Measurement properties of the Health Anxiety by Proxy Scale (HAPYS): A new questionnaire to assess parents' worries about their child's health

Abstract

ObjectiveHealth anxiety by proxy refers to parents' excessive worries about their child's health. The Health Anxiety by Proxy scale (HAPYS) is a new self-report questionnaire to assess parents' worries and behaviors regarding their child's health. This study aimed to investigate the measurement properties of the HAPYS. MethodsQuestionnaires were completed by 204 parents, and a HAPYS score was obtained for 200 parents: 39 parents diagnosed with health anxiety, 33 parents with different anxiety disorders, 33 parents with a Functional Somatic Disorder, and 95 healthy parents. We evaluated the following measurement properties: structural validity, reliability, convergent validity ((pain catastrophizing, parents' reports of child's emotional and physical symptoms), discriminant validity (parental reports of child's well-being), and known-groups validity (see compared groups above). ResultsHAPYS demonstrated a one factor dimensionality, and excellent internal reliability (α = 0.95; CI: 0.93–0.97) and test-retest reliability after two weeks (ICC = 0.91; CI: 0.87–0.94). Convergent validity with the construct of parental catastrophizing about child pain was good (r = 0.72; CI: 0.64–0.78)). Good known-groups validity was demonstrated by the largest total HAPYS score observed in parents with health anxiety (median = 35; IQR: 9–53) and the lowest score in healthy parents (median = 9; IQR: 5–15) (p < 0.001). ConclusionThe findings support that HAPYS is a useful measure of health anxiety by proxy. Future research should examine the measurement properties in larger samples and different languages with further statistical analyses of structural validity.