermatologic conditions on QOL and they have been widely used in clinical practice and research. Examples are the Skindex-29<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> and the Dermatology Life Quality Index (DLQI).<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> While other more specific instruments, such as the Skin Cancer Index<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> (recently validated in Spanish<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a>), are used to assess QOL in patients with nonmelanoma skin cancer, no specific questionnaires existed for AK until Esmann et al.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> developed the Actinic Keratosis Quality of Life questionnaire (AKQoL) in 2012.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Tools for evaluating QOL must, among other requirements, be understandable to the patient and this understanding is linked to sociocultural background. Most HRQOL scales, whether generic or specific to a disease and/or medical specialty, are created in English and only some have been translated and adapted for use in the Spanish population.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> When producing a new version of an HRQOL instrument, it is necessary to follow certain procedures to culturally validate the new instrument<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> and ensure that it measures what it was designed to measure (validity); it must also be sufficiently reliable, i.e., offer the necessary stability, accuracy, and consistency for measuring a determined trait.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Objective</span><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study was to produce a linguistically and semantically equivalent version of the AKQoL in Spanish that would constitute a specific tool for evaluating the QOL of patients with AK in our country. We also wished to evaluate the psychometric properties of the Spanish AKQoL.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">The AKQoL is a self-administered questionnaire, originally created in Danish, that evaluates different situations associated with the presence of AK lesions. It consists of 9 items scored on a 4-point scale ranging from 0 (rarely/not at all) to 4 (very much/all the time). It is composed of 3 domains, or subscales: function, which covers personal views of QOL, social life, and appearance (items 1, 8, and 9); emotions, which covers feelings such as fear, guilt, shame, worry, and irritation/bother (items 2, 4, and 6), and control over life in general (items 5 and 7). It also has a single global item (item 3). The total possible score thus ranges from 0 to 27, with higher scores indicating greater impairment of QOL.</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Adaptation of the AKQoL</span><p id="par0040" class="elsevierStylePara elsevierViewall">The original Danish questionnaire was translated and culturally adapted in accordance with the methodological model for the cultural adaptation of self-administered questionnaires<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> with the aim of maintaining semantic equivalence. The first step was the translation-backtranslation phase. The Danish questionnaire was translated into Spanish and the results were evaluated by a group of experts (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The Spanish questionnaire was then backtranslated (into Danish) by 2 native Danish translators and compared with the original. Once the preliminary version of the Spanish AKQoL had been agreed on, it was tested for understanding in a group of patients with comparable characteristics to the target population (38 elderly people with AK from the urban area of Barcelona) and then administered to a second group of volunteers without AK (people older than 18 years from the same geographic area) to evaluate test-retest reliability. The final version of the questionnaire was then administered to a third group of patients from a multicenter observational study to evaluate, among other factors, the impact of AK-related treatment on QOL.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">All the participants who completed the questionnaire in the different phases were previously informed of the nature and objectives of the study and they all voluntarily agreed to participate and to have their data recorded. The study and study material were approved by the clinical research ethics committee at Hospital General Universitario Gregorio Marañón in Madrid, Spain.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Validation of the Spanish AKQoL</span><p id="par0050" class="elsevierStylePara elsevierViewall">A sample size of 10 cases per item has traditionally been used to calculate the necessary sample size to reliably estimate the internal consistency of a scale or questionnaire (using the Cronbach α coefficient). Alpha values of higher than 0.7 are considered to indicate acceptable consistency. That said, sample size calculations for Cronbach α using Monte-Carlo simulations have shown that errors are minimized when samples of over 300 cases are used.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> Thus, considering a statistical power of 90%, an alpha error of 0.05, and an expected Cronbach α of 0.81 (original scale),<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> we calculated a necessary sample of 620 cases</p><p id="par0055" class="elsevierStylePara elsevierViewall">Test-retest reliability was evaluated using the Spearman rank-order correlation coefficient and a Bland-Altman plot of scores for individuals who completed the questionnaire twice, 2 weeks apart. To assess construct validity, we calculated interitem and item-scale correlations for each item and created a correlation matrix for the 3 domains (function, emotions, and control).