ABSTRACT
Objetivo. Evaluar la calidad de vida relacionada con la salud (CVRS) de los pacientes antes y después de su artroplastia total de rodilla (ATR) y cadera (ATC), y los factores relacionados al año. Metodología. Estudio prospectivo cuasi-experimental. Se seleccionaron hospitales de diferente nivel de complejidad y volumen en Cataluña y los pacientes con indicación de ATC o ATR. Se administraron el SF-36 y el WOMAC, variables demográficas, psicosociales y una pregunta sobre percepción de cambio a los pacientes por entrevista telefónica. Se calcularon las diferencias estandarizadas en las puntuaciones del SF-36 y WOMAC antes y después de la cirugía (tamaños del efecto [TE]) según percepción de cambio. Se analizaron los factores relacionados con la CVRS al año, a partir de modelos lineales generales ajustados. Resultados. A pesar de que a nivel global, los pacientes (n = 672) presentaron mejoría en la mayoría de dimensiones de CVRS, un 9% percibió poca mejoría al año, siendo sus puntuaciones muy parecidas en el basal y seguimiento (TE pequeñas: 0,0-0,4). Las mujeres, pacientes con bajo apoyo social, con puntuaciones más bajas (peores) en la salud mental percibida y CVRS basal, y que declaran que su enfermedad es más grave, percibieron peor CVRS al año (p < 0,05). Conclusiones. Se han identificado los factores relacionados con el peor pronóstico de la artroplastia consistentes con otros estudios publicados. La valoración de la CVRS puede ser un instrumento clave para identificar casos de posible no mejoría, y poder valorar las alternativas o aplicar alguna intervención previa y mejorar así la eficiencia del proceso asistencial(AU)
Aims. To assess the health related quality of life (HRQOL) and associated factors of patients before, and one year after, total knee (TKA) and hip (THA) arthroplasty. Methods. A quasi-experimental prospective study conducted in hospitals with different levels of complexity and volume in Catalonia, and on patients with an indication of a TKA or THA. Demographic and psychosocial variables were recorded, and the SF-36 and WOMAC, and a question on perception of change after surgery were administered to patients by telephone interview. The standardised differences (effect size) of perceived change using the SF-36 and WOMAC scores before and after surgery were calculated. The factors associated with HRQOL one year after surgery were analysed using adjusted general linear models. Results. Although there was an overall improvement in most HRQOL domains of patients (n=672), 9% saw little improvement after surgery, with their scores at baseline and follow-up being very similar (small size effect: 0.0-0.4). Women, patients with low social support, with lower scores (worse) in perceived mental health and baseline HRQOL, and who declared that their condition was more severe, perceived a poorer HRQOL one year after surgery (P<.05). Conclusions. Factors associated to a worse prognosis one year after an arthroplasty have been identified and are consistent with other published studies. The assessment of HRQOL can be a key instrument for identifying possible patients without improvement, in order to assess alternatives to an intervention, or apply other interventions in order to improve the efficiency of the healthcare process(AU)
Subject(s)
Humans , Male , Female , Arthroplasty/methods , /instrumentation , /methods , /instrumentation , /methods , Quality of Life , Telephone , Interviews as Topic , /trends , Prospective Studies , Mental Health/standardsABSTRACT
AIMS: To assess the health related quality of life (HRQOL) and associated factors of patients before, and one year after, total knee (TKA) and hip (THA) arthroplasty. METHODS: A quasi-experimental prospective study conducted in hospitals with different levels of complexity and volume in Catalonia, and on patients with an indication of a TKA or THA. Demographic and psychosocial variables were recorded, and the SF-36 and WOMAC, and a question on perception of change after surgery were administered to patients by telephone interview. The standardised differences (effect size) of perceived change using the SF-36 and WOMAC scores before and after surgery were calculated. The factors associated with HRQOL one year after surgery were analysed using adjusted general linear models. RESULTS: Although there was an overall improvement in most HRQOL domains of patients (n=672), 9% saw little improvement after surgery, with their scores at baseline and follow-up being very similar (small size effect: 0.0-0.4). Women, patients with low social support, with lower scores (worse) in perceived mental health and baseline HRQOL, and who declared that their condition was more severe, perceived a poorer HRQOL one year after surgery (P<.05). CONCLUSIONS: Factors associated to a worse prognosis one year after an arthroplasty have been identified and are consistent with other published studies. The assessment of HRQOL can be a key instrument for identifying possible patients without improvement, in order to assess alternatives to an intervention, or apply other interventions in order to improve the efficiency of the healthcare process.
