Newcombe Peter A, Sheffield Jeanie K, Juniper Elizabeth F, Marchant Julie M, Halsted Ria A, Masters I Brent, Chang Anne B
School of Psychology, The University of Queensland, 11 Salisbury Rd, Ipswich, QLD, Australia 4305.
Chest. 2008 Feb;133(2):386-95. doi: 10.1378/chest.07-0888.
Chronic cough affects at least 7% of children, and the impact of this on families is significant. Although adult cough-specific quality-of-life (QOL) instruments have been shown to be a useful cough outcome measure, no suitable cough-specific QOL for parents of children with chronic cough exists. This article compares two methods of item reduction (clinical impact and psychometric) and reports on the statistical properties of both QOL instruments.
One hundred seventy children (97 boys and 73 girls; median age, 4 years; interquartile range, 3 to 7.25 years) and one of their parents participated. A preliminary 50-item parent cough-specific QOL (PC-QOL) questionnaire was developed from conversations with parents of children with chronic cough (ie, cough for > 3 weeks). Parents also completed generic QOL questionnaires (eg, Pediatric Quality of Life Inventory, version 4.0 [PedsQL4.0] and the 12-item Short Form Health Survey, version 2 [SF-12v2]).
The clinical impact and psychometric method of item reduction resulted in 27-item and 26-item PC-QOL questionnaires, respectively, with approximately 50% of items overlapping. Internal consistency among the final items from both methods was excellent. Some evidence for concurrent and criterion validity of both methods was established as significant correlations were found between subscales of the PC-QOL questionnaire and the scales of the SF-12v2 and PedsQL4.0 scores. The PC-QOL questionnaire derived from both methods was sensitive to change following an intervention.
Chronic cough significantly impacts on the QOL of both parents and children. Although the PC-QOL questionnaires derived from a clinical impact method and from a psychometric method contained different items, both versions were shown to be internally consistent and valid. Further testing is required to compare both final versions to objective and subjective cough measures.
慢性咳嗽影响至少7%的儿童，且这对家庭的影响很大。尽管成人咳嗽特异性生活质量（QOL）工具已被证明是一种有用的咳嗽结局指标，但目前尚无适用于慢性咳嗽患儿家长的咳嗽特异性QOL工具。本文比较了两种条目删减方法（临床影响法和心理测量法），并报告了两种QOL工具的统计学特性。
170名儿童（97名男孩和73名女孩；中位年龄4岁；四分位间距3至7.25岁）及其一名家长参与研究。通过与慢性咳嗽患儿（即咳嗽超过3周）的家长交谈，编制了一份初步的50条目家长咳嗽特异性QOL（PC-QOL）问卷。家长们还完成了通用QOL问卷（如儿童生活质量量表第4版 [PedsQL4.0] 和12条目健康调查简表第2版 [SF-12v2]）。
临床影响法和心理测量法的条目删减分别产生了27条目和26条目PC-QOL问卷，约50%的条目重叠。两种方法最终条目的内部一致性都很好。由于PC-QOL问卷的子量表与SF-12v2和PedsQL4.0分数的量表之间存在显著相关性，因此确立了两种方法的一些同时效度和效标效度证据。两种方法得出的PC-QOL问卷对干预后的变化敏感。
慢性咳嗽对家长和儿童的QOL都有显著影响。尽管临床影响法和心理测量法得出的PC-QOL问卷包含不同的条目，但两个版本都显示出内部一致性和效度。需要进一步测试以将两个最终版本与客观和主观咳嗽指标进行比较。
