Abstract
BackgroundThe purpose of this study was to determine the construct validity of the PedsQL™ health related quality of life (HRQoL) instrument for use among injured children and to examine the impact of using different modes of administration, including paper and pencil, online and telephone.MethodsTwo hundred thirty-three participants (aged 0 – 16) were recruited from hospital wards and the emergency department of a pediatric hospital in a large urban center in British Columbia, Canada. Data used to evaluate the construct validity of the PedsQL™ were collected from participants at the time of seeking injury treatment (baseline) to capture a retrospective measure of pre injury health, and one month post injury. Data used to compare different modes of administration (n = 44) were collected at baseline. To assess construct validity repeated measures analysis of variance (rANOVA) was used to determine whether the PedsQL™ tool was able to discriminate between patients pre and post injury while investigating possible interaction by category of length of stay in hospital. The impact of different modalities of administering the PedsQL™ on item responses was investigated using Bland-Altman plots.ResultsrANOVA showed significant differences in PedsQL™ total score between baseline and one month post injury (p < .001), and differences in mean total score at one month post injury by category of injury severity (p < .001). There was also significant interaction by category of injury severity for the change in PedsQL™ total score from baseline to one month (p < .001). Pearson’s correlations were highly significant across three modalities of survey administration: paper and pencil, computer and telephone administration (range: .92 to .97, p < .001). Bland-Altman plots showed strong consistency.ConclusionThe PedsQL™ instrument is able to discriminate between pre and post injury HRQoL, as well as HRQoL post injury for injuries of varying severity. These findings are an indication that this instrument has good construct validity for the purpose of evaluating HRQoL of injured children. Data collected via paper-pencil, online and telephone administration were highly consistent. This is important as depending on the setting, clinical or research, different modalities of completing this instrument may be more appropriate.
Highlights
The purpose of this study was to determine the construct validity of the PedsQLTM health related quality of life (HRQoL) instrument for use among injured children and to examine the impact of using different modes of administration, including paper and pencil, online and telephone
While still in the hospital, each participant was given a questionnaire package that included the PedsQLTM instrument, a series of questions relating to the nature of the injury, including the body part injured, type of injury and how the injury occurred, as well as questions about patient demographics, including the child’s age, sex, and parent’s income
The difference in total PedsQLTM mean scores at one month post injury relative to baseline was statistically significantly greater than zero based on 95% CI for all three categories of length of stay in hospital (Table 2), only the two categories who had been hospitalized had clinically significant differences
Summary
The purpose of this study was to determine the construct validity of the PedsQLTM health related quality of life (HRQoL) instrument for use among injured children and to examine the impact of using different modes of administration, including paper and pencil, online and telephone. Unintentional injuries are the leading cause of mortality in Canada among individuals 1-34 years of age. In 2009, 663 children age 1-14 years and 2,096 individuals age 15 to 24 years died as the result of an unintentional injury [2]. Despite the major burden that injuries represent, studies investigating health related quality of life (HRQoL) after traumatic injury are scarce, for children and youth, and for those who were not admitted to hospital as a result of their injuries [4]. This study of children aged 5 to 14 years found that admission to hospital and length of stay, of >3 days, were negatively associated with children’s functioning at 2.5 months, five months and nine months post injury
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