Psychometric properties of kidney disease quality of life-36 (KDQOL-36) in dialysis patients in Indonesia

Abstract

Objective: The study aimed to evaluate the psychometric properties of KDQOL-36 Bahasa Indonesia in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients in Indonesia. Methods: The psychometric analysis was conducted in three hospitals offering both HD and CAPD. The validity was assessed through structural, convergent, and known-group validity, while reliability was evaluated using internal consistency and test–retest reliability. Results: The study involved 370 participants of which 71% received HD treatment. No floor and ceiling effects (< 10%) were identified. Confirmatory factor analysis supported a good model fit for both generic and kidney-specific domains, while exploratory factor analysis revealed three factors for kidney-specific domains and only three items with a loading factor below 0.4. Convergent validity showed positive correlations between kidney-specific domains, generic domains, and EQ-5D. The comparison of quality of life among subgroups based on dialysis type and whether or not patients had diabetes supported the hypotheses of known-group validity. Cronbach’s alpha and omega values had demonstrated good internal consistency. Test–retest reliability indicated burden of kidney disease had good reliability, while other domains had moderate reliability. Conclusion: The study supports the validity and reliability of both generic and kidney-specific domains of KDQOL-36 Bahasa Indonesia to evaluate quality of life in patients with HD and CAPD in Indonesia. As health-related quality of life is a crucial predictor of patient outcomes, this report contributes new evidence about validity and reliability to recommend the use of KDQOL-36 Bahasa Indonesia in dialysis centers.