</p><p id="par0060" class="elsevierStylePara elsevierViewall">To determine concurrent validity, we compared the Spanish AKQoL with another tool designed for a similar purpose (the Skindex 29) and measured the correlations between AKQoL and Skindex-29 scores using the Pearson correlation coefficient. To test the predictive validity of the questionnaire, we used 1-way analysis of variance to analyze differences among mean scores (for the overall questionnaire and the 3 domains) for members of the general population and patients with AK diagnosed by a dermatologist.</p><p id="par0065" class="elsevierStylePara elsevierViewall">We also evaluated the reliability and quality of the data (distribution and score range) and floor and ceiling effects, which reflect the proportion of patients who obtain extreme scores. These effects are considered to be absent if under 15% of respondents achieve the lowest score and the highest score. All correlations were calculated using the Spearman rank-order correlation coefficient.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Results were calculated from the number of valid cases and expressed as mean (SD), extreme values (minimum and maximum), and frequencies and proportions.</p><p id="par0075" class="elsevierStylePara elsevierViewall">A <span class="elsevierStyleItalic">P</span> value of less than .05 was considered statistically significant. All the results were analyzed using SPSS for Windows (version 22.0) and the R statistic program (version 2.15.0.)</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0080" class="elsevierStylePara elsevierViewall">The translation, cultural adaptation, and backtranslation phase was completed without disagreements between the evaluators. The comprehension test was performed by administering the prefinal version of the questionnaire to 38 individuals (66.7% men and 33.3% women) with a mean (SD) age of 63.7 (8.34) years. Only 1 item required clarification, and this was not related to language.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The final version of the AKQoL in Spanish was completed by 621 patients. The patients’ characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Psychometric Properties: Internal and Construct Validity</span><p id="par0090" class="elsevierStylePara elsevierViewall">A Cronbach α of 0.84 was obtained for internal consistency. The interitem and item-scale coefficients were similar to those obtained for the original Danish scale. Correlation between the 3 domains of the Spanish AKQoL was also high, and the results were also similar to those of the original scale (<a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Test-Retest Reliability</span><p id="par0095" class="elsevierStylePara elsevierViewall">The correlation coefficient (Spearman rho) for test-retest reliability over 2 weeks was 0.932 and the Bland Altman plot of the scores from both questionnaires showed that the majority of individual differences were situated within the confidence limits of the mean (SD) difference of 0.22 (1.46) (95% CI, -2.64 to 3.08) points (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Concurrent Validity</span><p id="par0100" class="elsevierStylePara elsevierViewall">Eighty participants rated their QOL using both the Skindex-29 and the AKQoL, and obtained mean scores of 1.87 (4.07) and 1.97 (2.98), respectively. The correlation between the scores was 0.344 (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.002, Spearman rho), with an r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.118. Therefore, the proportion of shared variance between the 2 questionnaires was 11.8%.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Quality of Life</span><p id="par0105" class="elsevierStylePara elsevierViewall">The mean (SD) AKQoL score for the full sample was 5.25 (4.73). A minimum score of 0 was obtained in 110 cases (17.7%) and a maximum score of 25 was obtained in 1 case (0.2%). The mean scores per domain were 1.87 (1.7) for function (range, 0-8), 1.88 (1.97) for emotions (range, 0-9), and 1.14 (1.3) for control (range, 0-6).</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Predictive Validity</span><p id="par0110" class="elsevierStylePara elsevierViewall">Patients with AK diagnosed by a dermatologist scored significantly higher on the AKQoL than members of the general population (mean [SD] score of 6.05 [4.64] vs 2.35 [3.8], <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0001).</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">The use of instruments to measure QOL and different aspects of health care is essential for both research purposes and for improving understanding of patient-related factors outside strictly clinical contexts. Conditions like AK are common reasons for consultation in routine practice, evidencing their impact. These conditions are chronic, affect visible parts of the body, frequently cause symptoms, and are invariably associated with local treatment-related adverse effects of varying severity.</p><p id="par0120" class="elsevierStylePara elsevierViewall">We have produced a validated, culturally adapted questionnaire with adequate levels of internal consistency and high specificity for AK for use among patients with this disease in our setting.</p><p id="par0125" class="elsevierStylePara elsevierViewall">According to the data in the literature,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> the AKQoL is the first specific HRQOL tool for patients with AK to be validated and adapted for use in Spanish. Not only is it semantically, conceptually, and culturally equivalent to the original questionnaire, but it also identifies differences between patients with AK diagnosed by a dermatologist.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Because AK is an incipient disease with a risk of malignancy, numerous aspects of its impact on QOL are not typically considered in other scales and questionnaires. De Troya-Martín et al.