{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:24:19Z","timestamp":1789093459639,"version":"build-2803163510"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003356","name":"Gazi University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003356","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to adapt and validate the Cryptoglandular Anal Fistula Quality of Life (AF-QoL) scale for Turkish-speaking patients, providing a disease-specific, patient-reported outcome measure (PROM) to assess quality of life (QoL) in cryptoglandular anal fistula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective, multicenter, cross-sectional study was conducted across seven tertiary centers in T\u00fcrkiye. The 22-item AF-QoL scale, originally validated in English, was translated and culturally adapted into Turkish following Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, including expert consensus and a pilot study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910). A total of 220 Turkish-speaking adults with cryptoglandular anal fistula completed the scale. Structural validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed using Cronbach\u2019s alpha, and item\u2013total correlations. Test\u2013retest reliability was evaluated in a clinically stable subgroup of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EFA confirmed a six-domain structure, comprising psychological impact, everyday activities, unpredictability\/disease control, seton-related issues, social limitations, and discharge\/discomfort, explaining 69.2% of the total variance. CFA demonstrated an acceptable overall model fit (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \/\n                      <jats:italic>df<\/jats:italic>\n                      \u2009=\u20091.94, root mean square error of approximation [RMSEA]\u2009=\u20090.048, Comparative Fit Index [CFI]\u2009=\u20090.945, standardized root mean square residual [SRMR]\u2009=\u20090.035). The Turkish AF-QoL demonstrated high internal consistency (Cronbach\u2019s\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.828), satisfactory item\u2013total correlations (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.32\u20130.76), and good test\u2013retest reliability (intraclass correlation coefficient\u2009=\u20090.74), indicating temporal stability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Turkish version of the AF-QoL demonstrates satisfactory reliability and structural validity for use in Turkish patients with cryptoglandular anal fistula. This cross-cultural validation provides a disease-specific PROM suitable for clinical and research applications. Further studies assessing additional measurement properties, including structural validity, measurement error, and responsiveness, are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>This study was not a clinical trial and thus was not registered in a clinical trial registry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-026-03321-9","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:47:26Z","timestamp":1777891646000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cross-cultural validation and reliability of the Turkish version of the anal fistula quality of life scale for cryptoglandular anal fistula"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-3718","authenticated-orcid":false,"given":"E.","family":"Erg\u00fcder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0680-0589","authenticated-orcid":false,"given":"S.","family":"Levento\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5993-9536","authenticated-orcid":false,"given":"A.","family":"Renc\u00fczo\u011fullar\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9754-8755","authenticated-orcid":false,"given":"B.","family":"G\u00fclc\u00fc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6417-8949","authenticated-orcid":false,"given":"B.","family":"Mente\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3941-5268","authenticated-orcid":false,"given":"C.","family":"Akyol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5854-6549","authenticated-orcid":false,"given":"\u00c7. E.","family":"\u015eahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8593-5101","authenticated-orcid":false,"given":"E.","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Pelgur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-2461","authenticated-orcid":false,"given":"\u0130.","family":"Ayd\u0131n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-7740","authenticated-orcid":false,"given":"\u0130. Cem","family":"Eray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-5035","authenticated-orcid":false,"given":"\u00d6.","family":"I\u015f\u0131k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-4228","authenticated-orcid":false,"given":"T.","family":"Bi\u015fgin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6481-1473","authenticated-orcid":false,"given":"U.","family":"\u00d6zgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9172-0545","authenticated-orcid":false,"given":"U.","family":"Sungurtekin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"3321_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/codi.16741","volume":"26","author":"L Reza","year":"2024","unstructured":"Reza L, Gottgens K, Kleijnen J, Breukink S, Ambe PC, Aigner F, Aytac E, Bislenghi G, Nordholm-Carstensen A, Elfeki H, Gallo G, Grossi U, Gulcu B, Iqbal N, Jimenez-Rodriguez R, Leventoglu S, Lisi G, Litta F, Lung P, Millan M, Ozturk E, Sackitey C, Shalaby M, Stijns J, Tozer P, Zimmerman D (2024) European Society of Coloproctology: guidelines for diagnosis and treatment of cryptoglandular anal fistula. Colorectal Dis 26:145\u2013196. https:\/\/doi.org\/10.1111\/codi.16741","journal-title":"Colorectal Dis"},{"key":"3321_CR2","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.cireng.2017.12.006","volume":"96","author":"M Ferrer-M\u00e1rquez","year":"2018","unstructured":"Ferrer-M\u00e1rquez M, Esp\u00ednola-Cort\u00e9s N, Reina-Duarte \u00c1, Granero-Molina J, Fern\u00e1ndez-Sola C, Hern\u00e1ndez-Padilla JM (2018) Analysis and description of disease-specific quality of life in patients with anal fistula. Cirug\u00eda Espa\u00f1ola (English Edition) 