Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Qual Life Res. 2012 May;21(4):727-36. doi: 10.1007/s11136-011-9975-7. Epub 2011 Jul 23.
To evaluate the PedsQLs performance in children with intermittent exotropia (X[T]) in terms of feasibility, internal consistency, floor-ceiling effects and levels of parent-child agreement.
Children with X(T) aged <12 years were recruited from 26 UK Hospital Eye Clinics/Orthoptic Departments. QOL was assessed using child (n = 166) and proxy (n = 392) versions of the PedsQLv4. Feasibility was assessed by percentage of missing responses; internal consistency by Cronbach's alpha and agreement by Bland-Altman plots and intraclass correlations. Analyses included age and gender comparisons.
Missing response rates were no higher than 1.8%. Cronbach's alpha reached ≥ 0.70 on all but one parent-rated scale and on most child-rated Total, Psychosocial Summary and Social Functioning scales, but was <0.70 on most child-rated Physical, Emotional and School Functioning scales. On parent-rated scales, there were no floor effects; ceiling effects reached 27-56% in parents' Physical, Social and School Functioning. On child-rated scales, there were 0-1% floor effects and 0-28% ceiling effects. Parent-child agreement was fair to poor and varied by child's gender.
Proxy-rated PedsQLs demonstrated good internal consistency/feasibility in parents of children with X(T); child-rated reports appeared acceptable, although caution is advised regarding Physical, Emotional and School Functioning scales in younger children. Low-fair agreement between proxy and self-ratings is common in paediatric QOL assessment, reiterating the importance of obtaining both perspectives. We encourage future studies to explore the influence of child's age and gender, and the relationship of the proxy respondent.
评估儿童间歇性外斜视（X[T]）患者的 PedsQL 表现，包括可行性、内部一致性、地板-天花板效应以及父母与子女之间的一致性水平。
从 26 家英国医院眼科诊所/视光科招募了年龄<12 岁的 X[T]患儿。使用儿童（n=166）和家长（n=392）版 PedsQLv4 评估生活质量。通过缺失应答率评估可行性；通过 Cronbach's alpha 评估内部一致性；通过 Bland-Altman 图和组内相关系数评估一致性。分析包括年龄和性别比较。
缺失应答率不超过 1.8%。除了一个家长评分量表外，所有量表的 Cronbach's alpha 均≥0.70，且大多数儿童的总评分、心理社会综合评分和社会功能评分的 Cronbach's alpha 也≥0.70，但大多数儿童的身体、情感和学业功能评分的 Cronbach's alpha <0.70。在家长评分量表中，没有地板效应；但在家长的身体、社会和学业功能评分中，天花板效应达到 27-56%。在儿童评分量表中，有 0-1%的地板效应和 0-28%的天花板效应。父母与子女之间的一致性为一般至较差，且因儿童的性别而异。
在 X[T]患儿的家长中，代理报告的 PedsQL 具有良好的内部一致性/可行性；儿童自评报告似乎可以接受，但在评估年幼儿童的身体、情感和学业功能评分时应谨慎。在儿科生活质量评估中，代理与自我评分之间的一致性低至一般是常见的，这再次强调了同时获得两种观点的重要性。我们鼓励未来的研究探索儿童年龄和性别以及代理回应者的关系的影响。