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> recently published the Spanish version of the Skin Cancer Index for measuring the QOL of patients with cervicofacial nonmelanoma skin cancer. The Skin Cancer Index has certain similarities to the AKQoL, not just because of the pathophysiological association between the 2 conditions, but also because of their possible psychological impact. The Skin Cancer Index, however, which has adequate psychometric properties, contains items that are specific to malignant lesions (e.g., evaluation of aspects such as metastasis and the physical, occupational, and social consequences of surgery) and not generalizable to AK.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our evaluation of the psychometric properties of the Spanish AKQoL shows sufficient homogeneity between items and between each of the scales in relation to the original questionnaire. The low correlation with the Skindex-29, which is a generic scale with good psychometric properties, suggests that the AKQoL is highly specific for AK. A previous study of the AKQoL in patients in Denmark showed negative and nonsignificant correlations between raw scores on this questionnaire and other questionnaires, such as the EQ-5D.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> In addition, the mean scores obtained for the Spanish AKQoL and the Skindex-29 show much lower floor and ceiling effects for the AKQoL. Therefore, considering our results and those reported in the literature, the Spanish version of the AKQoL can be considered a complementary tool, as it measures distinct HRQOL factors.</p><p id="par0140" class="elsevierStylePara elsevierViewall">One limitation of our study is that it was not possible to replicate the results of the factor analysis performed by Esmann et al.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> using a Rasch model. To compensate for this limitation, we applied nonparametric Spearman correlation tests to assess correlations between domains and compared our results to those of Esmann et al.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Apart from the procedures established for the validation of the AKQol and the questionnaire scores showing that AK has an impact on patient QOL, we would like to draw attention to the fact that women scored higher on average than men, although the difference was not statistically significant. Although these comparisons were not the object of our study, they do open the door to further research focusing on different aspects of QOL in patients with AK.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of Interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres824803" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec821279" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres824804" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec821280" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Objective" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Material and Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Adaptation of the AKQoL" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Validation of the Spanish AKQoL" ] ] ] 7 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Psychometric Properties: Internal and Construct Validity" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Test-Retest Reliability" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Concurrent Validity" ] 3 => array:2 [ "identificador" => "sec0050" "titulo" => "Quality of Life" ] 4 => array:2 [ "identificador" => "sec0055" "titulo" => "Predictive Validity" ] ] ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of Interest" ] 10 => array:2 [ "identificador" => "xack276604" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-10" "fechaAceptado" => "2016-03-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec821279" "palabras" => array:4 [ 0 => "Actinic keratosis" 1 => "Quality of life" 2 => "Validation study" 3 => "Spanish" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec821280" "palabras" => array:4 [ 0 => "Queratosis actínica" 1 => "Calidad de vida" 2 => "Estudio de validación" 3 => "Español" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">While there are questionnaires for evaluating the effects of skin cancer on patient quality of life, there are no specific questionnaires available in Spanish for evaluating quality of life in patients with actinic keratosis. The aim of this study was to translate and culturally adapt the Actinic Keratosis Quality of Life (AKQoL) questionnaire into Spanish.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The original questionnaire was translated into Spanish following the guidelines for the cross-cultural adaptation of self-report measures. Several measures of general reliability and validity were calculated, including Cronbach α for internal consistency and the Spearman rank-order correlation coefficient and a Bland-Altman plot for test-retest reliability. To test concurrent validity, we used the Pearson correlation coefficient to measure the correlation between AKQoL and Skindex-29 scores.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The final version of the questionnaire was administered to 621 patients with actinic keratosis, who scored a mean (SD) of 5.25 (4.73) points (total possible score, 0-25). The Cronbach α reliability coefficient analysis was 0.84. The correlation between the mean (SD) score on the Skindex-29 (1.87 [4.07]) and on the AKQoL (1.97 [2.98] was 0.344 (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.002, Spearman's rho), with a proportion of shared variance of 11.8%.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The translation, cross-cultural adaptation, and validation of the original AKQoL produced a reliable, easily understandable questionnaire for evaluating the impact of actinic keratosis on the quality of life of patients in our setting.