Validation of the chronic liver disease questionnaire in Serbian patients

Table 1 Demographic and clinical characteristics of patients with chronic liver disease n (%)

Characteristics	Statistics
Age1 (yr)	53.8 ± 12.9
Gender
Male	56 (54.4)
Female	47 (45.6)
Education
Unqualified2	6 (5.8)
Primary school	18 (17.5)
Secondary school	43 (41.7)
High school	17 (16.5)
University	18 (17.5)
Missing data	1 (1.0)
Current employment status
Employed	29 (28.2)
Unemployed	25 (24.3)
Retired	49 (47.5)
Profession
Housewife	13 (12.6)
Peasant	3 (2.9)
Worker	40 (38.8)
Official	21 (20.4)
Expert	21 (20.4)
Missing data	5 (4.9)
Marital status
Single	15 (14.6)
Married/cohabiting	68 (66.0)
Separated/divorced	13 (12.6)
Widowed	7 (6.8)
Alcohol consumption	56 (54.4)
Smoker	32 (31.1)
Disease severity
Non cirrhotic	23 (22.3)
Cirrhotic Child’s A	25 (24.3)
Cirrhotic Child’s B	30 (29.1)
Cirrhotic Child’s C	25 (24.3)
Etiology
Alcoholic	36 (35.0)
Viral	16 (15.5)3
Autoimmune/cholestatic	29 (28.2)
Other	22 (21.3)

¹mean ± SD;

²Without primary school;

³Four patients with hepatitis B surface antigen positive chronic liver disease (CLD) and 12 patients with anti-hepatitis C virus positive CLD.

Table 2 Distribution and reliability of the chronic liver disease guestionnaire

Scale	n	mean ± SD	Min value	Max value	Missing items1	Cronbach alpha
Abdominal symptoms	103	4.75 ± 1.63	1.33	7	0%	0.82
Fatigue	103	4.20 ± 1.60	1.60	7	0%	0.90
Systemic symptoms	101	5.27 ± 1.60	1.60	7	1.94%	0.74
Activity	103	4.47 ± 1.33	1.33	7	0%	0.49
Emotional function	103	4.61 ± 1.62	1.62	7	0%	0.89
Worry	103	4.24 ± 1.61	1.00	7	0%	0.85
CLDQ total	101	4.62 ± 1.11	1.90	6.78	1.94%	0.93

¹Proportion of patients with missing any item on the subscale. CLDQ: Chronic liver disease questionnaire.

Table 3 Exploratory factor analysis of the serbian version of the chronic liver disease questionnaire

Original CLDQ items	Factor 1 Systemic symptoms	Factor 2 Emotional function	Factor 3 Fatigue	Factor 4 Worry	Factor 5 Sleep	Factor 6 Nutrition
Fatigue
(2) tired or fatigued	0.542	0.173	0.63612	0.271	0.018	0.140
(4) sleepy during the day	0.105	0.200	0.86812	0.004	0.156	-0.012
(8) reduced strength	0.489	0.119	0.59512	0.310	-0.019	0.220
(11) decreased level of energy	0.374	0.159	0.60012	0.385	0.055	0.282
(13) drowsy	0.168	0.287	0.82412	0.114	0.172	-0.085
Emotional function
(10) anxious	0.313	0.52112	0.354	0.358	0.022	0.267
(12) unhappy	0.034	0.67712	0.283	0.284	0.096	0.264
(15) irritable	0.118	0.82312	0.157	0.082	0.036	0.091
(16) difficulty sleeping	0.256	0.184	0.175	0.229	0.74513	0.096
(19) mood fluctuations	0.127	0.79412	0.178	0.248	0.139	-0.042
(20) incapable to fall asleeP	0.252	0.183	0.123	0.155	0.82213	0.046
(24) felt depressed	0.162	0.81512	-0.003	0.288	0.203	0.092
(26) problem concentrating	0.161	0.69712	0.078	0.240	0.089	0.224
Worry
(18) impact on family	0.237	0.269	0.037	0.76012	0.081	0.036
(22) symptoms developing into major problems	0.153	0.361	0.170	0.69612	0.229	0.015
(25) condition getting worse	-0.028	0.269	0.188	0.79112	0.240	0.152
(28) never feeling any better	0.005	0.293	0.162	0.65912	0.151	0.232
(29) availability of a liver	-0.142	-0.018	0.103	0.59912	0.460	0.127
Abdominal symptoms
(1) abdominal bloating	0.76313	0.098	0.242	0.063	-0.041	0.074
(5) abdominal pain	0.78513	0.050	0.136	-0.054	0.207	0.110
(17) abdominal discomfort	0.81113	0.228	0.138	0.205	0.072	-0.049
Activity
(7) not able to eat as much as would like	0.186	0.406	0.175	0.066	-0.079	0.54313
(9) trouble lifting or carrying heavy objects	0.389	-0.105	0.48113	0.162	0.116	0.236
(14) restriction of diet	-0.073	0.182	0.100	0.212	0.199	0.70313
Systemic symptoms
(3) bodily pain	0.79812	0.103	0.116	0.097	0.121	-0.053
(6) shortness of breath in daily activities	0.367	0.296	0.43313	-0.047	0.083	0.389
(21) muscle cramps	0.47012	0.223	0.102	0.046	0.422	0.350
(23) dry mouth	0.55612	0.305	0.261	-0.065	0.316	0.172
(27) itching	0.252	0.011	-0.193	0.370	0.358	0.48113

¹Highest factor loadings for each factor;

²Factor loadings corresponding to the factors in the original version;

³Factor loadings indicate highest loadings on other factors than the original ones. The factors “activity” and “abdominal symptoms” could not be reproduced; a new factors “sleep” and “nutrition” were found. CLDQ: Chronic liver disease questionnaire.

Table 4 Distribution of chronic liver disease questionnaire-S score/sub-score according disease severity

	n	Abdominal symptoms	Fatigue	Systemic symptoms	Activity	Emotional function	Worry	Total score
Non cirrhotic	23	5.37 ± 1.391	4.81 ± 1.381	5.54 ± 1.14	4.80 ± 1.32	4.40 ± 1.52	4.23 ± 1.54	4.86 ± 1.05
Child's class A	25	5.08 ± 1.651	4.35 ± 1.30	5.34 ± 1.38	4.40 ± 1.39	4.62 ± 1.31	4.36 ± 1.70	4.69 ± 1.22
Child's class B	30	4.88 ± 1.581	4.18 ± 1.51	5.25 ± 1.34	4.37 ± 1.59	4.77 ± 1.30	4.27 ± 1.61	4.63 ± 1.17
Child's class C	25	3.68 ± 1.46	3.52 ± 1.45	4.95 ± 0.992	4.40 ± 1.37	4.60 ± 1.24	4.09 ± 1.65	4.31 ± 0.97
P value3		0.001	0.021	0.442	0.68	0.808	0.952	0.402

¹Significantly better score compared with “cirrhosis Child's C” score (post hoc analysis);

²For domain “systemic symptoms” (n = 23);

³P value for Analysis of variance.