Subject(s)
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Quality of Life , Aged , Female , Humans , Male , Prospective Studies , Spain , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVE: The aim is to present the functioning and results of the Catalan Arthroplasty Registry (RACat). MATERIAL AND METHOD: The RACat arose by the initiative of the Catalan Society of Orthopaedic Surgery and Traumatology, the Catalan Health Service (CHS) and the Catalan Agency for Health Information Assessment and Quality. Publicly funded hospitals sent information through the Internet (CHS Applications website) on knee and hip arthroplasties: patient identification, hospital, joint (hip/knee), type (primary/revision), side of operation, date of surgery and prosthesis (manufacturer's name and reference number). The quality of the data is analysed regularly. We estimate the risk of replacement by the Kaplan-Meier method. RESULTS: A total of 52 hospitals out of 62 send data to RACat, and information on 36,951 knee and 26,477 hip arthroplasties is available. Data quality improved between 2005 and 2010. In 2010 coverage exceeded 70%, with side of operation 97%, and prostheses identification of 80%. The risk of replacement at three years was 3.3% (95% CI:3.1-3.6) for knee, 2.9% (95% CI:2.5-3.3) for total hip, and 2.5% (95% CI:2.0-3.1) for partial hip. DISCUSSION: Risk of replacement is higher than that observed in other registers, although data quality and its improvement over time should be taken into account. CONCLUSIONS: The information available in the RACat will help to establish a standard that will enable hospitals to compare results.
Subject(s)
Arthroplasty, Replacement, Hip/statistics & numerical data , Arthroplasty, Replacement, Knee/statistics & numerical data , Hip Prosthesis/statistics & numerical data , Knee Prosthesis/statistics & numerical data , Product Surveillance, Postmarketing/methods , Registries , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Knee/instrumentation , Arthroplasty, Replacement, Knee/methods , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Outcome Assessment, Health Care , Product Surveillance, Postmarketing/standards , Product Surveillance, Postmarketing/statistics & numerical data , Reoperation/statistics & numerical data , SpainABSTRACT
Objetivo. El objetivo de este trabajo es presentar el funcionamiento y los resultados del Registro de Artroplastias de Cataluña (RACat). Material y método. El RACat surgió por iniciativa de la Sociedad Catalana de Cirugía Ortopédica y Traumatología, el Servicio Catalán de la Salud (SCS) y la Agencia de Información, Evaluación y Calidad en Salud. Los hospitales financiados públicamente envían mediante Internet (portal de aplicaciones, SCS) información sobre las artroplastias de rodilla y cadera: identificación del paciente, hospital, articulación (cadera/rodilla), tipo (primaria/recambio), lateralidad, fecha de cirugía y prótesis (fabricante y número de referencia). La calidad de los datos se analiza periódicamente. El riesgo de recambio se estima mediante el método de Kaplan-Meier. Resultados. En total 52 hospitales de 62 envían datos al RACat que dispone de información sobre 36.951 artroplastias de rodilla y 26.477 de cadera. La calidad de los datos mejoró entre 2005 y 2010, superando la cobertura el 70%, la información sobre lateralidad el 97% y la identificación de prótesis el 80%. El riesgo de recambio a los 3 años fue del 3,3% (IC 95%:3,1-3,6) para rodilla, del 2,9% (IC 95%:2,5-3,3) para las totales de cadera, y del 2,5% (IC 95%:2,0-3,1) para las parciales. Discusión. El riesgo de recambio es superior al observado en otros registros, aunque es necesario tener en cuenta la calidad de la información disponible y su mejora en el tiempo. Conclusiones. La información disponible en el RACat permitirá establecer un estándar de referencia que permita a los hospitales evaluar sus resultados (AU)