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Actualmente existen cuestionarios para valorar el impacto en la calidad de vida en pacientes con cáncer cutáneo. Sin embargo, no se cuenta con un instrumento específico aplicable a casos con queratosis actínica. El objetivo de este estudio ha sido la traducción y adaptación transcultural del cuestionario <span class="elsevierStyleItalic">Actinic Keratosis Quality of Life</span> (AKQoL) al español.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El cuestionario original se tradujo al español de acuerdo con el modelo metodológico para la adaptación transcultural de medidas autoadministradas. Se han calculado diversos índices para la fiabilidad general y la validez, incluyendo el coeficiente alfa de Cronbach y test-retest (correlación de rango de Spearman y prueba de Bland-Altman), mientras que para la validez concurrente se utilizó el coeficiente de correlación de Pearson entre los resultados de los cuestionarios AKQoL y Skindex-29.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La versión final se administró a un total de 621 sujetos con queratosis actínica con una puntuación media ±<span class="elsevierStyleHsp" style=""></span>desviación estándar de 5,25<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4,73 (0 a 25 puntos). El análisis de fiabilidad mostró una alfa de Cronbach de 0,84. La correlación entre el Skindex-29 (1,87<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4,07) y AKQoL (1,97<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2,98) fue de 0,344 (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,002; rho de Spearman), con una proporción de varianza compartida del 11,8%.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Mediante los distintos procesos de traducción, adaptación transcultural y validación en distintos grupos hemos generado una herramienta comprensible y fiable para valorar el impacto de la queratosis actínica en la calidad de vida de pacientes de nuestro entorno.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as: Longo Imedio I,. Adaptación y validación de la versión española del cuestionario <span class="elsevierStyleItalic">Actinic Keratosis Quality of Life</span> (AKQoL). Actas Dermosifiliogr. 2016;107:474–481.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3813 "Ancho" => 2420 "Tamanyo" => 369557 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart showing process used to translate, culturally adapt, and validate the Actinic Quality of Life Questionnaire (AKQoL) in Spanish.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1211 "Ancho" => 1653 "Tamanyo" => 106601 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Bland-Altman plot showing test-retest reliability (interval of 2 wk). The continuous line shows the mean difference between the test and the retest scores and the dotted lines show the 95% limits of agreement (mean difference ±<span class="elsevierStyleHsp" style=""></span>1.96<span class="elsevierStyleHsp" style=""></span>SD).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3095 "Ancho" => 2587 "Tamanyo" => 581180 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">English Translation<span class="elsevierStyleSup">a</span> of the Final Spanish Version of the AKQoL.</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span><span class="elsevierStyleHsp" style=""></span>This English version is an unvalidated translation of the Spanish AKQoL, provided only for purposes of understanding the present study.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: AK, actinic keratosis; AKQoL, Actinic Keratosis Quality of Life.</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span> Values are presented as mean (SD) and total number (percentage) of patients and were all calculated using the total number of valid cases for each variable.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total Sample</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients With AK \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Individuals Without a Diagnosis of AK by a Dermatologist</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Total Cases, No.</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">621</td><td class="td" title="table-entry " align="left" valign="top">487 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Sex</span></td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>386 (62.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>307 (63%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>54 (56.25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25 (65.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>235 (37.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>180 (37%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>42 (43.75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13 (34.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age, mean (SD), y</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">71.52 (11.16)</td><td class="td" title="table-entry " align="left" valign="top">79.93 (10,11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62.3 (11.18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64.0 (8.27) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Level of education</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No schooling \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>128 (22.7%)</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>118 (24.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11 (13.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>247 (43.9%)</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>209 (43.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38 (45.