Shakya Suraj, Sthapit Sabitri, Rana Mita, Kunwar Arun Raj, Bhandary Shital
Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.
Central Department of Psychology, Tribhuvan University, Kirtipur, Nepal.
JNMA J Nepal Med Assoc. 2024 Oct;62(278):646-654. doi: 10.31729/jnma.8785. Epub 2024 Oct 31.
The Tej Emotional and Behavioral Problem Checklist (TEJ-CL) was developed in Nepalese context to aid assessment of childhood emotional and problems of children. This study aimed to evaluate TEJ-CL's factor structure, reliability, and validity evidences as an add-on and symptom monitoring test.
This cross-sectional validation study included guardians of 320 children (age 5-17 years) from tertiary mental health centers in Kathmandu as referred group, along with 601 children from two schools (private and community) in Kathmandu as non-referred group. IRC was obtained ethical approval (ref: 183 (6-11-E)2/073/074 and ref: 776). TEJ-CL, an 89-item parent-reported questionnaire, served as the index test, while referral status acted as the reference standard. Factor structure, internal consistency, test-retest/cross-informant correlations and criterion validity evidence was assessed using principal component analysis, coefficient alpha, spearman's rank correlation and linear regression models, respectively.
Analysis was done using 179 referred and 412 non-referred individuals based on non-missing data. Principal component analysis in referred sample reduced the number of items of questionnaire to 65 from 89 and indicated six factors: externalizing behavioral issues, anxiety/worries, upset/sadness, somatic concern, miscellaneous syndrome, and severe issues with coefficient alpha ranging from .62 to .95. As criterion validity evidence, referred children showed significantly higher scores than non-referred children across composite and factor scores, except for anxiety/worries factor. Similarly, regression analyses within the referred group demonstrated significant associations between factor scores and specific diagnoses.
Reliability and validity estimate of questionnaire is comparable to similar empirically based scales. Future research should focus on assessing the tool's generalizability and improving discriminatory indexes.
“特杰儿童情绪与行为问题清单”（TEJ-CL）是在尼泊尔的背景下编制的，用于辅助评估儿童的情绪和行为问题。本研究旨在评估TEJ-CL作为一种附加测试和症状监测测试的因子结构、信度和效度证据。
这项横断面验证研究纳入了来自加德满都三级心理健康中心的320名儿童（5至17岁）的监护人作为转诊组，以及来自加德满都两所学校（私立和社区）的601名儿童作为非转诊组。该研究获得了伦理批准（编号：183(6-11-E)2/073/074和编号：776）。TEJ-CL是一份由家长报告的89项问卷，作为指标测试，而转诊状态作为参考标准。分别使用主成分分析、α系数、斯皮尔曼等级相关性和线性回归模型评估因子结构、内部一致性、重测/不同报告者之间的相关性以及效标效度证据。
基于无缺失数据，对179名转诊个体和412名非转诊个体进行了分析。转诊样本中的主成分分析将问卷项目数量从89项减少到65项，并显示出六个因子：外化行为问题、焦虑/担忧、心烦/悲伤、躯体关注、杂项综合征和严重问题，α系数范围为0.62至0.95。作为效标效度证据，除焦虑/担忧因子外，转诊儿童在综合得分和因子得分方面均显著高于非转诊儿童。同样，转诊组内的回归分析表明因子得分与特定诊断之间存在显著关联。
该问卷的信度和效度估计与类似的基于实证的量表相当。未来的研究应侧重于评估该工具的可推广性并改善鉴别指数。
