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Quality of Life Research

, Volume 22, Issue 8, pp 2151–2157 | Cite as

Confirmatory factor analysis of the PedsQL among youth in a residential treatment setting

  • Steven Hoffman
  • Matthew C. Lambert
  • Timothy D. Nelson
  • Alexandra L. Trout
  • Michael H. Epstein
  • Robert Pick
Brief Communication

Abstract

Purpose

The Pediatric Quality of Life assessment (PedsQL™) is the most widely used measure for assessing adolescent health-related quality of life (HRQoL). While youth in residential treatment facilities face many physical and mental health, behavioral, education, and familial challenges that could impact their HRQoL, no research has sought to assess the factor structure of the PedsQL™ among youth receiving residential care.

Methods

High school–aged youth (N = 229) attending a large residential treatment center in Omaha, NE were recruited to complete a data collection packet comprised of various health assessments including the PedsQL. Four competing confirmatory factor analysis models were used to test the hypothesized internal structure of the PedsQL™ 4.0 Teen Report.

Results

Models A, B, and C had acceptable CFI (≥.90), TLI (≥.90), and RMSEA (≤.08) fit indicators. However, factor loadings for items 5 and 6 were problematic. After removing the two problematic items, Model D was fit to the data and proved to be the superior of the four models. This model included two first-order factors (physical health problems; school attendance problems) and one second-order factor (psychological health problems).

Conclusions

The findings suggest that researchers and practitioners studying youth in residential settings can reliably use the PedsQL™ to assess their HRQoL.

Keywords

Quality of life Health Adolescent Residential treatment 

Notes

Acknowledgments

The research reported here was supported by the Institute of Education Sciences, U.S. Department of Education, through grant R324B110001 to the University of Nebraska-Lincoln. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education.

