Abstract
BackgroundTo assess cross-cultural validity between Dutch and English versions of the FVQ_CYP, a patient-reported outcome measure developed in the United Kingdom (UK) for children and adolescents with (severe) visual impairment or blindness (VI for brevity) to measure functional vision.MethodsThe 36-item FVQ_CYP was translated and adapted into Dutch using standard guidelines. The questionnaire was administered to Dutch children and adolescents aged 7–17 years (N = 253) with impaired vision (no restrictions regarding acuity). Data were compared to existing UK data of children and adolescents aged 10–15 years (N = 91) with VI (acuity LogMar worse than 0.48). As with the original UK FVQ_CYP validation, a rating scale model (RSM) was applied to the Dutch data.ResultsMinor adaptations were needed in translation-rounds. Significant differences in item responses were found between the Dutch and UK data. Item response theory assumptions were met, but fit to the RSM was unsatisfactory. Therefore, psychometric properties of the Dutch FVQ_CYP were analysed irrespective of the original model and criteria used. A graded response model led to the removal of 12 items due to missing data, low information, overlapping content and limited relevance to Dutch children. Fit indices for the remaining 24 items were adequate.ConclusionsDifferences in population characteristics, distribution of responses, non-invariance at the model level and small sample sizes challenged the cross-cultural validation process. However, the Dutch adapted FVQ_CYP showed high measurement precision and broad coverage of items measuring children’s functional vision. The underlying reasons for differences between countries in instrument performance are discussed with implications for future studies.
Highlights
To assess cross-cultural validity between Dutch and English versions of the FVQ_CYP, a patientreported outcome measure developed in the United Kingdom (UK) for children and adolescents with visual impairment or blindness (VI for brevity) to measure functional vision
It was noted that different wording might be necessary for younger children vs. the older children
This study shows that, with appropriate modification, it is possible to administer the questionnaire to children and adolescents outside the original 10–15 years age interval, and to children and adolescents with less severe visual impairment
Summary
To assess cross-cultural validity between Dutch and English versions of the FVQ_CYP, a patientreported outcome measure developed in the United Kingdom (UK) for children and adolescents with (severe) visual impairment or blindness (VI for brevity) to measure functional vision. Availability and implementation of instruments to assess functional vision in paediatric ophthalmology would complement objective clinical measures of visual function, such as visual acuity and visual field. These instruments can be used to monitor and evaluate the effectiveness of low vision rehabilitation. The Cardiff Visual Ability Questionnaire for Children and Young People has been developed and tested in a specific geographical area in the United Kingdom (UK), and translated and validated in Turkish and Chinese [15, 16], its applicability elsewhere is currently limited [17]
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