Objective. The aim is to present the functioning and results of the Catalan Arthroplasty Registry (RACat). Material and method. The RACat arose by the initiative of the Catalan Society of Orthopaedic Surgery and Traumatology, the Catalan Health Service (CHS) and the Catalan Agency for Health Information Assessment and Quality. Publicly funded hospitals sent information through the Internet (CHS Applications website) on knee and hip arthroplasties: patient identification, hospital, joint (hip/knee), type (primary/revision), side of operation, date of surgery and prosthesis (manufacturer's name and reference number). The quality of the data is analysed regularly. We estimate the risk of replacement by the Kaplan-Meier method. Results. A total of 52 hospitals out of 62 send data to RACat, and information on 36,951 knee and 26,477 hip arthroplasties is available. Data quality improved between 2005 and 2010. In 2010 coverage exceeded 70%, with side of operation 97%, and prostheses identification of 80%. The risk of replacement at three years was 3.3% (95% CI:3.1-3.6) for knee, 2.9% (95% CI:2.5-3.3) for total hip, and 2.5% (95% CI:2.0-3.1) for partial hip. Discussion. Risk of replacement is higher than that observed in other registers, although data quality and its improvement over time should be taken into account. Conclusions. The information available in the RACat will help to establish a standard that will enable hospitals to compare results (AU)
Subject(s)
Humans , Male , Female , Arthroplasty/methods , Arthroplasty/trends , Hip Fractures/surgery , /methods , /trends , /methods , /trends , Orthopedics/methods , Orthopedics/trends , Knee Injuries/epidemiology , Hip Fractures/economics , Hip Fractures/epidemiology , Outcome and Process Assessment, Health Care/organization & administration , Outcome and Process Assessment, Health Care/standards , Outcome and Process Assessment, Health CareABSTRACT
Objetivo: Analizar las artroplastias de cadera y de rodilla y sus características en el Sistema Nacional de Salud. Material y método: Estudio transversal llevado a cabo de forma global y por comunidades autónomas de las altas por artroplastia total primaria de cadera (ATC) y por artroplastias totales primarias de rodilla (ATR), así como las de revisión a partir de datos clínico-administrativos de 2005. Se calcularon las tasas estandarizadas de ATC y de ATR por edad y sexo por 10.000 habitantes analizando su variabilidad a partir del componente sistemático de variación (CSV). De cada alta se analizó: sexo, edad, motivo de intervención, índice de comorbilidad de Charlson, estancia, mortalidad intrahospitalaria y tromboembolismo pulmonar (TEP). Se analizó la carga de la cirugía de revisión a partir del porcentaje que representó sobre el total de artroplastias. Resultados: Las tasas fueron de 4,3 en ATC y de 7,3 en ATR variando de 2,3 a 10,0 en ATC (CSV del 24,4%) y de 4,0 a 12,8 en ATR (CSV del 20,6%). La mayoría de los pacientes fueron mayores de 65 años. La artrosis fue el principal motivo de intervención con escasa variabilidad. El ICC fue en general 0. La estancia mediana fue de 9 días en ATC y de 8 días en ATR. La mortalidad varió entre el 0 y el 0,9% y el TEP varió entre el 0 y el 0,6%. La carga de revisión en cadera fue del 9,2% y del 7% en rodilla. Conclusiones: La variabilidad de las tasas y las características de los pacientes puede estar indicando diferencias en los criterios de indicación. Será necesario establecer criterios de indicación homogéneos y desarrollar instrumentos para la evaluación de los resultados (AU)
Purpose:To analyze hip and knee arthroplasties and their characteristics in the Spanish National Health System.Materials and Methods: A cross-sectional at the global and Spanish autonomous comunity level of discharges of patients subjected to primary and revision total hip (THR) and knee (TKR) arthroplasties on the basis of clinical-administrative data gathered in 2005. Standardized THR and TKR rates were calculated by age and gender per 10,000 inhabitants analyzing their variability as compared with sistematic component of variation (SCV) values. Of each discharge we analyzed gender, age, reason for the procedure, the