Reliability and Validity of the ESRD Symptom Checklist -- Transplantation Module in Norwegian kidney transplant recipients

Knut Stavem; * Rüdiger Ganss


BMC Nephrology 

In This Article

Abstract and Background


Background. The aim of the study was to validate the Norwegian version of a self-administered 43-item questionnaire designed to assess quality of life in kidney transplant recipients, the End-Stage Renal Disease Symptom Checklist -- Transplantation Module (ESRD-SCL).
Methods. In total, 53 kidney transplant recipients from one university-affiliated hospital responded to a questionnaire including the ESRD-SCL and the Short Form 36 (SF-36). We assessed internal consistency reliability and test-retest reliability with 2 weeks between assessments. Construct validity was assessed by correlations of the ESRD-SCL subscales with related and unrelated SF-36 scales, demographic, and clinical characteristics.
Results. Subscales of the ESRD-SCL showed good internal consistency reliability (Cronbach's = 0.72–0.81) and for the aggregate total scale α was 0.94. Test-retest reliability median 14 days apart was excellent with intraclass coefficients ranging from 0.87 to 0.95. The pattern of correlations of the ESRD-SCL scales with related and unrelated scales SF-36 scales and demographic and clinical characteristics gave support to the construct validity of the ESRD-SCL.
Conclusion. The Norwegian translation of the ESRD-SCL showed satisfactory internal consistency reliability, test-retest reliability and construct validity, at the level of the original German version.


Kidney transplantation has a positive impact on survival and morbidity of patients with end-stage renal disease. Recently, there has been increasing attention to health-related quality of life (HRQoL) as an important consideration in evaluating the impact of kidney transplantation. Kidney transplant recipients have better HRQoL than transplant candidates maintained on hemodialysis,[1,2] and they experience an improvement of HRQoL in the first months after transplantation.[3,4]

The HRQoL in kidney transplantation can be evaluated using generic tools, such as the Sickness Impact Profile (SIP), the Nottingham Health Profile (NHP) or the Short Form 36 (SF-36).[5] Some disease-specific tools for evaluation of HRQoL in relationship to renal transplantation have been developed, including the Kidney Transplant Questionnaire,[6] and the ESRD symptom checklist – transplantation module (ESRD-SCL) questionnaire.[7] Also, the Kidney Disease-Quality of Life (KDQOL) questionnaire is commonly used,[8,9,10] although it was not developed specifically for the evaluation of transplantation.

To conduct studies on HRQoL outcomes in kidney transplant patients, it is necessary to adapt relevant questionnaires and tools to the appropriate language and assess the psychometric properties of the questionnaires in relevant populations. Based on content analysis and available documentation, we identified the ESRD-SCL as a feasible questionnaire for use in kidney transplantation, in particular to evaluate the effects of immunosuppressant medication.[11]

The objective of the present study was to assess the reliability and construct validity of a Norwegian version of the ESRD-SCL in renal transplant recipients.


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