Theunissen Meinou H C, Vogels Anton G C, de Wolff Marianne S, Crone Mathilde R, Reijneveld Sijmen A
TNO Child Health, P. O. Box 2215, 2301 CE, Leiden, NL, The Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
BMC Pediatr. 2015 Jul 16;15:84. doi: 10.1186/s12887-015-0391-y.
Validated questionnaires help community pediatric services to identify psychosocial problems. Our aim was to assess which of three short questionnaires was most suitable for this identification among pre-school children.
We included 1,650 children (response 64 %) aged 3-4 years undergoing routine well-child health assessments in 18 services across the Netherlands. Child healthcare professionals (CHPs) interviewed and examined children and parents. Parents were randomized regarding filling out the Strengths and Difficulties Questionnaire (SDQ) or the KIPPPI, a Dutch-origin questionnaire. In addition, all filled out the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) and the Child Behavior Checklist (CBCL). We assessed the internal consistency and validity of each questionnaire, with CBCL and treatment status as criteria, and the degree to which each questionnaire could improve identification based solely on clinical assessment.
The internal consistency of the total problems scale of each questionnaire was satisfactory, Cronbach's alphas varied between 0.75 and 0.98. Only the SDQ discriminated sufficiently between children with and without problems as measured by the CBCL (sensitivity = 0.76 at a cut-off point with specificity = 0.90), in contrast to the other two questionnaires (with sensitivity indices varying between 0.51-0.63). Similar results were found for the treatment status criterion, although sensitivity was lower for all questionnaires. The SDQ seemed to add most to the identification of psychosocial problems by CHPs, but the differences between the SDQ and the ASQ:SE were not statistically significant.
The SDQ is the best tool for the identification of psychosocial problems in pre-school children by community paediatric services.
经过验证的问卷有助于社区儿科服务识别心理社会问题。我们的目的是评估三种简短问卷中哪一种最适合用于识别学龄前儿童的此类问题。
我们纳入了荷兰18家机构中1650名3至4岁接受常规儿童健康评估的儿童（应答率64%）。儿童保健专业人员（CHP）对儿童及其家长进行了访谈和检查。家长被随机分配填写优势与困难问卷（SDQ）或荷兰本土问卷KIPPPI。此外，所有人都填写了年龄与发育进程问卷：社会情绪（ASQ:SE）和儿童行为量表（CBCL）。我们以CBCL和治疗状态为标准，评估了每份问卷的内部一致性和效度，以及每份问卷仅基于临床评估能够在多大程度上改善识别效果。
每份问卷的总问题量表的内部一致性令人满意，Cronbach's α系数在0.75至0.98之间。与其他两份问卷相比（敏感性指数在0.51 - 0.63之间），只有SDQ在区分有问题和无问题儿童方面具有足够的鉴别力（以CBCL衡量，在特异性为0.90的截断点时敏感性 = 0.76）。对于治疗状态标准也发现了类似结果，尽管所有问卷的敏感性都较低。SDQ似乎在CHP识别心理社会问题方面增加的信息最多，但SDQ与ASQ:SE之间的差异无统计学意义。
SDQ是社区儿科服务识别学龄前儿童心理社会问题的最佳工具。