Charlson comorbidity index (CCI), length of stay, in-hospital mortality and pulmonary thromboembolism (PTE). We also analyzed the burden represented by revision surgery on the basis of the number of revision procedures as a percentage of the total number of arthroplasties. Results: The rates obtained were 4.3 for THR and 7.3 for TKR, ranging from 2.3 to 10.0 in THR (SCV: 24.4%) and from 4.0 to 12.8 (SCV: 20.6%) in TKR. The majority of patients were older than 65 years. Osteoarthritis was the main reason for surgery with little variability. Generally speaking, the CCI was 0. Median length of stay was 9 days in THR and 8 in TKR. Mortality varied between 0% and 0.9% and PTE between 0% and 0.6%. The percentage of hip revisions was 9.2% and that of knee revisions was 7%. Conclusions: Variability in terms of the different rates and patient characteristics could be pointing to differences in the indication criteria. Homogeneous indication criteria should be established and instruments should be developed for assessing the results (AU)
Subject(s)
Humans , Male , Female , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Hip/statistics & numerical data , Arthroplasty, Replacement, Knee/methods , Arthroplasty, Replacement, Knee/statistics & numerical data , National Health Systems , Pulmonary Embolism/complications , Pulmonary Embolism/diagnosis , Cross-Sectional Studies , Comorbidity/trends , Pulmonary Embolism/physiopathology , Hospital Mortality/trendsABSTRACT
Objetivos: Evaluar la concordancia entre padres e hijos sobre los cambios producidos en la calidad de vida relacionada con la salud (CVRS) de niños tratados por trastorno por déficit de atención con hiperactividad (TDAH) durante un corto período de tiempo y comparar las puntuaciones con las normas de referencia de la población general. Métodos: Estudio prospectivo en niños de 6 a 12 años con TDAH. Los padres y sus hijos completaron la versión española del CHIP-CE (Child Health and Illness Profile-Child Edition Perfil de salud infantil) al iniciar el tratamiento y a las 8 semanas. Las puntuaciones del CHIP-CE de ambas visitas se compararon mediante el test de la t de Student para datos apareados, el tamaño del efecto (TE), los coeficientes de correlación intraclase (CCI) y los diagramas de dispersión. Las evaluaciones de padres e hijos se compararon con las puntuaciones del CHIP-CE de la muestra de referencia española. Resultados: En el análisis se incluyó a 31 niños y a sus padres. El mayor cambio entre la visita inicial y la visita de seguimiento se produjo en la dimensión de riesgos, tanto en los niños como en los padres (TE=0,24 y 0,49, respectivamente). El CCI presentó un intervalo de entre 0,44 (satisfacción) y 0,01 (riesgos). Las puntuaciones de los niños fueron similares a los valores de referencia poblacional. Todas las dimensiones de la versión de padres del CHIP-CE presentaron puntuaciones medias estandarizadas inferiores a los valores de referencia en la visita inicial y fueron próximas a los valores de referencia tras el tratamiento. Conclusiones: El presente estudio mostró poca concordancia entre padres e hijos y sugiere que se deberían recoger ambas perspectivas en futuros estudios del impacto y del tratamiento del TDAH (AU)
Objectives: To assess parent-child agreement on changes over a short-term period of time in the HRQOL of children treated for ADHD over a short period of time, and to compare child and parent ratings of children with ADHD with general population norms. Methods: Prospective study in children 6-12 years old with ADHD. Children and parents completed the Spanish versions of the Child Health and Illness Profile-Child Edition (CHIP-CE) before and after 8 weeks of treatment. CHIP-PE scores at both visits were compared using paired t tests and effect sizes (ES), intra-class correlation coefficients (ICC), and scatter plots. Child and parent ratings were compared with CHIP-CE scores for a general population sample. Results: Thirty-one children and parents were included in the analysis. The highest change