Quality of Life Perception among Portuguese Celiac Patients: A Cross-Sectional Study Using the Celiac Disease Questionnaire (CDQ)

Abstract

The aim of this study is to assess Portuguese celiac patients’ quality of life (QoL) perception. A cross-sectional study was performed with a non-probability convenience sample of Portuguese celiac patients using an online self-administered celiac disease quality of life questionnaire (CDQ), previously validated for the Portuguese population. The final sample comprised 234 celiac patients, which included the following: primarily women (69.2%); aged between 18 and 49 years old (56.4%); with a partner (60.6%); with a high educational level (58.9%—graduated or post-graduated); following a gluten-free diet (GFD) (55.1%); and not using antidepressants (93.1%). The Portuguese CDQ presented good reliability and responsiveness in this sample of Portuguese celiac patients. In general, the CDQ in Portugal was affected by age at diagnosis (p = 0.017), educational level (p = 0.005), and compliance with GFD (p = 0.034). The emotion domain was affected only by using antidepressants (p = 0.036). The social domain was affected by gender (females had lower rates, p = 0.016), age at diagnosis (p = 0.009), educational level (p = 0.000), and compliance with a GFD (p = 0.002). The worries domain did not differ according to socioeconomic data. The symptoms domain was affected by compliance with GFD (p = 0.000), age at diagnosis (p = 0.000), and educational level (p = 0.014). Data on celiac QoL is essential to support the formulation and implementation of strategies to minimize the issues suffered by celiac patients, lowering their physical, emotional, and social burden. Additionally, data on Portuguese celiac disease patients using the CDQ will allow future comparative research among celiac populations from different countries.

Enhancing life with celiac disease: unveiling effective tools for assessing health-related quality of life

“…Throughout various studies conducted in different countries, the CDQ was used for measuring HRQOL in its original version, developed and validated in Germany ( 17 ), and has also been translated, culturally adapted, and validated to a diverse range of populations. The adapted versions were applied to populations in Italy ( 25 , 26 , 46 ), Portugal ( 28 , 53 ), France ( 29 , 51 ), Turkey, Brazil ( 21 , 45 ), Poland ( 9 ), Iran ( 38 ), Argentina ( 43 ), Morocco ( 52 ), and Spain ( 50 ). Furthermore, the original CDQ was employed in studies conducted in Germany ( 17 ), Italy ( 23 ), Poland ( 9 ), Australia ( 40 ), Hungary ( 47 ), UK ( 8 ).…”

“…The CD populations that presented the highest and lowest CDQ scores were Italian (159 score) ( 26 ) and Portuguese (103 score) ( 53 ). As the instrument has been applied only once in Portugal, it is not possible to compare the QOL scores over time.…”

“…As the instrument has been applied only once in Portugal, it is not possible to compare the QOL scores over time. However, as the data was collected during COVID-19 pandemic, it could have negatively interfered with the score, especially over the social domain punctuation ( 53 ). However, as discussed by the Portuguese study, isolation can have a positive effect on GFD adherence, and it can be analyzed in Brazilian scores ( 53 ).…”

Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires

“…Considering the specific questionnaires to measure CD patients' QoL, the Celiac Disease Questionnaire (CDQ) is broadly applied (11,23) that used SF-36 in its validation process (13). CDQ was developed, validated and applied in Germany ( 2006) and later, it was translated and applied in several European and Extra-European countries (5,6,15,23,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). In Portugal, a study translated and validated the CDQ into Portuguese (41) and our previous study evaluated the quality of life (QoL) perception among Portuguese celiac patients using this Portuguese version of CDQ (42).…”

“…CDQ was developed, validated and applied in Germany ( 2006) and later, it was translated and applied in several European and Extra-European countries (5,6,15,23,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). In Portugal, a study translated and validated the CDQ into Portuguese (41) and our previous study evaluated the quality of life (QoL) perception among Portuguese celiac patients using this Portuguese version of CDQ (42). Furthermore, a separate study conducted in Portugal utilized the general questionnaire SF-36 to assess the perception of QoL in a sample of 195 Portuguese celiacs regarding compliance with a gluten-free diet (GFD) (44).…”