96:213\u2013220. https:\/\/doi.org\/10.1016\/j.cireng.2017.12.006","journal-title":"Cirug\u00eda Espa\u00f1ola (English Edition)"},{"key":"3321_CR3","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1111\/codi.16917","volume":"26","author":"N Iqbal","year":"2024","unstructured":"Iqbal N, Alrubaiy L, Hart A, Siviter R, Wilson L, Tozer P (2024) The development of a cryptoglandular anal fistula quality of life scale (AF-QoL). Colorectal Dis 26:716\u2013725. https:\/\/doi.org\/10.1111\/codi.16917","journal-title":"Colorectal Dis"},{"key":"3321_CR4","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","volume":"30","author":"JE Ware Jr","year":"1992","unstructured":"Ware JE Jr, Sherbourne CD (1992) The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473\u2013483","journal-title":"Med Care"},{"key":"3321_CR5","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.1007\/s00464-025-11585-9","volume":"39","author":"KM S\u00f8rensen","year":"2025","unstructured":"S\u00f8rensen KM, Qvist N (2025) Fistulectomy and primary sphincter reconstruction for high cryptoglandular anal fistula: a retrospective cohort study with long-term results. Surg Endosc 39:2073\u20132079. https:\/\/doi.org\/10.1007\/s00464-025-11585-9","journal-title":"Surg Endosc"},{"key":"3321_CR6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/BF02237236","volume":"43","author":"TH Rockwood","year":"2000","unstructured":"Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG et\u00a0al (2000) Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9\u201316. https:\/\/doi.org\/10.1007\/BF02237236","journal-title":"Dis Colon Rectum"},{"key":"3321_CR7","volume-title":"Health measurement scales: a practical guide to their development and use","author":"DL Streiner","year":"2000","unstructured":"Streiner DL, Norman GR, Cairney J (2000) Health measurement scales: a practical guide to their development and use. Oxford University Press, Oxford"},{"key":"3321_CR8","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1007\/s11136-021-02822-4","volume":"30","author":"JJ Gagnier","year":"2021","unstructured":"Gagnier JJ, Lai J, Mokkink LB, Terwee CB (2021) COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Qual Life Res 30:2197\u20132218. https:\/\/doi.org\/10.1007\/s11136-021-02822-4","journal-title":"Qual Life Res"},{"key":"3321_CR9","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/S0897-1897(05)80008-4","volume":"5","author":"LL Davis","year":"1992","unstructured":"Davis LL (1992) Instrument review: getting the most from a panel of experts. Appl Nurs Res 5:194\u2013197. https:\/\/doi.org\/10.1016\/S0897-1897(05)80008-4","journal-title":"Appl Nurs Res"},{"key":"3321_CR10","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","volume":"60","author":"CB Terwee","year":"2007","unstructured":"Terwee CB, Bot SD, de Boer MR, Van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34\u201342. https:\/\/doi.org\/10.1016\/j.jclinepi.2006.03.012","journal-title":"J Clin Epidemiol"},{"key":"3321_CR11","doi-asserted-by":"publisher","first-page":"628","DOI":"10.3390\/clinpract12040066","volume":"12","author":"N Iqbal","year":"2022","unstructured":"Iqbal N, Shah R, Alrubaiy L, Tozer P (2022) Do patient-reported quality-of-life (QoL) scales provide an adequate assessment of patients with cryptoglandular anal fistulae? A systematic review of measurement instruments and their content validity. Clin Pract 12:628\u2013639. https:\/\/doi.org\/10.3390\/clinpract12040066","journal-title":"Clin Pract"},{"key":"3321_CR12","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.jclinepi.2010.02.006","volume":"63","author":"LB Mokkink","year":"2010","unstructured":"Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737\u2013745. https:\/\/doi.org\/10.1016\/j.jclinepi.2010.02.006","journal-title":"J Clin Epidemiol"},{"key":"3321_CR13","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1136\/gutjnl-2019-320553","volume":"70","author":"SO Adegbola","year":"2021","unstructured":"Adegbola SO, Dibley L, Sahnan K, Wade T, Verjee A, Sawyer R, Mannick S, McCluskey D, Bassett P, Yassin N, Warusavitarne J, Faiz O, Phillips R, Tozer PJ, Norton C, Hart AL (2021) Development and initial psychometric validation of a patient-reported outcome measure for Crohn\u2019s perianal fistula: the Crohn\u2019s Anal Fistula Quality of Life (CAF-QoL) scale. Gut 70:1649\u20131656. https:\/\/doi.org\/10.1136\/gutjnl-2019-320553","journal-title":"Gut"},{"key":"3321_CR14","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1007\/s10151-021-02452-5","volume":"25","author":"A Machielsen","year":"2021","unstructured":"Machielsen A, Iqbal N, Kimman M, Sahnan K, Adegbola S, Kane G, Woodcock R, Kleijnen J, Grossi U, Breukink SO, Tozer PJ (2021) Heterogeneity in outcome selection, definition and measurement in studies assessing the treatment of cryptoglandular anal fistula: findings from a systematic review. Tech Coloproctol 25:761\u2013830. https:\/\/doi.org\/10.1007\/s10151-021-02452-5","journal-title":"Tech Coloproctol"}],"container-title":["Techniques in Coloproctology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10151-026-03321-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03321-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03321-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T01:11:20Z","timestamp":1782090680000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10151-026-03321-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["3321"],"URL":"https:\/\/doi.org\/10.1007\/s10151-026-03321-9","relation":{},"ISSN":["1123-6337","1128-045X"],"issn-type":[{"value":"1123-6337","type":"print"},{"value":"1128-045X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"15 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Ethics Committee of Ankara Etlik City Hospital (approval no. AE\u015eH-BADEK-20241255) and conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}},{"value":"Permission to translate and adapt the original Anal Fistula Quality of Life (AF-QoL) scale was obtained from the corresponding author of the original development study, Dr. Nusrat Iqbal, prior to the commencement of this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Permission to reproduce material from other sources"}}],"article-number":"81"}}