Conway Lauryn, Widjaja Elysa, Smith Mary Lou, Speechley Kathy N, Ferro Mark A
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada.
Epilepsia. 2017 Apr;58(4):646-656. doi: 10.1111/epi.13697. Epub 2017 Feb 15.
The aim of this study was to validate the newly developed shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) in a sample of children with drug-resistant epilepsy.
Data came from 136 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Confirmatory factor analysis was used to assess the higher-order factor structure of the QOLCE-55. Convergent and divergent validity was assessed by correlating subscales of the KIDSCREEN-27 with the QOLCE-55. Measurement equivalence of the QOLCE-55 was evaluated using multiple-group confirmatory factor analysis of children with drug-resistant epilepsy from PEPSQOL versus children with new-onset epilepsy from HERQULES (Health-Related Quality of Life in Children with Epilepsy Study).
The higher-order factor structure of the QOLCE-55 demonstrated adequate fit: Comparative Fit Index (CFI) = 0.948; Tucker-Lewis Index (TLI) = 0.946; Root Mean Square of Approximation (RMSEA) = 0.060 (90% confidence interval [CI] 0.054-0.065); Weighted Root Mean Square Residuals (WRMR) = 1.247. Higher-order factor loadings were strong, ranging from λ = 0.74 to 0.81. Internal consistency reliability was excellent (α = 0.97, subscales α > 0.82). QOLCE-55 subscales demonstrated moderate to strong correlations with similar subscales of the KIDSCREEN-27 (ρ = 0.43-0.75) and weak to moderate correlations with dissimilar subscales (ρ = 0.25-0.42). The QOLCE-55 demonstrated partial measurement equivalence at the level of strict invariance - χ (2,823) = 3,727.9, CFI = 0.961, TLI = 0.962, RMSEA = 0.049 (0.044, 0.053), WRMR = 1.834.
The findings provide support for the factor structure of the QOLCE-55 and contribute to its robust psychometric profile as a reliable and valid measure. Researchers and health practitioners should consider the QOLCE-55 as a viable option for reducing respondent burden when assessing health-related quality of life in children with epilepsy.
本研究旨在验证新开发的缩短版儿童癫痫生活质量问卷（QOLCE - 55）在耐药性癫痫患儿样本中的有效性。
数据来自136名参与儿童癫痫手术对健康相关生活质量影响研究（PEPSQOL）的儿童，这是一项多中心前瞻性队列研究。验证性因素分析用于评估QOLCE - 55的高阶因素结构。通过将KIDSCREEN - 27的子量表与QOLCE - 55进行相关性分析来评估收敛效度和区分效度。使用对PEPSQOL中耐药性癫痫患儿与HERQULES（癫痫患儿健康相关生活质量研究）中新发癫痫患儿的多组验证性因素分析来评估QOLCE - 55的测量等价性。
QOLCE - 55的高阶因素结构显示出良好的拟合度：比较拟合指数（CFI）= 0.948；塔克 - 刘易斯指数（TLI）= 0.946；近似均方根（RMSEA）= 0.060（90%置信区间[CI] 0.054 - 0.065）；加权均方根残差（WRMR）= 1.247。高阶因素负荷很强，范围从λ = 0.74到0.81。内部一致性信度极佳（α = 0.97，子量表α > 0.82）。QOLCE - 55子量表与KIDSCREEN - 27的相似子量表显示出中度到强的相关性（ρ = 0. 43 - 0.75），与不同子量表的相关性较弱到中度（ρ = 0.25 - 0.42）。QOLCE - 55在严格不变性水平上显示出部分测量等价性 - χ（2,823）= 3,727.9，CFI = 0.961，TLI = 0.962，RMSEA = 0.049（0.044，0.053），WRMR = 1.834。
研究结果为QOLCE - 55的因素结构提供了支持，并有助于其作为一种可靠有效的测量工具的强大心理测量特征。研究人员和健康从业者在评估癫痫患儿的健康相关生活质量时，应将QOLCE - 55视为减轻受访者负担的可行选择。
