Validation of an “In the Moment” Pediatric Quality of Life Scale for Hospitalized Children

2.50
Hdl Handle:
http://hdl.handle.net/10755/603068
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Title:
Validation of an “In the Moment” Pediatric Quality of Life Scale for Hospitalized Children
Other Titles:
Discussions of Quality of Life in Children with Healthcare Issues [Session]
Author(s):
Ryan-Wenger, Nancy A.; Kesic-Sellers, Aricka; Kesic-Sellers, Aricka
Lead Author STTI Affiliation:
Epsilon
Author Details:
Nancy A. Ryan-Wenger, RN, PhD, CPNP, Ryan-Wenger.10@OSU.edu; Aricka Kesic-Sellers, RN, NP-C
Abstract:
Session presented on Saturday, November 7, 2015: BACKGROUND: Health-related quality of life from the individual’s perspective is widely used to measure of the impact of illness on the individual, outcomes of treatment, and quality of care. Varni and colleagues developed a series of Pediatric Quality of Life (PedsQL™) scales for children ages 5 to 18 years, including a generic Core Scale and scales for chronic disease-specific dimensions of children’s quality of life. These instruments capture quality of life over a specified period of time such as the past week, or the past month. During hospitalization, when perceptions of illness and treatment change daily or hourly, a brief in-the-moment quality of life measure was needed to evaluate quality of care and treatment outcomes. PURPOSE: We evaluated the psychometric properties of the Pediatric Quality of Life “In the Moment” scale (PedsQL-IM), a brief measure of the impact of illness and outcomes of treatment during hospitalization. The instrument was based on Ecological Momentary Assessment Theory in which individuals’ behavior, emotions, and symptoms are assessed in his or her natural environment at that specific moment, thus, minimizing recall bias. METHODS: In a cross-sectional study on the quality of nursing care from the children’s perspective, volunteer participants included 496 children and adolescents, ages 6 to 21 years, hospitalized in a 400-bed freestanding children’s hospital. This study is a secondary analysis of data from 410 (82.7%) patients who completed both the PedsQL-IM and the Revised Children’s Anxiety and Depression Scale (RCADS), which was used for convergent validity. The six PedsQL-IM items included “I feel: afraid or scared, sad or blue, angry, worried about what will happen to me, tired, and pain or hurt,” measured on an ordinal scale, e.g., “I feel angry…” 1=not at all, 2=a little bit angry, 3=somewhat, 4=quite a bit, 5=very much. Total scores ranged from 6 to 30. An Emotional Distress subscale score was the sum of the first four items, ranging from 4 to 20. Psychometric properties were analyzed from three theoretical perspectives: classical measurement theory, domain sampling theory, and generalizability theory. RESULTS: The most frequently experienced PedsQL-IM symptom was tired, followed by pain, worried, sad, afraid, and angry. The mean Total Score was 4.5 ±3.6 and the mean Emotional Distress subscale score was 2.2 ±2.4. Internal consistency reliability of the PedsQL-IM was 0.71. Analyses based on generalizability theory indicated that differences among subjects explained 66.4% of the total variance, items explained 6.7%, and the interaction of subjects by items explained 26.9%. The generalizability coefficient of reliability was 0.71. Unrotated exploratory factor analysis indicated that all 6 items loaded from 0.593 to 0.719 on the first component. The two physical symptoms, tired and pain, also loaded strongly on component 2 (0.557 and 0.487 respectively). Convergent validity was demonstrated by moderately high correlations between RCADS T-scores and PedsQL-IM Total scores ( r =0.494, p≤0.001), and Emotional Distress subscale scores (r =0.452, p ≤0.001). Each item correlated r ≥0.388 with at least one RCADS scale. Nearly 20% (n=80, 19.5%) of the 410 children had at least one RCADS subscale T-score in the borderline and/or clinical range. An ROC analysis indicated that a cut-off PedsQL-IM score of ≥4 included 65 (81%) of these children with a sensitivity of 81.3%. CONCLUSIONS: Hospitalized children are frequently asked about their levels of pain, but are rarely asked about being worried about what will happen to them, afraid, angry, sad, or tired. The total PedsQL-IM score can be useful to evaluate overall “In the moment” quality of life over time. Children who rate any of these symptoms as somewhat, quite a bit, or very much, are signaling to their nurses and other providers that further questioning, intervention, and follow-up are essential. The PedsQL-IM could be administered with vital signs to evaluate the process and outcomes of pediatric patient care.
