ABSTRACT
OBJECTIVES: To assess the psychometric properties of the German self-reported version of the Kiddy-KINDL that measures Health Related Quality of Life (HRQoL) in 3 to 5 year old kindergarten children. STUDY DESIGN: The population of the study comprised baseline data of a longitudinal study whose main aim is to investigate self-reported health outcomes in young children (N = 317). METHODS: Missing values, the distribution of data, internal consistency (Cronbach's alpha and Guttman's lambda), and reliability (split half and two weeks test-retest) were analysed. To assess discriminant validity, mean differences were tested splitting the sample regarding socio-emotional competences (VBV 3-6), age and gender. Structural validity was investigated with Confirmatory Factor Analysis (CFA). RESULTS: Mean HRQoL was 69.79 (SD 16.84). Overall missing values were 8.1%, overall Cronbach's alpha was 0.75 and overall Guttman's lambda was 0.77; for the whole scale Spearman-Brown test for split half reliability resulted in 0.80 and ICC for test-retest in 0.83. Discriminant validity investigation differentiated groups with high and low socio-emotional competence and those children who were 4.5 years or older, compared to the younger ones. Differences between boys and girls were also found. CFA suggested two main dimensions: physical and socio-emotional. CONCLUSION: This preliminary validation of the Kiddy-KINDL in very young children shows satisfactory psychometric properties. However, results of the Cronbach's alpha, Guttman's lambda and the CFA depicted problems, mainly in the psychological dimension. Due to these we recommend to use the Kiddy-KINDL as an instrument with only two dimensions. Further studies in general population samples are needed.
Subject(s)
Health Status Indicators , Psychometrics/instrumentation , Quality of Life/psychology , Surveys and Questionnaires/standards , Child , Emotions , Factor Analysis, Statistical , Female , Humans , Longitudinal Studies , Male , Psychometrics/statistics & numerical data , Reproducibility of Results , Self Report , Sensitivity and SpecificityABSTRACT
Normal pressure hydrocephalus (NPH) is characterised by gait disturbance, urinary incontinence and dementia. Even though dementia is a cardinal symptom of NPH, there is few data available concerning cognitive functioning. The aim of this observational case-control study was to evaluate the use of neuropsychological (NPSY) tests prior and after spinal tap test, which might be helpful for diagnosis, treatment and as a prognostic factor for shunt surgery. 15 patients with NPH and 18 controls were examined with eleven different tests covering all neuropsychological domains on two consecutive days. The second examination in NPH patients was 1 day after a spinal tap of 30-50 ml cerebrospinal fluid. A significant difference between NPH and controls in the change between baseline and 1 day after spinal tap was only observed in MMSE. In the domains of visuo-constructive function and attention, controls performed slightly better at day one compared to baseline, which could be interpreted as a learning effect, but after adjusting for multiple testing none of the P values were significant. In contrast to other reports, the MMSE seems to provide a sensitive evaluation of the response to spinal tap in NPH patients and might therefore be included into the routine work up of NPH patients. All other NPSY tests showed less prominent changes within 1 day after spinal tap.
Subject(s)
Cognition , Hydrocephalus, Normal Pressure/psychology , Mental Status Schedule/standards , Neuropsychological Tests/standards , Spinal Puncture/psychology , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Hydrocephalus, Normal Pressure/diagnosis , Male , Middle Aged , Observational Studies as Topic , Spinal Puncture/methods , Time FactorsABSTRACT
BACKGROUND: Health-related quality of life (HRQOL) associated or not with the measurement of neuropsychological functioning is a relatively new outcome variable in the field of traumatic brain injury (TBI). In both cases, accuracy and precision are increased in outcome estimation. Validation of generic, cross-culturally (cc) administered HRQOL measures in persons after TBI is not yet well established. Disease-specific HRQOL instruments do not exist in an international context. The objective here is to present the TBI consensus group's (QOLIBRI-Group) approach in cc development of a specific HRQOL measure--the QOLIBRI (Quality of Life after Brain Injury). METHODS: Special issues of TBI-specific instrument creation will be highlighted as well as cc questionnaire construction, development, translation and psychometric testing. RESULTS: The validation process of the preliminary version of the disease-specific QOLIBRI in 15 countries and 13 languages will be described. The QOLIBRI assesses HRQOL within six domains (physical condition, thinking activities, feelings and emotions, functioning in daily life, relationships and social/leisure activities, current situation and future prospects). The QOLIBRI integrates disease-specific issues of TBI patients, i.e. cognition, existential aspects (as the sense of self) etc., which are missing in generic tools. CONCLUSION: In TBI patients, generic and disease-specific aspects of HRQOL need to be assessed with measures of adequate psychometric quality, applicable across different populations and cultural conditions. The QOLIBRI is a promising instrument for sensitive patient-centered specific outcome evaluation after TBI.
