PinQ: A valid, reliable and reproducible quality-of-life measure in children with bladder dysfunction
Introduction
Quality-of-life, which denotes a more general and holistic measure of wellbeing than disease impact [1], is a validated way of measuring a patient's perspective of his/her life situation [2]. Self-completion of a robust questionnaire communicates the individual child's perceptions and views, which may differ from those of his/her parents or clinicians. Recently a cross-cultural continence-specific paediatric quality-of-life measurement tool (PinQ) has been developed and tested psychometrically [3]. This new tool has the potential for use as an outcome measure and may also alert the clinician to compromised areas of wellbeing directly related to bladder dysfunction. A holistic treatment approach can address such psychosocial issues, facilitating child and family compliance, a factor known to be associated with positive treatment outcome.
The aim of this study was to evaluate the test re-test reliability of PinQ in a cohort of children with bladder dysfunction, in order to appraise the reproducibility of scores. A secondary aim was to compare the parent-completed proxy version with child-reported scores.
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Subjects and methods
Forty children aged between 6 and 16 years (mean age 9.18 years, SD 2.65), who were attending a children's continence care service for management of a bladder disorder in either Holland or Hong Kong, were invited to participate in test re-test evaluation of PinQ. Ethics approval was obtained from the Survey and Behavioural Research Ethics Committee of the Chinese University of Hong Kong.
The PinQ was translated into Chinese and Dutch by native-speaking bilingual health professionals. It was then
Results
Aside from one parent and one child who failed to complete the second page of PinQ, there were no missing values in the data set. As can be seen from Table 1, the ICC for comparison between total scores and factor scores showed excellent agreement [4]. Individual items showed excellent agreement in five cases (>0.7) and moderate agreement in 14 cases (0.4–0.7). One extrinsic item was not reproducible (ICC = 0.25, P = 0.063).
Overall, proxy scores varied little from the child-reported scores. Five
Discussion
This study has demonstrated that the new tool PinQ for use in children with bladder dysfunction gives reproducible responses and scores. Furthermore, it appears to be easily completed and, when attention is drawn to the two sides of the tool, the data sets are likely to be complete. Total scores and factor sub-scores all showed excellent test re-test reliability. One item “I wear clothes that will hide any wee accidents” was found to have a pronounced floor effect; that is, on initial testing
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