A psychometric evaluation of the PedsQL Family Impact Module in parents of children with sickle cell disease

Julie A Panepinto, Raymond G Hoffmann, Nicholas M Pajewski, Julie A Panepinto, Raymond G Hoffmann, Nicholas M Pajewski

Abstract

Background: Caring for a child with a chronic condition, such as sickle cell disease, can have a significant impact on parents and families. In order to provide comprehensive care and support to these families, psychometrically sound instruments are needed as an initial step in measuring the impact of chronic diseases on parents and families. We sought to evaluate the psychometric properties of the PedsQL Family Impact Module in populations of children with and without sickle cell disease. In addition, we sought to determine the correlation between parent's well being and their proxy report of their child's health-related quality of life (HRQL).

Methods: We conducted a cross-sectional study of parents of children with and without sickle cell disease who presented to an urban hospital-based sickle cell disease clinic and an urban primary care clinic. We assessed the HRQL and family functioning of both groups of parents utilizing the PedsQL Family Impact Module. The reliability, validity and factor structure of the instrument were determined and scores from the instrument were correlated with scores from parent-proxy report of their child's HRQL using the PedsQL 4.0 Generic Core Scales.

Results: Parents of 170 children completed the module (97 parents of children with sickle cell disease and 73 parents of children without sickle cell disease). The Family Impact Module had high ceiling effects but was reliable (Cronbach's alpha > 0.80 in all scales). The empirical factor structure was generally consistent with the theoretical factor structure and supported construct validity. The Family Impact Module discriminated between parents of children with severe sickle cell disease from parents of children with mild disease or no disease in the areas of communication and worry. There were no significant differences across any of the subscales between parents of children with mild sickle cell disease and those with no disease. Parents with higher scores, representing better HRQL and family functioning, generally reported higher HRQL scores for their children.

Conclusion: The PedsQL Family Impact module was reliable, however it displayed large ceiling effects and did not discriminate well between parents of children with and without sickle cell disease. Future research to evaluate the psychometric properties of the Family Impact Module for parents of healthy children may be helpful.

Figures

Figure 1
Figure 1
Median Summary and Scale Scores for PedsQL™ Family Impact Module. A Comparison of Parents of Healthy Children without Sickle Cell Disease to Children with Sickle Cell Disease.

