RhinAsthma Patient Perspective: Cross-Cultural Adaptation and Validation of a Brief Rhinitis and Asthma Quality-of-Life Measure in Chinese Adults

@article{zhang2026rhinasthma,
  title = {{RhinAsthma Patient Perspective: Cross-Cultural Adaptation and Validation of a Brief Rhinitis and Asthma Quality-of-Life Measure in Chinese Adults}},
  author = {Zhang P and Zhang Y and Hu Y and Baiardini I and Braido F and Wang J and Chen T and Xie Y},
  journal = {Journal of Asthma and Allergy},
  year = {2026},
  month = nov,
  url = {https://www.dovepress.com/rhinasthma-patient-perspective-cross-cultural-adaptation-and-validatio-peer-reviewed-fulltext-article-JAA},
  note = {CC BY},
}

TY  - JOUR
TI  - RhinAsthma Patient Perspective: Cross-Cultural Adaptation and Validation of a Brief Rhinitis and Asthma Quality-of-Life Measure in Chinese Adults
AU  - Zhang P
AU  - Zhang Y
AU  - Hu Y
AU  - Baiardini I
AU  - Braido F
AU  - Wang J
AU  - Chen T
AU  - Xie Y
PY  - 2026
DA  - 2026/11/08
JO  - Journal of Asthma and Allergy
UR  - https://www.dovepress.com/rhinasthma-patient-perspective-cross-cultural-adaptation-and-validatio-peer-reviewed-fulltext-article-JAA
AB  - Peng Zhang,1,2 Yiyin Zhang,1,2 Yiyang Hu,1,2 Ilaria Baiardini,3 Fulvio Braido,4 Jiajia Wang,1,2,5 Tao Chen,2,6 Yang Xie1,2,5 1Lung Disease Diagnosis and Treatment Center, National Medical Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 2Henan International Joint Laboratory of Evidence-Based Evaluation for Respiratory Diseases, Henan Province Clinical Research Center for Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 3Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova – Azienda Policlinico IRCCS San Martino, Genova, Italy; 4Department of Biomedical Sciences, Humanitas University, Milan, Italy; 5Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 6Global Health Trials Unit, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UKCorrespondence: Yang Xie, Lung Disease Diagnosis and Treatment Center, National Medical Center, The First Affiliated Hospital of Henan University of Chinese Medicine, No. 19 Renmin Road, Zhengzhou, Henan, 450000, People’s Republic of China, Email [email protected]: Combined allergic rhinitis and asthma syndrome (CARAS) impairs health-related quality of life (HRQoL). The 8-item RhinAsthma Patient Perspective (RAPP) measures their combined impact. We translated and culturally adapted the RAPP for China and evaluated its psychometric properties.Methods: Following International Society for Pharmacoeconomics and Outcomes Research principles, the RAPP was translated from Italian into simplified Chinese and cognitively debriefed. Psychometric evaluation included 164 adults with comorbid allergic rhinitis and asthma; 80 with isolated allergic rhinitis and 80 with isolated asthma served as exploratory comparators. Internal consistency, 2-week test-retest reliability, structural, convergent, and discriminant validity, 4-week responsiveness, sex-related differential item functioning (DIF), item response theory (IRT) characteristics, and feasibility were evaluated. In participants with both conditions, responsiveness was assessed after 4 weeks of individualized, consensus-guided traditional Chinese medicine treatment based on syndrome differentiation.Results: Internal consistency (Cronbach α = 0.876) and test‑retest reliability (intraclass correlation coefficient = 0.835) were good. Confirmatory factor analysis supported a single-factor structure (comparative fit index = 0.983; root mean square error of approximation = 0.053). RAPP scores correlated with RQLQ (r = 0.613), AQLQ (r = − 0.659), and ACT (r = − 0.772; all P < 0.001) and differed across clinical phases and asthma-control levels. Distribution-based indices indicated sensitivity to change (effect size = 0.41; standardized response mean = 0.79). IRT parameters were acceptable overall, although item 7, which assesses the burden of having to take medication, provided less information. No sex-related DIF was detected. Mean completion time was 1.89 minutes.Conclusion: The simplified Chinese RAPP demonstrated acceptable reliability, validity, and feasibility, with preliminary evidence of responsiveness, in adults with CARAS. Its brief format supports routine clinical assessment, follow-up monitoring, and outcome evaluation in research.Plain Language Summary: Why was the study done? People who have both allergic rhinitis and asthma can experience connected upper- and lower-airway symptoms that interfere with sleep, concentration, work, exercise, and other daily activities. The brief RhinAsthma Patient Perspective questionnaire measures this combined burden, but a validated Chinese version was not available.What did the researchers do and find? We translated the 8-item questionnaire into simplified Chinese, checked that patients understood it, and tested it in 164 adults with both conditions. We also included 80 adults with allergic rhinitis alone and 80 with asthma alone for exploratory comparisons. The Chinese questionnaire produced consistent scores, remained stable over 2 weeks in clinically controlled participants, agreed with established quality-of-life and asthma-control questionnaires, detected improvement over 4 weeks, and usually took less than 2 minutes to complete.What do the results mean? The Chinese questionnaire offers clinicians and researchers a short way to understand how combined allergic rhinitis and asthma affect daily life. It is intended to measure patient-perceived burden and change over time, not to diagnose disease. Larger studies in different regions are needed to confirm how well it performs over longer periods and to define the smallest change that matters to patients.Keywords: combined allergic rhinitis and asthma syndrome, allergic rhinitis, asthma, health-related quality of life, patient-reported outcome measures, psychometric validation
SN  - 1178-6965
ER  -