Validity and reliability of a quality-of-life assessment instrument in children aged between 6 and 11 years

Abstract

BACKGROUND: There is increasing recognition of the importance of obtaining children's reports of their health, but significant challenges remain in accomplishing these goals in a systematic, community-based approach. OBJECTIVES: The aim of study was to evaluate the validity and reliability of the culturally adapted Turkish version of the “Child Health and Illness Profile - Child Edition (CHIP-CE) (6-11) for children 6 to 11 years of age. DESIGN: Cross-sectional analytical study conducted at Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey. SETTING: Children's health and diseases clinic. PATIENTS AND METHODS: For the purpose of this study, face-to-face interviews were conducted with inpatients (children aged between 6 and 11 years staying in the hospital) and healthy children (children aged between 6 and 11 years attending a private elementary school in the spring semester of 2010-2011). The Turkish version of CHIP-CE (6-11) was administered after the original version of CHIP-CE in English was translated into Turkish, and then back translated into English. All steps in the cultural adaptation process were undertaken meticulously by an expert committee. Confirmatory factor analysis (CFA) was conducted to test construct validity. The Cronbach's alpha and item-total correlations were used to evaluate internal consistency for reliability testing. MAIN OUTCOME MEASURES: Domain scores on the CHIP-CE questionnaire, Cronbach's alpha and item-total correlations. RESULTS: The Turkish version of CHIP-CE (6-11) was administered to 235 children, including 109 (46.4%) girls and 126 (53.6%) boys receiving inpatient treatment in the hospital, and 194 healthy children, including 89 (45.9%) girls and 105 (54.1%) boys. The mean (standard deviation) age was 6.9 (1.6) years in the group of children receiving inpatient treatment, and 9.2 (1.6) years in the healthy children. In the reliability testing of the CHIP-CE form, Cronbach's alpha was 0.79 in children receiving inpatient treatment, and 0.80 in healthy children. These values indicate excellent reliability. The CFA measurement model produced results consistent with standards: χ2=185.76 df=160 P=.07986 RMSEA=0.026 in the children receiving inpatient treatment, and χ2=180.20 df=109 P=.00002 RMSEA=0.058 in healthy children. CONCLUSION: CHIP-CE proved to be a reliable and valid measurement instrument for children receiving treatment for various diseases and healthy children. The internal consistency of the Turkish version of CHIP-CE is acceptable. LIMITATIONS: The sample, although large and diverse, was self-selected and does not represent the population of children in Turkey.