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Canadian-French, German and UK versions of the Child Health Questionnaire: methodology and preliminary item scaling results

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Abstract

Using emerging international guidelines, stringent procedures were used to develop and evaluate Canadian-French, German and UK translations/ adaptions of the 50 item, parent-completed Child Health Questionnaire (CHQ-PF50). Multitrait analysis was used to evaluate the convergent and discriminant validity of the hypothesized item sets across countries relative to the results obtained for a representative sample of children in the US. Cronbach's a coefficient was used to estimate the internal consistency reliability for each of the health scales. Floor and ceiling effects were also examined. Seventy-nine percent of all the item-scale correlations achieved acceptable internal consistency (0.40 or higher). The tests of the item convergent and discriminant validity were successful at least 87% of the time across all scales and countries. Equal item variance was observed 90% of the time across all countries. The reliability coefficients ranged from a low of 0.43 (parental time impact, Canadian English) to a high of 0.97 (physical functioning index, Canadian French) across all scales (median 0.80). Negligible floor effects were observed across countries. Noteworthy ceiling effects were observed, as expected, for the hypothesized physical scales (mean effect 73%). Conversely, fewer ceiling effects were observed for the psychosocial scales (range 3–17% behaviour parental emotional impact). The item-scaling results obtained in these pilot studies support the psychometric properties of the American-English CHQ-PF50 and its respective translations.

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References

  1. Landgraf JM, Ware JE Jr, Schor E, Davies AR, R-Roh K. Health profiles in children with psychiatric and other medical conditions. Paper presented at the Ninth World Congress of Psychiatry, Rio de Janiero, Brasil, 6–12 June, 1993.

  2. Landgraf JM, Ware JE Jr, Schor E, Davies AR, R-Roh K. Comparison of health status profiles for children with medical conditions: preliminary psychometric and clinical results from the Children's Health and Quality of Life Project. Paper presented at the Tenth Annual Meeting of the Association for Health Services Research, Washington, DC, 27–29 June, 1993.

  3. Landgraf JM, Abetz L, Ware JE, Jr. The CHQ: A User's Manual. 1st edn. Boston, MA: The Health Institute, New England Medical Center, 1996.

    Google Scholar 

  4. Landgraf JM, Abetz L. Influences of sociodemographic characteristics on parental reports of children's physical and psychosocial well-being: early experiences with the Child Health Questionnaire (CHQ-PF50), In: Drotar D, ed. Quality of Life Assessment in Children. Lawrence Erlbaum, 1997.

  5. Landgraf JM, Abetz L. Functional status and well-being of children representing three cultural groups: initial self-reports using the CHQ-CF87. J Psychol Health, 1977; 12(6): 1-16.

    Google Scholar 

  6. Kurtin P, Landgraf JM, Abetz L. Patient-based health status measurements in pediatric dialysis: expanding the assessment of outcomes. Am J Kidney Dis 1994; 24(2): 376-382.

    Google Scholar 

  7. Powers P, Abetz L, Landgraf JM. Adolescents with cystic fibrosis: mother, father and child reports of health. Poster presentation at the 104th Annual Convention of the American Psychological Association, Toronto, Canada, August 1996.

  8. Landgraf JM, Abetz LN, DeNardo BA, Tucker LB. Clinical validity of the Child Health Questionnaire-Parent Form in children with rheumatoid arthritis. Poster presentation at the 1995 National Scientific Meeting of the American College of Rheumatology, San Francisco, CA, 21–16 October 1995.

  9. Ware JE, Keller SD, Gandek B et al. Evaluating translations of health status questionnaires: methods from the IQOLA project. Int J Technol Assess Health Care 1995; 11(3): 525-550.

    Google Scholar 

  10. Ware JE, Gandek B, IQOLA Project Group. Evaluating instruments used cross-nationally: IQOLA project methods. In: Spilker B, ed. Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd edn., 1995.

  11. EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199-208.

    Google Scholar 

  12. Aaronson NK, Acquadro C., Alonso J et al. International Quality of Life (IQOLA) project. Qual Life Res 1992; 1: 349-351.

    Google Scholar 

  13. Bullinger M, Anderson R, Cella D, Aaronson N. Developing and evaluating cross-cultural instruments from minimum requirements to optimal models. Qual Life Res 1993; 2: 451-459.

    Google Scholar 

  14. Bullinger M. Ensuring international equivalence of quality of life measures: problems and approaches to solutions. In: Orley J, Kuyken W, eds. Quality of Life Assessment: International Perspectives. Berlin: Springer-Verlag, 1994: 33-40.