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secondary education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>113 (20.1%)</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>90 (18.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23 (27.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Higher education \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>75 (13.3%)</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>65 (13.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11 (13.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Chronic disease under treatment</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>380 (68.0%)</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>354 (73.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26 (33.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Raw AKQoL scores</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">5.25 (4.73)</td><td class="td" title="table-entry " align="left" valign="top">6.05 (4.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.97 (2.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.31 (5.34) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">1.88 (1.71)</td><td class="td" title="table-entry " align="left" valign="top">2.08 (1.70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.02 (1.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.42 (1.90) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Emotions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">1.88 (1.97)</td><td class="td" title="table-entry " align="left" valign="top">2.22 (1.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.48 (1.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.05 (2.19) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " colspan="2" align="left" valign="top">1.14 (1.30)</td><td class="td" title="table-entry " align="left" valign="top">1.32 (1.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.38 (0.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.76 (1.32) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386700.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Characteristics of Sample and Quality of Life Scores.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Reliability-Internal Consistency</th></tr><tr title="table-row"><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Cronbach α Coefficient</th><th class="td" title="table-head " align="left" valign="top" scope="col">0.845 \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Item \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Interitem Correlations (Minimum and Maximum Values)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Item-Scale Correlation<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.194-0.400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.520 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.247-0.543 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.678 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.360-0.624 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.660 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.320-0.547 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.820 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.187-0.442 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.497 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.243-0.496 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.626 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.255-0.506 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.702 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.302-0.624 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.608 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.187-0.547 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.717 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Test-retest reliability (2-wk interval)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Spearman rho coefficient</td><td class="td" title="table-entry " align="char" valign="top">0.932 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386699.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Spearman correlation coefficients.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001 for all correlations.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Psychometric Characteristics of the Spanish Actinic Keratosis Quality of Life Questionnaire.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Function</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Emotions</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Spanish AKQoL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AKQoL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Spanish AKQoL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AKQoL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Spanish AKQoL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AKQoL \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.652<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.530 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.533<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.427 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Emotions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.652<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.530 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.568<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.533<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.427 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.568<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386698.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Spearman correlation coefficients; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.01 for all correlations for the Spanish AKQoL.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Correlations<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a> Between Domains in the Spanish Version of the Actinic Keratosis Quality of Life Questionnaire (AKQoL) and Results for the Original Questionnaire.