Follansbee-Junger Katherine W, Mann Krista A, Guilfoyle Shanna M, Morita Diego A, Varni James W, Modi Avani C
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.
Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.
Epilepsy Behav. 2016 Sep;62:115-20. doi: 10.1016/j.yebeh.2016.06.011. Epub 2016 Jul 23.
Youth with epilepsy have impaired health-related quality of life (HRQOL). Existing epilepsy-specific HRQOL measures are limited by not having parallel self- and parent-proxy versions, having a restricted age range, not being inclusive of children with developmental disabilities, or being too lengthy for use in a clinical setting. Generic HRQOL measures do not adequately capture the idiosyncrasies of epilepsy. The purpose of the present study was to develop items and content validity for the PedsQL™ Epilepsy Module.
An iterative qualitative process of conducting focus group interviews with families of children with epilepsy, obtaining expert input, and conducting cognitive interviews and debriefing was utilized to develop empirically derived content for the instrument. Eleven health providers with expertise in pediatric epilepsy from across the country provided feedback on the conceptual model and content, including epileptologists, nurse practitioners, social workers, and psychologists. Ten pediatric patients (age 4-16years) with a diagnosis of epilepsy and 11 parents participated in focus groups. Thirteen pediatric patients (age 5-17years) and 17 parents participated in cognitive interviews.
Focus groups, expert input, and cognitive debriefing resulted in 6 final domains including restrictions, seizure management, cognitive/executive functioning, social, sleep/fatigue, and mood/behavior. Patient self-report versions ranged from 30 to 33 items and parent proxy-report versions ranged from 26 to 33 items, with the toddler and young child versions having fewer items.
Standardized qualitative methodology was employed to develop the items and content for the novel PedsQL™ Epilepsy Module. The PedsQL™ Epilepsy Module has the potential to enhance clinical decision-making in pediatric epilepsy by capturing and monitoring important patient-identified contributors to HRQOL.
患有癫痫的青少年的健康相关生活质量(HRQOL)受损。现有的癫痫特异性HRQOL测量方法存在局限性,如没有平行的自我报告和家长代理报告版本、年龄范围受限、不包括发育障碍儿童或在临床环境中使用过长。通用的HRQOL测量方法不能充分反映癫痫的特质。本研究的目的是开发PedsQL™癫痫模块的条目并进行内容效度检验。
采用迭代定性过程,对癫痫患儿家庭进行焦点小组访谈、获取专家意见,并进行认知访谈和汇报,以开发该工具的经验性内容。来自全国各地的11名儿科癫痫专家,包括癫痫学家、执业护士、社会工作者和心理学家,对概念模型和内容提供了反馈。10名诊断为癫痫的儿科患者(4 - 16岁)和11名家长参加了焦点小组。13名儿科患者(5 - 17岁)和17名家长参加了认知访谈。
焦点小组、专家意见和认知汇报产生了6个最终领域,包括限制、癫痫发作管理、认知/执行功能、社交、睡眠/疲劳和情绪/行为。患者自我报告版本有30至33个条目,家长代理报告版本有26至33个条目,幼儿和年幼儿童版本的条目较少。
采用标准化的定性方法开发了新型PedsQL™癫痫模块的条目和内容。PedsQL™癫痫模块有可能通过捕捉和监测患者确定的对HRQOL有重要影响的因素,增强儿科癫痫的临床决策。