Tadić Valerija, Cooper Andrew, Cumberland Phillippa, Lewando-Hundt Gillian, Rahi Jugnoo S
Population, Policy and Practice Programme, Life Course Epidemiology and Biostatistics Section, University College London (UCL) Institute of Child Health, London, United Kingdom (United Kingdom).
Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
PLoS One. 2016 Feb 26;11(2):e0146225. doi: 10.1371/journal.pone.0146225. eCollection 2016.
To report piloting and initial validation of the VQoL_CYP, a novel age-appropriate vision-related quality of life (VQoL) instrument for self-reporting by children with visual impairment (VI).
Participants were a random patient sample of children with VI aged 10-15 years. 69 patients, drawn from patient databases at Great Ormond Street Hospital and Moorfields Eye Hospital, United Kingdom, participated in piloting of the draft 47-item VQoL instrument, which enabled preliminary item reduction. Subsequent administration of the instrument, alongside functional vision (FV) and generic health-related quality of life (HRQoL) self-report measures, to 101 children with VI comprising a nationally representative sample enabled further item reduction and evaluation of psychometric properties using Rasch analysis. Construct validity was assessed through Pearson correlation coefficients.
Item reduction through piloting (8 items removed for skewness and individual item response pattern) and validation (1 item removed for skewness and 3 for misfit in Rasch) produced a 35-item scale, with fit values within acceptable limits, no notable differential item functioning, good measurement precision, ordered response categories and acceptable targeting in Rasch. The VQoL_CYP showed good construct validity, correlating strongly with HRQoL scores, moderately with FV scores but not with acuity.
Robust child-appropriate self-report VQoL measures for children with VI are necessary for understanding the broader impacts of living with a visual disability, distinguishing these from limited functioning per se. Future planned use in larger patient samples will allow further psychometric development of the VQoL_CYP as an adjunct to objective outcomes assessment.
报告VQoL_CYP的试行及初步验证情况。VQoL_CYP是一种新颖的、适合儿童年龄的视力相关生活质量（VQoL）工具，用于视力障碍（VI）儿童的自我报告。
参与者为10 - 15岁视力障碍儿童的随机患者样本。从英国大奥蒙德街医院和摩尔菲尔德眼科医院的患者数据库中抽取69名患者，参与了47项VQoL工具草案的试行，这使得能够进行初步的项目删减。随后，对101名视力障碍儿童（包括一个具有全国代表性的样本）使用该工具，并同时进行功能性视力（FV）和一般健康相关生活质量（HRQoL）自我报告测量，从而能够进一步删减项目，并使用拉施分析评估心理测量特性。通过皮尔逊相关系数评估结构效度。
通过试行（因偏度和单个项目反应模式删除8项）和验证（因偏度删除1项，因拉施模型不匹配删除3项）进行项目删减后，得到一个35项的量表，其拟合值在可接受范围内，无明显的项目功能差异，测量精度良好，反应类别有序，且在拉施模型中有可接受的目标定位。VQoL_CYP显示出良好的结构效度，与HRQoL分数高度相关，与FV分数中度相关，但与视力不相关。
对于视力障碍儿童而言，强有力的、适合儿童的自我报告VQoL测量对于理解视力残疾生活的更广泛影响、将这些影响与本身有限的功能区分开来是必要的。未来计划在更大的患者样本中使用，将允许进一步对VQoL_CYP进行心理测量学开发，作为客观结果评估的辅助手段。