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0085" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality of life in dermatology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Halioua" 1 => "M.G. Beumont" 2 => "F. Lunel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2000" "volumen" => "39" "paginaInicial" => "801" "paginaFinal" => "806" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11123437" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0090" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measuring health-related quality of life" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.H. Guyatt" 1 => "D.H. Feeny" 2 => "D.L. Patrick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med." "fecha" => "1993" "volumen" => "118" "paginaInicial" => "622" "paginaFinal" => "629" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8452328" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0095" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I.B. Wilson" 1 => "P.D. Cleary" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA." "fecha" => "1995" "volumen" => "273" "paginaInicial" => "59" "paginaFinal" => "65" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7996652" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0100" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calidad de vida relacionada con la salud: Elementos conceptuales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Urzúa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "/S0034-98872010000300017" "Revista" => array:6 [ "tituloSerie" => "Rev Med Chile." "fecha" => "2010" "volumen" => "138" "paginaInicial" => "358" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20556342" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0105" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spanish adaptation of the European guidelines for the evaluation and treatment of actinic keratosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Ferrándiz" 1 => "E. Fonseca-Capdevila" 2 => "A. García-Diez" 3 => "C. Guillén-Barona" 4 => "I. Belinchón-Romero" 5 => "P. Redondo-Bellón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosiliogr" "fecha" => "2014" "volumen" => "105" "paginaInicial" => "378" "paginaFinal" => "393" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0110" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La versión española de Skindex-29. Un instrumento de medida de la calidad de vida en pacientes con enfermedades cutáneas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Jones-Caballero" 1 => "P.F. Peñas" 2 => "A. García-Díez" 3 => "M.M. Chren" 4 => "X. Badía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)." "fecha" => "2002" "volumen" => "118" "paginaInicial" => "5" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11803004" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0115" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adaptación transcultural al español del cuestionario <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> (DLQI): El Índice de Calidad de Vida en Dermatología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.G. De Tiedra" 1 => "J. Mercadal" 2 => "X. Badía" 3 => "J.M. Mascaró" 4 => "M. Herdman" 5 => "R. Lozano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "1998" "volumen" => "89" "paginaInicial" => "692" "paginaFinal" => "700" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0120" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of a quality-of-life instrument for patients with nonmelanoma skin cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.S. Rhee" 1 => "B.A. Matthews" 2 => "M. Neuburg" 3 => "B.R. Logan" 4 => "M. Burzynski" 5 => "A.B. Nattinger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archfaci.8.5.314" "Revista" => array:6 [ "tituloSerie" => "Arch Facial Plast Surg." "fecha" => "2006" "volumen" => "8" "paginaInicial" => "314" "paginaFinal" => "318" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16982987" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0125" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spanish version of the Skin Cancer Index. A questionnaire for measuring quality of life in patients with cervicofacial non-melanoma skin cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. De Troya-Martín" 1 => "F. Rivas-Ruiz" 2 => "Blázquez Sánchez-N" 3 => "I. Fernández-Canedo" 4 => "M. Aguilar-Bernier" 5 => "J.B. Repiso Jiménez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.13173" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2015" "volumen" => "172" "paginaInicial" => "160" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24910357" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0130" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing the influence of actinic keratosis on patients’ quality of life: The AKQoL questionnaire" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Esmann" 1 => "G.R. Vinding" 2 => "K.B. Christensen" 3 => "G.B. Jemec" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.12036" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2013" "volumen" => "168" "paginaInicial" => "277" "paginaFinal" => "283" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22962980" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0135" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calidad de vida (II). Calidad de vida en Dermatología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Jones-Caballero" 1 => "P.F. Peñas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2002" "volumen" => "93" "paginaInicial" => "481" "paginaFinal" => "489" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0140" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Badia X, Salamero M, Alonso J. La medida de la salud. Guía de escalas de medición en español. 