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The development and validation of a handicap questionnaire for children with a chronic illness
S B Detmar1, E J Hosli, A M J Chorus
1TNO Prevention and Health, Leiden, The Netherlands. SB.Detmar@pg.tno.nl
Insights
The Handicap Scale for Children (HSC) is a new, valid tool for assessing social participation in children aged 8-18. It is feasible and reliable for children with chronic conditions.
Area of Science:
- Pediatric Health
- Psychometrics
- Child Development
Background:
- The London Handicap Scale (LHS) measures adult social participation.
- A need exists for a similar tool for pediatric populations.
- The Handicap Scale for Children (HSC) was developed based on the LHS.
Purpose of the Study:
- To develop and psychometrically evaluate the Handicap Scale for Children (HSC).
- To assess the feasibility and validity of the HSC in children aged 8-18.
- To measure social participation and handicap in children with and without chronic diseases.
Main Methods:
- A multidisciplinary team developed the HSC.
- The HSC was administered to 114 children with chronic diseases and 239 healthy children (ages 8-18).
- Conceptual and criterion validity were assessed using the Health Utility Index Mark 3 (HUI3).
Main Results:
- The HSC has five dimensions: mobility, physical independence, daily activities, social integration, and orientation.
- Feasibility testing showed no difficulties for children completing the questionnaire.
- Satisfactory conceptual and criterion validity were demonstrated, with significant differences between healthy and chronically ill children.
Conclusions:
- The Handicap Scale for Children (HSC) is a feasible and valid instrument.
- The HSC is suitable for assessing social participation in children aged 8-18.
- The HSC can differentiate between healthy children and those with chronic conditions.
Introduction:
This paper describes the development and initial psychometric evaluation of the Handicap Scale for Children (HSC). This questionnaire is based on the London Handicap Scale (LHS), a valid and reliable utility instrument for measuring social participation in adults.
Methods:
A multidisciplinary research group was involved in developing the HSC. The questionnaire was tested in 114 children with a chronic disease and 239 healthy children in the 8-18 age range. Relating the Health Utility Index Mark 3 (HUI3) attributes to corresponding HSC scores tested the assumption that a negative health status would lead to participation problems.
Results:
Questionnaire development resulted in a five-dimension questionnaire: mobility, physical independence, daily activities, social integration and orientation. Each dimension included one item with a six-point response scale. A higher score indicates greater handicap. Feasibility testing with 10 children showed that none of the children experienced difficulties in filling in the questionnaire. Conceptual validity, measured by correlations between the dimensions of the HSC and HUI3, was satisfactory. As expected, moderate correlation coefficients between predefined pairs of HUI and HSC attributes were found; other correlation coefficients were low. Criterion validity was also satisfactory, as shown by large differences between the healthy and the chronically ill group and by several criteria within the chronically ill group.
Conclusion:
Based on this initial evaluation, the questionnaire seems feasible and valid for use with children in the age range 8-18 years.
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