between the first and the follow-up visit was on the Risk Avoidance domain both children and parents (effect size [ES]=0.24 and 0.40, respectively). The ICC ranged from 0.44 (Satisfaction) to 0.01 (Risk avoidance). Child self-ratings were close to general population values. All domains of the parent version presented standardized means below the reference values at the baseline visit and closer to the general population norm after treatment. Conclusions: This study found poor parent-child agreement and suggests that both ratings should be collected in future studies on the impact of ADHD and treatment effectiveness (AU)
Subject(s)
Humans , Male , Female , Child , Attention Deficit Disorder with Hyperactivity/psychology , Quality of Life/psychology , Longitudinal Studies , Parent-Child Relations , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To assess parent-child agreement on changes over a short-term period of time in the HRQOL of children treated for ADHD over a short period of time, and to compare child and parent ratings of children with ADHD with general population norms. METHODS: Prospective study in children 6-12 years old with ADHD. Children and parents completed the Spanish versions of the Child Health and Illness Profile-Child Edition (CHIP-CE) before and after 8 weeks of treatment. CHIP-PE scores at both visits were compared using paired t tests and effect sizes (ES), intra-class correlation coefficients (ICC), and scatter plots. Child and parent ratings were compared with CHIP-CE scores for a general population sample. RESULTS: Thirty-one children and parents were included in the analysis. The highest change between the first and the follow-up visit was on the Risk Avoidance domain both children and parents (effect size [ES]=0.24 and 0.40, respectively). The ICC ranged from 0.44 (Satisfaction) to 0.01 (Risk avoidance). Child self-ratings were close to general population values. All domains of the parent version presented standardized means below the reference values at the baseline visit and closer to the general population norm after treatment. CONCLUSIONS: This study found poor parent-child agreement and suggests that both ratings should be collected in future studies on the impact of ADHD and treatment effectiveness.
Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Parents , Quality of Life , Surveys and Questionnaires , Child , Female , Humans , Male , Observer Variation , Prospective StudiesABSTRACT
OBJECTIVE: To assess the psychometric properties of the Spanish version of the Vecú et Santé Perçue de l'Adolescent (VSP-A) in terms of reliability and validity. DESIGN: Cross-sectional study. SETTING: Pilot study parallel to the European Kidscreen project. Two secondary schools, one public and one private, were selected for their suitability in Barcelona and Gerona (Catalonia, Spain). The sample unit was the classroom. PARTICIPANTS: A sample of 354 adolescents aged 12 to 18 years old was selected. MAIN MEASUREMENTS: The Spanish VSP-A questionnaire was administered, and again a week later to check its test-retest stability. The KINDL questionnaire was administered in parallel. RESULTS: The response rate was 82% (n=291). The Spanish version of the VSP-A showed good internal consistency and acceptable test-retest reliability (Cronbach's alpha: 0.69-0.92, intraclass correlation coefficient [ICC]: 0.69-0.74) in most domains. Domains measuring a similar concept in the VSP-A and KINDL had closer correlation coefficients than those measuring different constructs (P<.05), which demonstrates its convergent validity. Girls had worse self-perceived health than boys (lower vitality, physical and emotional well-being and self-esteem, and a lower general score on the VSP-A; p<.01). These differences were more obvious in older teens (16-18 years old). CONCLUSIONS: The Spanish VSP-A showed good psychometric properties and results were consistent with the original French version. The results mean we have an adequate HRQL instrument for teens and for use in primary care and public health.