    Google Scholar 

  15. Bullinger M, Mackensen S, Landgraf JM. Assessing quality of life in children. Qual Life Res 1994; 1: 41

    Google Scholar 

  16. Landgraf JM, Maunsell E, Speechly KN et al. Psychometric properties of the Child Health Questionnaire (Parent Form) among English and French-speaking Canadian respondents: preliminary results. Paper presented at the Second Meeting of the International Society for Quality of Life Research, Montreal, Quebec, Canada, 14–17 October 1995.

  17. Landgraf JM, Erling A, Wilkund I, Abetz L, Ware JE. The Child Health Questionnaire: issues in translation, language and culture for Swedish children and their parents. Poster presentation at the Second Meeting of the International Society for Quality of Life Research, Montreal, Quebec, Canada, 14–17 October 1995.

  18. Dekker R, Walda I. Validation of the Dutch Child Health Questionnaire. Rotterdam: Landbouwuniversiteit Wageningen, 1995.

    Google Scholar 

  19. Brislin RW. Back-translation for cross-cultural research. J Cross-Cultural Psychol 1970; 1(3): 185-216.

    Google Scholar 

  20. Werner O, Campbell DT. Translating, working through interpreters and the problem of decentering. In: Naroll R, Cohen R,eds. A Handbook of Cultural Anthropology. New York: American Museum of Natural History, 1970.

    Google Scholar 

  21. Thalji L., Haggerty CC, Rubin R, Berckmans T.R, Pardee BL. 1990 National Survey of Functional Health Status: Final Report. Chicago, IL: NORC, 1991.

    Google Scholar 

  22. Eisen M, Ware JE Jr, Donald CA et al. Measuring components of children's health status. Med Care 1979; 17: 902-921.

    Google Scholar 

  23. Boyle MH, Offord DR, Hofmann HG et al. Ontario child health study. I. Methodology. Arch Gen Psychiatr 1987; 44: 826-831.

    Google Scholar 

  24. Stein REK, Jessop DJ. Functional status II(R): a measure of child health status. Med Care 1990; 28: 1041-1055.

    Google Scholar 

  25. Starfield B, Bergner M, Ensminger M et al. Adolescent health status measurement: development of the child health and illness profile. Pediatrics 1993; 91: 430-435.

    Google Scholar 

  26. Starfield B, Reiley A, Green B et al. The adolescent child health and illness profile: a population-based measure of health. Med Care 1995; 33(5): 553-566.

    Google Scholar 

  27. Wasson, JH, Kairys S, Nelson E et al. A short survey for assessing health and social problems of adolescents. J Family Practice 1994; 38(5): 489-494.

    Google Scholar 

  28. Apajasalo M, Sintonen H, Holmberg C et al. Quality of life in early adolescence: a sixteen dimensional health-related measure (16 D). Qual Life Res 1994; 5: 205-211.

    Google Scholar 

  29. French DJ, Christie MJ, Sowden AJ. The reproducibility of the Childhood Asthma Questionnaires: measures of quality of life for children with asthma ages 4–16 years. Qual Life Res 1994; 3: 215-224.

    Google Scholar 

  30. Lindstrom B, Erikkson B. Quality of life among children in the Nordic countries. Qual Life Res 1993; 2: 23-32.

    Google Scholar 

  31. Nespoli L, Verri AP, Locatelli F, Bertuggia RM, Taibi RM, Burgio GR. The impact of paediatric bone marrow transplantation on quality of life. Qual Life Res 1995; 4: 223-240.

    Google Scholar 

  32. Wilkund I, Wiren L, Erling A, Karlberg J, Albertsson-Wikland. A new self-assessment questionnaire to measure well-being in children, particularly those of short stature. Qual Life Res 1994; 3: 449-455.

    Google Scholar 

  33. Bullers S. Women's roles and health: the mediating effect of perceived control. Women Health 22(2): 11-30.

  34. Hong Gong-Soog, White-Means SI. Do working mothers have healthy children. J Family Econ Issues 14(2): 163-186.

  35. Likert RA. A technique for the measurement of attitudes. Arch Psychol 32;140: 5.

  36. Landgraf JM, Abetz L. Measuring health outcomes in pediatric populations: issues in psychometrics and application. In: Spilker B, ed. Quality of Life and Pharmacoeconomics in Clinical Trials. Raven Press, 1995: 793-802.

  37. Landgraf JM. Pretend, pretend goodluck bear is walking...: an examination of the communicative devices used by peers to initiate and sustain convergent interaction. Thesis, San Diego State University, San Diego, 1986.

    Google Scholar 

  38. Landgraf JM, Beach W. The cycle of children s play: gaining access and sustaining focus in sibling interactions. Paper presented at the Annual Convention of the International Communication Association, Montreal, Canada, May 1986.

  39. Landgraf JM, Nelson EC. Increasing one's understanding of patient health: a preliminary summary of the WONCA/COOP Chart International Field Trial. Aust Family J 1992; 21(3): 255-269.

