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Psychometric properties of PedsQL generic core scales for children with functional constipation in the Netherlands
Esther E Hartman1, Manjiri Pawaskar, Valerie Williams
1*Medical Psychology, Tilburg University, Tilburg, the Netherlands †Shire, Wayne, PA ‡RTI Health Solutions, Research Triangle Park, NC §Université Libre de Bruxelles, Brussels, Belgium ||Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands ¶Shire, Nyon, Switzerland.
Insights
The Pediatric Quality of Life Inventory (PedsQL) shows good reliability for Dutch children aged 8-18 with functional constipation. Further research is needed for younger children (ages 5-7).
Area of Science:
- Pediatric gastroenterology
- Health outcomes research
- Psychometrics
Background:
- Functional constipation (FC) significantly impacts children's quality of life.
- Accurate measurement of health-related quality of life (HRQoL) is crucial for evaluating interventions in pediatric FC.
- The Pediatric Quality of Life Inventory version 4.0 Generic Core Scales (PedsQL) is a widely used HRQoL measure.
Purpose of the Study:
- To evaluate the psychometric properties of the Dutch translation of the PedsQL in children diagnosed with functional constipation (FC).
- To assess the reliability and validity of the PedsQL for measuring HRQoL in this specific pediatric population.
Main Methods:
- The Dutch PedsQL was administered to 269 children (ages 5-18) with FC and their parents.
- Construct validity was assessed using the PedsQL Gastrointestinal Symptoms Module and a defecation disorder list.
- Internal consistency, patient-parent agreement, and discriminant ability were analyzed.
Main Results:
- The PedsQL demonstrated satisfactory internal consistency for total, physical, and psychosocial health scores (Cronbach's alpha: 0.86-0.88).
- Self-reported HRQoL was generally lower than parent-reported, except in younger children (ages 5-7).
- The PedsQL effectively distinguished between healthy children and those with FC, and between mild and severe FC symptoms.
Conclusions:
- The Dutch PedsQL exhibits satisfactory measurement properties for self- and proxy-reports in children aged 8-18 with FC.
- Further investigation is recommended to confirm internal consistency and validity in younger children (ages 5-7) with FC.
Objectives:
The aim of the study was to evaluate the psychometric properties of the Dutch translation of the Pediatric Quality of Life Inventory version 4.0 Generic Core Scales (PedsQL) in children with functional constipation (FC).
Methods:
The PedsQL was completed by children with FC ages 5 to 18 years and by the parents of children ages 2 to 18 years. To assess construct validity, all of the parents and children completed the PedsQL Gastrointestinal Symptoms Module (GI module) and children ages 8 to 18 years completed the defecation disorder list. Item response distributions, internal consistency reliability, patient-parent agreement, and discriminating ability were evaluated.
Results:
Overall, 269 children were enrolled. The PedsQL showed minimal missing responses (self-report: 5.3% with >50% missing, parent report: 2.6% with >50% missing) and achieved satisfactory internal consistency for the total (self-report: α = 0.86, parent report: α = 0.88), physical health (self-report: α = 0.75, parent report α = 0.83), and psychosocial health (self-report: α = 0.80; parent report: α = 0.85) scores. Internal consistency was less convincing for those ages 5 to 7 years (α = 0.53-0.77) than for older individuals. Self-reported health-related quality of life was lower than parent reported, with the exception of children ages 5 to 7 years. Interrater reliability intraclass correlations were 0.52 to 0.61 for the overall population. Correlations among the PedsQL, GI module, and defecation disorder list were consistent with a priori hypotheses and generally supported construct validity. The PedsQL distinguished between a previously published healthy reference sample and children with FC, and between those with mild and severe symptoms (P < 0.05).
Conclusions:
The self-reported and proxy reported PedsQL demonstrated satisfactory measurement properties in Dutch children with FC ages 8 to 18 years. Further research is needed to establish internal consistency and validity in those ages 5 to 7 years.
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