Reliability and Validity of the Turkish Version of the CLEFT-Q in Patients with Cleft Lip and Palate: A Psychometric Evaluation
Serife Kiran Aydil, Beyza Tagrikulu, Asuman Deniz Gumru CelikelObjective
To evaluate the psychometric properties of the Turkish version of the CLEFT-Q in patients with cleft lip and palate.
Design
Cross-sectional psychometric validation study.
Setting
Single-center university hospital in Turkey.
Patients, Participants
A total of 138 Turkish-speaking patients aged 8–29 years with unilateral or bilateral CLP were included. A subgroup of 45 participants completed the questionnaire twice for test–retest reliability analysis.
Main Outcome Measures
Internal consistency (Cronbach's alpha, McDonald's omega, Guttman split-half), test–retest reliability (ICC(A,2)), structural validity via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), inter-scale correlations, and floor/ceiling effects were evaluated.
Results
All scales and the Eating/Drinking checklist demonstrated high internal consistency, with Cronbach's alpha values ranging from 0.868 to 0.964. ICC(A,2) values ranged from 0.858 to 0.972, indicating good-to-excellent test–retest reliability. EFA supported a unidimensional structure for all scales. CFA findings were heterogeneous: 3 scales (nostrils, teeth, and jaws) met all predefined criteria; several scales showed partial fit; the Eating/Drinking checklist showed consistently poor fit (root mean square error of approximation [RMSEA] = 0.123; standardized root mean square residual [SRMR] = 0.094). Clinically significant floor effects (≥15%) were observed for nostrils and cleft lip scar; ceiling effects for speech distress, psychological function, school, and social function. Inter-scale correlations were broadly consistent with the conceptual structure of the instrument.
Conclusions
The Turkish CLEFT-Q demonstrated satisfactory internal consistency and good-to-excellent test–retest reliability. Structural validity was variable across scales. The instrument provides partial psychometric support for scale-level use in research contexts; the Eating/Drinking checklist requires further evaluation.