Display options
Share it on

Child Indic Res. 2011 Jan;4(1):145-160. doi: 10.1007/s12187-010-9079-x.

Quality of Life Measurement for Children with Life-Threatening Conditions: Limitations and a New Framework.

Child indicators research

I-Chan Huang, Pey-Shan Wen, Dennis A Revicki, Elizabeth A Shenkman

Affiliations

  1. Departments of Health Outcomes and Policy, and the Institute for Child Health Policy, University of Florida, 1329 SW 16th Street, Room 5277, Gainesville, FL 32608, USA.

PMID: 21760876 PMCID: PMC3133777 DOI: 10.1007/s12187-010-9079-x

Abstract

About 500,000 children are coping with life-threatening conditions (LTC) in the United States every year. Different service programs such as an integrated pediatric palliative care program may benefit health-related quality of life (HRQOL) which is a great concern of this children population and their families. However, evidence is limited about the appropriate HRQOL instruments for use. This study aims to validate psychometric properties of a generic HRQOL instrument, the Pediatric Quality of Life (PedsQL) 4.0, for children with LTC. The parent proxy-report was used. We conducted a telephone interview to collect data of 257 parents whose children had LTC and were enrolled in Medicaid. We used standard psychometric methods to validate the PedsQL: scale reliability, item-domain convergent/discriminant validity, and known-groups validity. We also conducted Rasch analysis to assess construct validity. Results suggest that the PedsQL did not demonstrate valid psychometric properties for measuring HRQOL in this population. Rasch analysis suggests that the contents of the items in all domains did not appropriately cover the latent HRQOL of children with LTC. We document several methodological challenges in using a generic instrument to measuring HRQOL and propose a new framework to improve HRQOL measures for children with LTC. The strategies include revising the content of existing items, designing new items, adding important themes (e.g., financial challenge), and applying computerized adaptive test to better select appropriate items for individual children with LTC.

References

  1. Qual Health Res. 2003 Feb;13(2):227-46 - PubMed
  2. J Palliat Med. 2008 Nov;11(9):1212-20 - PubMed
  3. Med Care. 1999 Feb;37(2):126-39 - PubMed
  4. Pediatrics. 2006 Jan;117(1):168-83 - PubMed
  5. Med Care. 2000 Sep;38(9 Suppl):II28-42 - PubMed
  6. Med Care. 2007 May;45(5 Suppl 1):S3-S11 - PubMed
  7. N Engl J Med. 2004 Apr 22;350(17):1752-62 - PubMed
  8. J Intellect Disabil Res. 2003 May-Jun;47(Pt 4-5):385-99 - PubMed
  9. Value Health. 2009 Jul-Aug;12(5):773-81 - PubMed
  10. Med J Aust. 2003 Sep 15;179(S6):S20-2 - PubMed
  11. Ambul Pediatr. 2002 Jan-Feb;2(1):71-9 - PubMed
  12. Health Qual Life Outcomes. 2007 Jan 03;5:2 - PubMed
  13. Pediatrics. 2000 Aug;106(2 Pt 1):351-7 - PubMed
  14. J Palliat Med. 2006 Jun;9(3):716-28 - PubMed
  15. Health Qual Life Outcomes. 2007 Jan 03;5:1 - PubMed
  16. Med Care. 2007 May;45(5 Suppl 1):S22-31 - PubMed
  17. Child Care Health Dev. 2008 Mar;34(2):207-13 - PubMed
  18. Pediatrics. 2004 Oct;114(4):e477-82 - PubMed
  19. Pediatr Blood Cancer. 2008 May;50(5):1047-51 - PubMed
  20. Soc Sci Med. 1991;32(9):981-7 - PubMed
  21. J Clin Epidemiol. 2009 Mar;62(3):337-46 - PubMed

Publication Types

Grant support