References

  1. 1.
    Matza, L. S., Swensen, A. R., Flood, E. M., Secnik, K., & Leidy, N. K. (2004). Assessment of health-related quality of life in children: A review of conceptual, methodological, and regulatory issues. Value in Health, 7, 79–92.PubMedCrossRefGoogle Scholar
  2. 2.
    Dalmida, S. G. (2006). Spirituality, mental health, physical health, and health-related quality of life among women with HIV/AIDS: Integrating spirituality into mental health care. Issues in Mental Health Nursing, 27, 185–198.PubMedCrossRefGoogle Scholar
  3. 3.
    Eton, D. T., & Lepore, S. J. (2002). Prostate cancer and health-related quality of life: A review of the literature. Psychooncology, 11, 307–326.PubMedCrossRefGoogle Scholar
  4. 4.
    Eisenman, D. P., Gelberg, L., Liu, H., & Shapiro, M. F. (2003). Mental health and health-related quality of life among adult Latino primary care patients living in the United States with previous exposure to political violence. The Journal of the American Medical Association, 290, 627–634.CrossRefGoogle Scholar
  5. 5.
    Institute of Medicine. (2012). Living well with chronic illness: A call for public health action. Washington, DC: The National Academics Press.Google Scholar
  6. 6.
    Asarnow, J. R., Aoki, W., & Elson, S. (1996). Children in residential treatment: A follow-up study. Journal of Clinical Child Psychology, 25, 209–214.CrossRefGoogle Scholar
  7. 7.
    Drais-Parrillo, A. A., Baker, A., Fojaz, S., Gunn, S., Kurland, D., & Schnur, E. (2005). The Odyssey project: A descriptive and prospective study of children and youth in residential group care and therapeutic foster care. Washington, DC: Child Welfare League of America.Google Scholar
  8. 8.
    Nelson, T. D., Smith, T. R., Thompson, R. W., Epstein, M. H., Griffith, A. K., Duppong Hurley, K., et al. (2011). Prevalence of physical health problems among youth entering residential treatment. Pediatrics, 128, e1226–e1232.PubMedCrossRefGoogle Scholar
  9. 9.
    Varni, J. W. (2012). About the model. The PedsQL™ Measurement Model for the Pediatric Quality of Life Inventory. http://www.pedsql.org/about_pedsql.html. Accessed June 28, 2012.
  10. 10.
    Hao, Y., Tian, Q., Lu, Y., Chai, Y., & Rao, S. (2010). Psychometric properties of the Chinese version of the Pediatric Quality of Life Inventory 4.0 generic core scales. Quality of Life Research, 19, 1229–1233.PubMedCrossRefGoogle Scholar
  11. 11.
    Lin, C. Y., Luh, W. M., Yang, A. L., Su, C. T., Wang, J. D., & Ma, J. I. (2012). Psychometric properties and gender invariance of the Chinese version of the self-report Pediatric Quality of Life Inventory version 4.0: Short form is acceptable. Quality of Life Research, 21, 177–182.PubMedCrossRefGoogle Scholar
  12. 12.
    Panepinto, J. A., Hoffmann, R. G., & Pajewski, N. M. (2009). A psychometric evaluation of the PedsQL™ family impact module in parents of children with sickle cell disease. Health and Quality of Life Outcomes, 7, 1–11.Google Scholar
  13. 13.
    Perrin, J. M., Kuhlthau, K., Chughtai, A., Romm, D., Kirschener, B. S., Ferry, G. D., et al. (2008). Measuring quality of life in pediatric patients with inflammatory bowel disease: Psychometric and clinical characteristics. Journal of Pediatric Gastroenterology and Nutrition, 46, 164–171.PubMedCrossRefGoogle Scholar
  14. 14.
    Muthén, L. K., & Muthén, B. O. (1998–2009). Mplus user’s guide (6th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
  15. 15.
    Limbers, C. A., Newman, D. A., & Varni, J. W. (2008). Factorial invariance of child self-report across healthy and chronic health condition groups: A confirmatory factor analysis utilizing the PedsQL 4.0 Generic Core Scales. Journal of Pediatric Psychology, 33, 630–639.PubMedCrossRefGoogle Scholar
  16. 16.
    Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in healthy and patient populations. Medical Care, 39, 800–812.PubMedCrossRefGoogle Scholar
  17. 17.
    Varni, J. W., Seid, M., & Rode, C. A. (1999). The PedsQL: Measurement model for the Pediatric Quality of Life Inventory. Medical Care, 37, 126–139.PubMedCrossRefGoogle Scholar
  18. 18.
    Varni, J. W. (2010). Scaling and scoring of the Pediatric Quality of Life Inventory™ (PedsQL™). France: Mapi Research Trust.Google Scholar
  19. 19.
    Little, T. D., Slegers, D. W., & Card, N. A. (2006). A non-arbitrary method of identifying and scaling latent variables in SEM and MACS models. Structural Equation Modeling, 13(1), 59–72.CrossRefGoogle Scholar
  20. 20.
    Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246.PubMedCrossRefGoogle Scholar
  21. 21.
    Tucker, L., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10.CrossRefGoogle Scholar
  22. 22.
    Steiger, J. H., & Lind, J. C. (1980, May). Statistically based tests for the number of common factors. Paper presented at the annual meeting of the Psychometric Society, Iowa City, IA.Google Scholar
  23. 23.
    Browne, M. W., & Cudeck, R. (1993). Alternative ways of accessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.Google Scholar
  24. 24.
    Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Steven Hoffman
    • 1
  • Matthew C. Lambert
    • 2
  • Timothy D. Nelson
    • 3
  • Alexandra L. Trout
    • 4
  • Michael H. Epstein
    • 5
  • Robert Pick
    • 6
  1. 1.213 Barkley Memorial CenterLincolnUSA
  2. 2.211 Barkley Memorial CenterLincolnUSA
  3. 3.319 Burnett HallLincolnUSA
  4. 4.247F Barkley Memorial CenterLincolnUSA
  5. 5.202F Barkley Memorial CenterLincolnUSA
  6. 6.Boys Town National HeadquartersBoys TownUSA

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