Psychometric properties of quality of life instruments for children and using the instrument to examine quality of life in overweight children

• Main Authors: Chung-YingLin, 林宗瑩
• Other Authors: Hui-Ing Ma
• Format: Others
• Language: en_US
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/12016827023181275282

博士 === 國立成功大學 === 健康照護科學研究所 === 101 === Quality of life (QoL), a multi-dimensional health index, is important to health professionals for understanding a person’s overall health status. Another important issue for health professionals is the risk factors for being overweight. Therefore, more and more studies examine the relationship between QoL and being overweight. However, although many studies discuss the QoL of overweight children, no studies have been done in Taiwan. Therefore, this dissertation, which includes three studies on the QoL of overweight children, aimed to probe the information of QoL and being overweight in Taiwanese children. The first study evaluated the psychometric properties of one broadly used generic pediatric QoL instrument, the Pediatric Quality of Life Inventory 4.0 (PedsQL). A convenience sample of 8- to 12-year-old children was recruited (n = 479). The results showed that the internal consistency of child-reported PedsQL was satisfactory for all subscales and for the total score (Cronbach’s α =.62-.90), and had acceptable test-retest reliability (intraclass correlation coefficient =.67-.84). Moreover, the result of confirmatory factor analysis (GFI =.905-.938, TLI =.910-.932, CFI =.921-.944, IFI =.922-.945, RMSEA =.056-.059) confirmed the construct validity for child-reported PedsQL. Therefore, I conclude that child-reported PedsQL is a reliable and valid instrument for measuring children’s QoL. After the PedsQL was validated, the second study used it to measure QoL for overweight boys in Taiwan. The physical activity (PA) level and the association between QoL and PA were also examined. Eighteen overweight boys and 18 of their normal-weight counterparts were recruited. Each boy filled out the PedsQL and wore an accelerometer on his waist. The accelerometers were used to measure how many minutes of moderate-to-vigorous PA (MVPA) the participants engaged in for one whole week. The results showed that overweight boys reported significantly lower QoL (81.04 ± 10.85 vs. 89.67 ± 8.40, p =.012) and significantly less MVPA (735.15 ± 270.32 minutes vs. 938.71 ± 214.65, p =.02) than normal-weight boys did. In addition, overweight boys reported significantly more MVPA on weekdays than on weekend days (113.19 ± 38.46 vs. 84.61 ± 54.67, p =.016). Moreover, a positive and marginally significant correlation (r =.47, p =.06) was found between QoL and weekend PA in overweight boys. Therefore, health professionals should consider designing PA programs for overweight children to engage in more PA on weekends. The third study was done to further understand the differences between child-reported and parent-reported QoL in obese children. One hundred eighty-seven dyads of 8- to 12-year old children (60 obese and 127 normal-weight) completed child-reported PedsQL and one of their parents completed a parent-reported PedsQL. In agreement with the second study, the obese children rated their QoL lower than their normal-weight counterparts did (82.95 ± 14.80 vs. 87.60 ± 10.29, p 〈.05). Moreover, the obese children also rated their QoL lower than their parents did (82.95 ± 14.80 vs. 86.35 ± 10.91, p 〈.05). The results suggest that parents of obese children were insensitive to their children’s QoL difficulties. In summary, overweight children in Taiwan say that their QoL is lower than that of normal-weight children. In addition, PA is a potential positive factor related to overweight children’s QoL, and health professionals should encourage overweight children to engage in more PA. In addition, parents of obese children seemed not to be aware of the effects of obese on their children’s QoL. Therefore, helping parents to understand their obese children’s difficulties may also be beneficial for obese children.