Development and Validation of the Anaphylaxis Quality of Life Scale for Adults


Background: Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. Objective: The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). Methods: All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). Results: The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α = 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). Conclusions: The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences
Additional Information: © 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license ( Funding: The project was paid for by a grant from the Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Uncontrolled Keywords: Adults,Anaphylaxis,Quality of life,Scale,Immunology and Allergy
Publication ISSN: 2213-2198
Last Modified: 27 May 2024 07:37
Date Deposited: 16 Mar 2022 10:38
Full Text Link:
Related URLs: https://www.sci ... 213219822002240 (Publisher URL)
PURE Output Type: Article
Published Date: 2022-06
Published Online Date: 2022-03-05
Accepted Date: 2022-02-09
Authors: Knibb, Rebecca C. (ORCID Profile 0000-0001-5561-0904)
Huissoon, Aarnoud P.
Baretto, Richard
Ekbote, Anjali
Onyango-Odera, Sham
Screti, Cassandra
Newman, Kristina L.
Krishna, Mamidipudi T.



Version: Accepted Version

License: Creative Commons Attribution

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