Quality of Life Research

, Volume 22, Issue 8, pp 2201–2211 | Cite as

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

  • Mark A. Ferro
  • Jeanne M. Landgraf
  • Kathy N. Speechley



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.


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.


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).


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.


Children Epilepsy Factor analysis Health-related quality of life Measurement Psychometrics 



anti-epileptic drugs


Center for Epidemiological Studies Depression Scale


Confirmatory Factor Analysis


Comparative Fit Index


Child Health Questionnaire

Family APGAR

Family Adaptability, Partnership, Growth, Affection, and Resolve


Family Inventory of Life Events and Changes


Family Inventory of Resources for Management


Global Assessment of Severity of Epilepsy


Health-related Quality of Life in Children with Epilepsy Study


Health-related Quality of Life


Root Mean Square Error of Approximation


Tucker–Lewis Index


Weighted Root Mean Square Residual



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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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Mark A. Ferro
    • 1
  • Jeanne M. Landgraf
    • 2
  • Kathy N. Speechley
    • 3
    • 4
    • 5
  1. 1.Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child StudiesMcMaster UniversityHamiltonCanada
  2. 2.HealthActCHQ Inc.CambridgeUSA
  3. 3.Department of PaediatricsWestern UniversityLondonCanada
  4. 4.Department of Epidemiology and BiostatisticsWestern UniversityLondonCanada
  5. 5.Children’s Health Research InstituteWestern UniversityLondonCanada

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