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Measuring health-related quality of life in young children with physical illness: psychometric properties of the parent-reported KIDSCREEN-27

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Abstract

Purpose

This study examined whether the KIDSCREEN-27 was reliable and valid in young children 2–7 years with chronic physical illnesses which included estimating inter-domain correlations and internal consistency; measurement invariance testing; and, discriminant and convergent validity assessments.

Methods

Data come from the Multimorbidity in Children and Youth across the Life-course; a longitudinal study of individuals aged 2–16 years with physical illness. The parent-reported KIDSCREEN-27 was administered. Children (2–7 years; n = 106) were compared to adolescents (8–16 years; n = 157). Reliability was estimated using Cronbach α for internal consistency. Multiple group confirmatory factor analysis tested for measurement invariance. Cohen’s d and Pearson coefficient were used to assess discriminant validity by sex and age. Convergent validity was tested using Pearson coefficients with the WHODAS 2.0 (child functioning/impairment). Multiple regression examined associations between multimorbidity (co-occurring physical and mental illness) and HRQL.

Results

Internal consistency reliabilities were α = 0.74–0.88 (children) and α = 0.77–0.88 (adolescents). Inter-domain correlations were relatively low (children: r = 0.18–0.59; adolescents: r = 0.30–0.62) indicating that each KIDSCREEN-27 domain was measuring a unique aspect of health-related quality of life. Measurement invariance was demonstrated (scalar level). Parameter estimates of the invariant models were similar for children and adolescents. Small, non-significant correlations were found for sex and age for children and adolescents. Medium, significant correlations were found for both groups between the KIDSCREEN-27 and WHODAS 2.0. Children and adolescents with multimorbidity had significantly lower physical well-being, psychological well-being, and school environment scores compare to those without multimorbidity. Regression coefficients were similar between groups.

Conclusion

Findings provide evidence of adequate psychometrics for the KIDSCREEN-27 in young children with chronic physical illness.

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Acknowledgements

The authors gratefully acknowledge the children, parents, and health professionals and their staff without whose participation this study would not have been possible. We especially thank Jessica Zelman, Robyn Wojcicki, and Charlene Attard for co-ordinating the study and Saad Qureshi for helping with the literature review.

Funding

This study was funded by the Canadian Institutes of Health Research (PJT-148602). Dr. Ferro holds the Canada Research Chair in Youth Mental Health and the Early Researcher Award from the Ministry of Research, Innovation and Science.

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Authors and Affiliations

  1. School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Canada

    Mark A. Ferro

  2. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Christiane Otto & Ulrike Ravens-Sieberer

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  1. Mark A. Ferro
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  2. Christiane Otto
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  3. Ulrike Ravens-Sieberer
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Contributions

Dr. MAF conceptualized and designed the study, co-ordinated and supervised data collection, conducted the analysis, and drafted the manuscript. Drs. CO and UR-S were involved in the initial development of scale, interpreted findings, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript.

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Correspondence to Mark A. Ferro.

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All participants 16 years and older provided informed consent, children 7–15 provided assent, and children 6 and younger were consented by their parents.

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MY LIFE received ethical approval from the University of Waterloo Human Research Ethics Board (ORE-22183) and the Hamilton Integrated Research Ethics Board (2797).

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Ferro, M.A., Otto, C. & Ravens-Sieberer, U. Measuring health-related quality of life in young children with physical illness: psychometric properties of the parent-reported KIDSCREEN-27. Qual Life Res 31, 1509–1520 (2022). https://doi.org/10.1007/s11136-021-03054-2

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