    Google Scholar 

  40. Nelson EC, Landgraf JM, Hays RD et al. The COOP function charts: a system to measure patient function in physicians offices, In: Lipkin M, ed. Frontiers in Primary Care: Functional Status Measurement in Primary Care. Springer-Verlag, 1990, 97-131.

  41. Lustig R, Giglio K, Landgraf JM, Myers S. Connotative versus denotative meaning in intercultural communication: a research note. Paper presented at the Annual Meeting of the Western Speech Communication Association Intercultural Communication Division, Fresno, CA, February 1985.

  42. Ware JE, Kosinksi M, Snow K, Gandek B. The SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA: The Health Institute, New England Medical Center, 1993.

    Google Scholar 

  43. Bullinger M, von Mackensen S, Kirchberger I. KINDL — a questionnaire for health-related quality of life assessment in children. Zeitschrift Gesundheitpsychol 1994; II(1): 564-577.

    Google Scholar 

  44. Bullinger M. German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA project. Soc Science Med 1995 4(10): 1359-1366.

    Google Scholar 

  45. McKinley RK, Cragg DK. Comparison of out of hours care provided by patients own general practitioners and commercial deputising services: a randomized controlled trial. II: The outcome of care. BMJ 1997; 314: 190-193.

    Google Scholar 

  46. Gibbons L, Mao Y, Levy IG, Miller AB. The Canadian Childhood Cancer Control Program. Can Med Assoc J 1994; 151(12): 1704-1709.

    Google Scholar 

  47. Hays RD, Hayashi T, Carson S, Ware JE. User's Guide for the Multitrait Analysis Program (MAP). Rand Corporation, 1988.

  48. Ware JE, Harris W, Gandek B, et al. MAP-R for Windows: User Manual. Boston: The Health Institute, New England Medical Center, 1998.

    Google Scholar 

  49. Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959; 56: 85-105.

    Google Scholar 

  50. Howard KL, Forehand GC. A method for correcting item-total correlations for the effect of relevant item inclusion. Educ Psychol Measure 1962: 22: 731.

    Google Scholar 

  51. Cronbach LJ. Coefficient α and the internal structure of tests. Psychometrika 1951; 16: 297-334.

    Google Scholar 

  52. Helmsteader GC. Principles of Psychological Measurement. New York: Appleton-Centry-Crofts, Inc., 1964.

    Google Scholar 

  53. Nunnally JC, Bernstein IR. Psychometric Theory, 3rd edn. New York: McGraw-Hill, 1994.

    Google Scholar 

  54. Ware JE Jr, Karmos AH. Development and Validation of Scales to Measure Perceived Health and Patient Role Propensity: Volume II of a Final Report. Carbondale, IL, Southern Illinois University School of Medicine, 1976.

    Google Scholar 

  55. Ware JE Jr, Davies-Avery A, Donald CA. Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. V, General Health Perceptions. Santa Monica, CA: The RAND Corporation; 1978.

    Google Scholar 

  56. Ware JE Jr, Johnston SA, Davies-Avery A et al. Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. III, Mental Health. Santa Monica, CA: The RAND Corporation, 1979.

    Google Scholar 

  57. Feeny D, Furlong W, Boyle M, Torrance G. Multi-attribute Health Status Classification Systems: Health Utilities Index. Pharmacoeconomics 1995; 7(6): 490-502.

    Google Scholar 

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Author information

Authors and Affiliations

  1. New England Medical Center, The Health Institute, Boston, MA, USA (J. M. Landgraf, L. Abetz, J. E. Ware)

    J. M. Landgraf, L. Abetz & J. E. Ware

  2. HealthAct, Boston, MA, USA

    E. Maunsell

  3. Epidemiology Research Group, Université, Laval, Québec, Canada (E. Maunsell)

    K. Nixon Speechley

  4. Child Health Research Institute and University of Western Ontario, London, Ontario, Canada

    K. Nixon Speechley

  5. Abteilung Für Medizinishe Psychologie, Universitatskrankenhaus Eppendorf, Hamburg, Germany

    M. Bullinger

  6. Rusholme Health Centre, Department of General Practice, University of Manchester, Manchester, UK

    S. Campbell

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  1. J. M. Landgraf
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  4. M. Bullinger
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  5. S. Campbell
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  6. L. Abetz
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  7. J. E. Ware
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Landgraf, J.M., Maunsell, E., Nixon Speechley, K. et al. Canadian-French, German and UK versions of the Child Health Questionnaire: methodology and preliminary item scaling results. Qual Life Res 7, 433–445 (1998). https://doi.org/10.1023/A:1008810004694

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  • DOI: https://doi.org/10.1023/A:1008810004694

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