3.<span class="elsevierStyleSup">a</span> edición, Barcelona 2002." ] ] ] 12 => array:3 [ "identificador" => "bib0145" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the process of cross-cultural adaptation of self-report measures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.E. Beaton" 1 => "C. Bombardier" 2 => "F. Guillemin" 3 => "M.B. Ferraz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine." "fecha" => "2000" "volumen" => "25" "paginaInicial" => "3186" "paginaFinal" => "3191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11124735" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0150" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cultural adaptation of instruments utilized in occupational health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.M.C. Alexandre" 1 => "E.B. Guirardello" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Rev Panam Salud Publica" "fecha" => "2002" "volumen" => "11" "paginaInicial" => "109111" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0155" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Minimum Sample Size for Cronbach's Coefficient Alpha: A Monte-Carlo Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Yurdugul" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "HUJ Education" "fecha" => "2008" "volumen" => "35" "paginaInicial" => "397" "paginaFinal" => "405" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0160" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health related quality of life in patients with actinic keratosis—an observational study of patients treated in dermatology specialist care in Denmark" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.R. Tennvall" 1 => "J.M. Norlin" 2 => "I. Malmberg" 3 => "A.M. Erlendsson" 4 => "M. Hædersdal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12955-015-0295-4" "Revista" => array:5 [ "tituloSerie" => "Health Qual Life Outcomes." "fecha" => "2015" "volumen" => "13" "paginaInicial" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26220553" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack276604" "titulo" => "Acknowledgments" "texto" => "<p id="par0155" class="elsevierStylePara elsevierViewall">We would like to thank all the health care professionals and patients who participated in the different cultural adaptation and validation phases of the study. We would also like to thank Dr Martí Gil for designing and helping with the psychometric evaluation and Dr Larios for providing editorial assistance during preparation of the manuscript. Both doctors work in the Medical Department of Clever Instruments SL in Barcelona.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000006/v2_201704050141/S1578219016300865/v2_201704050141/en/main.assets" "Apartado" => array:4 [ "identificador" => "23902" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010700000006/v2_201704050141/S1578219016300865/v2_201704050141/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016300865?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 11 | 17 |
| 2024 Octubre | 66 | 35 | 101 |
| 2024 Septiembre | 77 | 28 | 105 |
| 2024 Agosto | 107 | 38 | 145 |
| 2024 Julio | 77 | 34 | 111 |
| 2024 Junio | 82 | 23 | 105 |
| 2024 Mayo | 82 | 32 | 114 |
| 2024 Abril | 77 | 21 | 98 |
| 2024 Marzo | 71 | 30 | 101 |
| 2024 Febrero | 57 | 37 | 94 |
| 2024 Enero | 79 | 38 | 117 |
| 2023 Diciembre | 65 | 17 | 82 |
| 2023 Noviembre | 80 | 25 | 105 |
| 2023 Octubre | 63 | 21 | 84 |
| 2023 Septiembre | 64 | 30 | 94 |
| 2023 Agosto | 62 | 18 | 80 |
| 2023 Julio | 69 | 39 | 108 |
| 2023 Junio | 83 | 30 | 113 |
| 2023 Mayo | 102 | 32 | 134 |
| 2023 Abril | 57 | 17 | 74 |
| 2023 Marzo | 83 | 22 | 105 |
| 2023 Febrero | 73 | 26 | 99 |
| 2023 Enero | 51 | 26 | 77 |
| 2022 Diciembre | 67 | 39 | 106 |
| 2022 Noviembre | 77 | 30 | 107 |
| 2022 Octubre | 30 | 76 | 106 |
| 2022 Septiembre | 21 | 63 | 84 |
| 2022 Agosto | 29 | 35 | 64 |
| 2022 Julio | 27 | 38 | 65 |
| 2022 Junio | 21 | 21 | 42 |
| 2022 Mayo | 64 | 39 | 103 |
| 2022 Abril | 41 | 31 | 72 |
| 2022 Marzo | 43 | 47 | 90 |
| 2022 Febrero | 29 | 32 | 61 |
| 2022 Enero | 39 | 42 | 81 |
| 2021 Diciembre | 27 | 42 | 69 |
| 2021 Noviembre | 28 | 39 | 67 |
| 2021 Octubre | 40 | 58 | 98 |
| 2021 Septiembre | 26 | 51 | 77 |
| 2021 Agosto | 18 | 28 | 46 |
| 2021 Julio | 21 | 29 | 50 |
| 2021 Junio | 31 | 33 | 64 |
| 2021 Mayo | 39 | 58 | 97 |
| 2021 Abril | 90 | 39 | 129 |
| 2021 Marzo | 54 | 26 | 80 |
| 2021 Febrero | 40 | 20 | 60 |
| 2021 Enero | 37 | 16 | 53 |
| 2020 Diciembre | 23 | 12 | 35 |
| 2020 Noviembre | 24 | 22 | 46 |
| 2020 Octubre | 29 | 9 | 38 |
| 2020 Septiembre | 27 | 12 | 39 |
| 2020 Agosto | 19 | 20 | 39 |
| 2020 Julio | 29 | 16 | 45 |
| 2020 Junio | 28 | 28 | 56 |
| 2020 Mayo | 31 | 18 | 49 |
| 2020 Abril | 33 | 30 | 63 |
| 2020 Marzo | 39 | 32 | 71 |
| 2020 Febrero | 11 | 1 | 12 |
| 2020 Enero | 2 | 0 | 2 |
| 2019 Diciembre | 9 | 0 | 9 |
| 2019 Noviembre | 2 | 0 | 2 |
| 2019 Septiembre | 8 | 0 | 8 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 6 | 0 | 6 |
| 2019 Mayo | 7 | 1 | 8 |
| 2019 Abril | 2 | 2 | 4 |
| 2019 Marzo | 2 | 5 | 7 |
| 2019 Febrero | 1 | 0 | 1 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 4 | 0 | 4 |
| 2018 Noviembre | 10 | 0 | 10 |
| 2018 Octubre | 58 | 0 | 58 |
| 2018 Septiembre | 8 | 0 | 8 |
| 2018 Febrero | 18 | 3 | 21 |
| 2018 Enero | 33 | 8 | 41 |
| 2017 Diciembre | 32 | 8 | 40 |
| 2017 Noviembre | 23 | 10 | 33 |
| 2017 Octubre | 23 | 8 | 31 |
| 2017 Septiembre | 21 | 4 | 25 |
| 2017 Agosto | 23 | 9 | 32 |
| 2017 Julio | 20 | 5 | 25 |
| 2017 Junio | 31 | 13 | 44 |
| 2017 Mayo | 32 | 10 | 42 |
| 2017 Abril | 26 | 8 | 34 |
| 2017 Marzo | 17 | 24 | 41 |
| 2017 Febrero | 11 | 11 | 22 |
| 2017 Enero | 16 | 5 | 21 |
| 2016 Diciembre | 38 | 19 | 57 |
| 2016 Noviembre | 36 | 20 | 56 |
| 2016 Octubre | 22 | 21 | 43 |
| 2016 Julio | 2 | 6 | 8 |
Mostrar todo
