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Factor structure of the Child Health Questionnaire Parent Form-50 and predictors of health-related quality of life in children with epilepsy

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Abstract

Purpose

The present study investigated the higher-order summary factor structure of the Child Health Questionnaire Parent Form-50 (CHQ) in a sample of children with new-onset epilepsy. The secondary aim was to identify risk factors predicting health-related quality of life (HRQL) 24 months post-diagnosis.

Methods

Data came from the Health-related Quality of Life in Children with Epilepsy Study (HERQULES, N = 374), a multi-site study documenting HRQL among children with epilepsy from diagnosis through 24 months. Confirmatory factor analysis was used to determine goodness of fit between the original structure of the CHQ and HERQULES data. Multiple regression was used to identify risk factors at diagnosis for HRQL at 24 months.

Results

The models demonstrated good fit: baseline: CFI = 0.945; TLI = 0.941; WRMR = 1.461; RMSEA = 0.058; 24 months: CFI = 0.957; TLI = 0.954; WRMR = 1.393; RMSEA = 0.055. Factor loadings were high and no cross-loadings observed (first order: λ = 0.27–0.99, 0.24–0.98; second order: λ = 0.69–0.86, 0.54–0.92; p < 0.001 for all). Controlling for HRQL at diagnosis, predictors for better 24-month HRQL were as follows: physical health: fewer cognitive problems (p = 0.023) and parents with fewer depressive symptoms (p = 0.049); psychosocial health: older parent age (p = 0.043), fewer behavior problems (p = 0.004), and families with better functioning (p = 0.008) and fewer demands (p = 0.009).

Conclusions

The CHQ higher-order summary factor structure was replicated in a sample of children with new-onset epilepsy, and child and family risk factors at diagnosis were found to predict HRQL 24 months post-diagnosis. These findings suggest it is possible to identify at-risk children early in the illness process and provide impetus for adopting family-centered care practices.

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Abbreviations

AEDs:

anti-epileptic drugs

CES-D:

Center for Epidemiological Studies Depression Scale

CFA:

Confirmatory Factor Analysis

CFI:

Comparative Fit Index

CHQ:

Child Health Questionnaire

Family APGAR:

Family Adaptability, Partnership, Growth, Affection, and Resolve

FILE:

Family Inventory of Life Events and Changes

FIRM:

Family Inventory of Resources for Management

GASE:

Global Assessment of Severity of Epilepsy

HERQULES:

Health-related Quality of Life in Children with Epilepsy Study

HRQL:

Health-related Quality of Life

RMSEA:

Root Mean Square Error of Approximation

TLI:

Tucker–Lewis Index

WRMR:

Weighted Root Mean Square Residual

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Acknowledgments

Dr. Ferro is supported by the Banting Postdoctoral Fellowship from the Canadian Institutes for Health Research. Dr. Speechley is the recipient of a Canadian Institutes for Health Research grant for HERQULES (MOP-64311).

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Authors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Chedoke Site, Central Building, Room 310, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Mark A. Ferro

  2. HealthActCHQ Inc., 2 Canal Park, 5th Floor, Cambridge, MA, 02141, USA

    Jeanne M. Landgraf

  3. Department of Paediatrics, Western University, 800 Commissioners Road East, Room E6-103, London, ON, N6A 5W9, Canada

    Kathy N. Speechley

  4. Department of Epidemiology and Biostatistics, Western University, London, Canada

    Kathy N. Speechley

  5. Children’s Health Research Institute, Western University, London, Canada

    Kathy N. Speechley

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  1. Mark A. Ferro
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  3. Kathy N. Speechley
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Correspondence to Mark A. Ferro.

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Ferro, M.A., Landgraf, J.M. & Speechley, K.N. Factor structure of the Child Health Questionnaire Parent Form-50 and predictors of health-related quality of life in children with epilepsy. Qual Life Res 22, 2201–2211 (2013). https://doi.org/10.1007/s11136-013-0351-7

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