Keywords:
hospitalized children; quality of life; instrument development
Repository Posting Date:
21-Mar-2016
Date of Publication:
21-Mar-2016
Other Identifiers:
CONV15A26
Conference Date:
2015
Conference Name:
43rd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Las Vegas, Nevada, USA
Description:
43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.titleValidation of an “In the Moment” Pediatric Quality of Life Scale for Hospitalized Childrenen
dc.title.alternativeDiscussions of Quality of Life in Children with Healthcare Issues [Session]en
dc.contributor.authorRyan-Wenger, Nancy A.en
dc.contributor.authorKesic-Sellers, Arickaen
dc.contributor.authorKesic-Sellers, Arickaen
dc.contributor.departmentEpsilonen
dc.author.detailsNancy A. Ryan-Wenger, RN, PhD, CPNP, Ryan-Wenger.10@OSU.edu; Aricka Kesic-Sellers, RN, NP-Cen
dc.identifier.urihttp://hdl.handle.net/10755/603068en
dc.description.abstractSession presented on Saturday, November 7, 2015: BACKGROUND: Health-related quality of life from the individual’s perspective is widely used to measure of the impact of illness on the individual, outcomes of treatment, and quality of care. Varni and colleagues developed a series of Pediatric Quality of Life (PedsQL™) scales for children ages 5 to 18 years, including a generic Core Scale and scales for chronic disease-specific dimensions of children’s quality of life. These instruments capture quality of life over a specified period of time such as the past week, or the past month. During hospitalization, when perceptions of illness and treatment change daily or hourly, a brief in-the-moment quality of life measure was needed to evaluate quality of care and treatment outcomes. PURPOSE: We evaluated the psychometric properties of the Pediatric Quality of Life “In the Moment” scale (PedsQL-IM), a brief measure of the impact of illness and outcomes of treatment during hospitalization. The instrument was based on Ecological Momentary Assessment Theory in which individuals’ behavior, emotions, and symptoms are assessed in his or her natural environment at that specific moment, thus, minimizing recall bias. METHODS: In a cross-sectional study on the quality of nursing care from the children’s perspective, volunteer participants included 496 children and adolescents, ages 6 to 21 years, hospitalized in a 400-bed freestanding children’s hospital. This study is a secondary analysis of data from 410 (82.7%) patients who completed both the PedsQL-IM and the Revised Children’s Anxiety and Depression Scale (RCADS), which was used for convergent validity. The six PedsQL-IM items included “I feel: afraid or scared, sad or blue, angry, worried about what will happen to me, tired, and pain or hurt,” measured on an ordinal scale, e.g., “I feel angry…” 1=not at all, 2=a little bit angry, 3=somewhat, 4=quite a bit, 5=very much. Total scores ranged from 6 to 30. An Emotional Distress subscale score was the sum of the first four items, ranging from 4 to 20. Psychometric properties were analyzed from three theoretical perspectives: classical measurement theory, domain sampling theory, and generalizability theory. RESULTS: The most frequently experienced PedsQL-IM symptom was tired, followed by pain, worried, sad, afraid, and angry. The mean Total Score was 4.5 ±3.6 and the mean Emotional Distress subscale score was 2.2 ±2.4. Internal consistency reliability of the PedsQL-IM was 0.71. Analyses based on generalizability theory indicated that differences among subjects explained 66.4% of the total variance, items explained 6.7%, and the interaction of subjects by items explained 26.9%. The generalizability coefficient of reliability was 0.71. Unrotated exploratory factor analysis indicated that all 6 items loaded from 0.593 to 0.719 on the first component. The two physical symptoms, tired and pain, also loaded strongly on component 2 (0.557 and 0.487 respectively). Convergent validity was demonstrated by moderately high correlations between RCADS T-scores and PedsQL-IM Total scores ( r =0.494, p≤0.001), and Emotional Distress subscale scores (r =0.452, p ≤0.001). Each item correlated r ≥0.388 with at least one RCADS scale. Nearly 20% (n=80, 19.5%) of the 410 children had at least one RCADS subscale T-score in the borderline and/or clinical range. An ROC analysis indicated that a cut-off PedsQL-IM score of ≥4 included 65 (81%) of these children with a sensitivity of 81.3%. CONCLUSIONS: Hospitalized children are frequently asked about their levels of pain, but are rarely asked about being worried about what will happen to them, afraid, angry, sad, or tired. The total PedsQL-IM score can be useful to evaluate overall “In the moment” quality of life over time. Children who rate any of these symptoms as somewhat, quite a bit, or very much, are signaling to their nurses and other providers that further questioning, intervention, and follow-up are essential. The PedsQL-IM could be administered with vital signs to evaluate the process and outcomes of pediatric patient care.en
dc.subjecthospitalized childrenen
dc.subjectquality of lifeen
dc.subjectinstrument developmenten
dc.date.available2016-03-21T16:42:37Zen
dc.date.issued2016-03-21en
dc.date.accessioned2016-03-21T16:42:37Zen
dc.conference.date2015en
dc.conference.name43rd Biennial Conventionen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationLas Vegas, Nevada, USAen
dc.description43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`en
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.