Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Chedoke Site, Central Building, Room 310, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada,
Qual Life Res. 2013 Oct;22(8):2201-11. doi: 10.1007/s11136-013-0351-7. Epub 2013 Jan 20.
The present study investigated the higher-order summary factor structure of the Child Health Questionnaire Parent Form-50 (CHQ) in a sample of children with new-onset epilepsy. The secondary aim was to identify risk factors predicting health-related quality of life (HRQL) 24 months post-diagnosis.
Data came from the Health-related Quality of Life in Children with Epilepsy Study (HERQULES, N = 374), a multi-site study documenting HRQL among children with epilepsy from diagnosis through 24 months. Confirmatory factor analysis was used to determine goodness of fit between the original structure of the CHQ and HERQULES data. Multiple regression was used to identify risk factors at diagnosis for HRQL at 24 months.
The models demonstrated good fit: baseline: CFI = 0.945; TLI = 0.941; WRMR = 1.461; RMSEA = 0.058; 24 months: CFI = 0.957; TLI = 0.954; WRMR = 1.393; RMSEA = 0.055. Factor loadings were high and no cross-loadings observed (first order: λ = 0.27-0.99, 0.24-0.98; second order: λ = 0.69-0.86, 0.54-0.92; p < 0.001 for all). Controlling for HRQL at diagnosis, predictors for better 24-month HRQL were as follows: physical health: fewer cognitive problems (p = 0.023) and parents with fewer depressive symptoms (p = 0.049); psychosocial health: older parent age (p = 0.043), fewer behavior problems (p = 0.004), and families with better functioning (p = 0.008) and fewer demands (p = 0.009).
The CHQ higher-order summary factor structure was replicated in a sample of children with new-onset epilepsy, and child and family risk factors at diagnosis were found to predict HRQL 24 months post-diagnosis. These findings suggest it is possible to identify at-risk children early in the illness process and provide impetus for adopting family-centered care practices.
本研究旨在新诊断癫痫儿童样本中调查儿童健康问卷家长形式 50 项（CHQ）的高阶综合因子结构。次要目的是确定预测诊断后 24 个月健康相关生活质量（HRQL）的风险因素。
数据来自新诊断癫痫儿童健康相关生活质量研究（HERQULES，N=374），该多中心研究从诊断开始，通过 24 个月记录癫痫儿童的 HRQL。验证性因子分析用于确定 CHQ 和 HERQULES 数据原始结构之间的拟合优度。多元回归用于确定诊断时的风险因素与 24 个月时的 HRQL。
模型表现出良好的拟合度：基线：CFI=0.945；TLI=0.941；WRMR=1.461；RMSEA=0.058；24 个月：CFI=0.957；TLI=0.954；WRMR=1.393；RMSEA=0.055。因子负荷较高，无交叉负荷（一阶：λ=0.27-0.99，0.24-0.98；二阶：λ=0.69-0.86，0.54-0.92；p<0.001）。控制诊断时的 HRQL，更好的 24 个月 HRQL 的预测因素如下：身体健康：认知问题较少（p=0.023）和父母抑郁症状较少（p=0.049）；心理社会健康：父母年龄较大（p=0.043）、行为问题较少（p=0.004）、家庭功能更好（p=0.008）和需求较少（p=0.009）。
CHQ 高阶综合因子结构在新诊断癫痫儿童样本中得到了复制，并且诊断时的儿童和家庭风险因素被发现可以预测诊断后 24 个月的 HRQL。这些发现表明，有可能在疾病早期识别出高危儿童，并为采用以家庭为中心的护理实践提供动力。