References

    1. Lawoko S, Soares JJ. Quality of life among parents of children with congenital heart disease, parents of children with other diseases and parents of healthy children. Qual Life Res. 2003;12:655–666. doi: 10.1023/A:1025114331419.
    1. Sales E. Family burden and quality of life. Qual Life Res. 2003;12:33–41. doi: 10.1023/A:1023513218433.
    1. Helgeson VS. Social support and quality of life. Qual Life Res. 2003;12:25–31. doi: 10.1023/A:1023509117524.
    1. Moskowitz JT, Butensky E, Harmatz P, et al. Caregiving time in sickle cell disease: psychological effects in maternal caregivers. Pediatr Blood Cancer. 2007;48:64–71. doi: 10.1002/pbc.20792.
    1. Campo JV, Comer DM, Jansen-Mcwilliams L, Gardner W, Kelleher KJ. Recurrent pain, emotional distress, and health service use in childhood. J Pediatr. 2002;141:76–83. doi: 10.1067/mpd.2002.125491.
    1. Janicke DM, Finney JW, Riley AW. Children's health care use: a prospective investigation of factors related to care-seeking. Med Care. 2001;39:990–1001. doi: 10.1097/00005650-200109000-00009.
    1. Brandow AM, Brousseau DC, Panepinto JA. Postdischarge pain, functional limitations and impact on caregivers of children with sickle cell disease treated for painful events. Br J Haematol. 2009;144:782–8. doi: 10.1111/j.1365-2141.2008.07512.x.
    1. Panepinto JA, Brousseau DC, Hillery CA, Scott JP. Variation in hospitalizations and hospital length of stay in children with vaso-occlusive crises in sickle cell disease. Pediatr Blood Cancer. 2005;44:182–186. doi: 10.1002/pbc.20180.
    1. Swift AV, Cohen MJ, Hynd GW, et al. Neuropsychologic impairment in children with sickle cell anemia. Pediatrics. 1989;84:1077–1085.
    1. Schatz J, Brown RT, Pascual JM, Hsu L, DeBaun MR. Poor school and cognitive functioning with silent cerebral infarcts and sickle cell disease. Neurology. 2001;56:1109–1111.
    1. Cremeens J, Eiser C, Blades M. Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes. 2006;4:58. doi: 10.1186/1477-7525-4-58.
    1. Panepinto JA, O'Mahar KM, DeBaun MR, Rennie KM, Scott JP. Validity of the child health questionnaire for use in children with sickle cell disease. J Pediatr Hematol Oncol. 2004;26:574–578. doi: 10.1097/01.mph.0000136453.93704.2e.
    1. Panepinto JA, Pajewski NM, Foerster LM, Hoffmann RG. The performance of the PedsQL generic core scales in children with sickle cell disease. J Pediatr Hematol Oncol. 2008;30:666–673. doi: 10.1097/MPH.0b013e31817e4a44.
    1. Charache S, Terrin ML, Moore RD, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia. N Engl J Med. 1995;332:1317–1322. doi: 10.1056/NEJM199505183322001.
    1. Scott JP, Hillery CA, Brown ER, Misiewicz V, Labotka RJ. Hydroxyurea therapy in children severely affected with sickle cell disease. J Pediatr. 1996;128:820–828. doi: 10.1016/S0022-3476(96)70335-9.
    1. Walters MC, Patience M, Leisenring W, et al. Bone marrow transplantation for sickle cell disease. N Engl J Med. 1996;335:369–376. doi: 10.1056/NEJM199608083350601.
    1. Varni JW, Sherman SA, Burwinkle TM, Dickinson PE, Dixon P. The PedsQL Family Impact Module: preliminary reliability and validity. Health Qual Life Outcomes. 2004;2:55. doi: 10.1186/1477-7525-2-55.
    1. Scarpelli AC, Paiva SM, Pordeus IA, Varni JW, Viegas CM, Allison PJ. The pediatric quality of life inventory (PedsQL) family impact module: reliability and validity of the Brazilian version. Health Qual Life Outcomes. 2008;6:35. doi: 10.1186/1477-7525-6-35.
    1. Varni J. The PedsQL™ 4.0 Measurement Model for the Pediatric Quality of Life Inventory™ Version 4.0: Administration Guidelines. 2004.
    1. Varni JW. The PedsQL™ Scoring Algorithm: Scoring the Pediatric Quality of Life Inventory™. 2007.
    1. Cohen LaH M. Statistics for social scientists. London: Harper and Row; 1982.
    1. Varni JW, Burwinkle TM, Seid M. The PedsQL 4.0 as a school population health measure: feasibility, reliability, and validity. Qual Life Res. 2006;15:203–215. doi: 10.1007/s11136-005-1388-z.
    1. Raat H, Landgraf JM, Oostenbrink R, Moll HA, Essink-Bot ML. Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample. Qual Life Res. 2007;16:445–460. doi: 10.1007/s11136-006-9134-8.
    1. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr. 2003;3:329–341. doi: 10.1367/1539-4409(2003)003<0329:TPAAPP>;2.
    1. Panepinto JA, Pajewski NM, Foerster LM, Sabnis S, Hoffmann RG. Impact of family income and sickle cell disease on the health-related quality of life of children. Qual Life Res. 2009;18:5–13. doi: 10.1007/s11136-008-9412-8. Epub 2008 Nov 7.
    1. Tweel XW van den, Hatzmann J, Ensink E, et al. Quality of life of female caregivers of children with sickle cell disease: a survey. Haematologica. 2008;93:588–593. doi: 10.3324/haematol.11610.
    1. Mansour ME, Kotagal U, Rose B, et al. Health-related quality of life in urban elementary schoolchildren. Pediatrics. 2003;111:1372–1381. doi: 10.1542/peds.111.6.1372.
    1. Price MR, Bratton DL, Klinnert MD. Caregiver negative affect is a primary determinant of caregiver report of pediatric asthma quality of life. Ann Allergy Asthma Immunol. 2002;89:572–577.
    1. Spilker B. Quality of Life and Pharmacoeconomics in Clinical Trials. Lippincott Williams and Wilkins; 1996.

Source: PubMed

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