Subject(s)
Health Status , Quality of Life , Surveys and Questionnaires , Adolescent , Child , Cross-Sectional Studies , Female , Humans , Male , Pilot Projects , Reproducibility of ResultsABSTRACT
Objetivo. Evaluar las propiedades psicométricas de la versión española del Vecú et Santé Perçue de l'Adolescent (VSP-A) en términos de fiabilidad y validez. Diseño. Estudio transversal. Emplazamiento. Estudio piloto paralelo al proyecto europeo Kidscreen. Se seleccionaron por conveniencia 2 colegios de enseñanza secundaria (ESO, bachillerato y ciclos formativos) y de titularidad pública y privada en Barcelona y Gerona. La unidad muestral fue el aula. Participantes. Se seleccionaron 354 adolescentes entre 12 y 18 años. Mediciones principales. Se administró la versión española del VSP-A. Se volvió a administrar 1 semana después para analizar su estabilidad (test-retest). De forma paralela se administró el cuestionario KINDL. Resultados. La proporción de respuesta obtenida fue del 82% (n = 291). La versión española del VSP-A presentó una consistencia interna y una estabilidad test-retest aceptables (* de Cronbach, 0,69-0,92 y coeficiente de correlación intraclase, 0,69-0,74) en la mayoría de sus dimensiones. Las dimensiones del VSP-A que miden un constructo similar a las del KINDL presentaron correlaciones más elevadas que las dimensiones que miden constructos diferentes (p < 0,05), lo que apoya su validez convergente. Las chicas presentaron peor salud percibida que los chicos (menos energía, bienestar emocional, bienestar físico y autoestima y una puntuación global en el VSP-A más baja; p < 0,01). Estas diferencias fueron más evidentes en los de más edad (16-18 años). Conclusiones. La versión española del VSP-A ha mostrado buenas propiedades psicométricas. Los resultados son consistentes en la versión original francesa y permiten disponer de un instrumento de calidad de vida relacionada con la salud para adolescentes adecuado para uso en atención primaria y salud pública
Objective. To assess the psychometric properties of the Spanish version of the Vecú et Santé Perçue de l'Adolescent (VSP-A) in terms of reliability and validity. Design. Cross-sectional study. Setting. Pilot study parallel to the European Kidscreen project. Two secondary schools, one public and one private, were selected for their suitability in Barcelona and Gerona (Catalonia, Spain). The sample unit was the classroom. Participants. A sample of 354 adolescents aged 12 to 18 years old was selected. Main measurements. The Spanish VSP-A questionnaire was administered, and again a week later to check its test-retest stability. The KINDL questionnaire was administered in parallel. Results. The response rate was 82% (n=291). The Spanish version of the VSP-A showed good internal consistency and acceptable test-retest reliability (Cronbach's *: 0.69-0.92, intraclass correlation coefficient [ICC]: 0.69-0.74) in most domains. Domains measuring a similar concept in the VSP-A and KINDL had closer correlation coefficients than those measuring different constructs (P<.05), which demonstrates its convergent validity. Girls had worse self-perceived health than boys (lower vitality, physical and emotional well-being and self-esteem, and a lower general score on the VSP-A; P<.01). These differences were more obvious in older teens (16-18 years old). Conclusions. The Spanish VSP-A showed good psychometric properties and results were consistent with the original French version. The results mean we have an adequate HRQL instrument for teens and for use in primary care and public health
Subject(s)
Male , Female , Adolescent , Humans , Quality of Life , Psychometrics/instrumentation , Health Status , Quality of Life , Cross-Sectional Studies , Adolescent DevelopmentABSTRACT
OBJECTIVES: To obtain a Spanish version of the Kindl semantically and culturally equivalent to the original German version and to test its psychometric properties. MATERIAL AND METHODS: The methodology used in the adaptation process was based on the forward-backward translation method. To assess the psychometric properties of the Spanish Kindl, the pilot test of the project "Screening for and promotion of HRQL in children and adolescents: a European Public Health perspective (Kidscreen)" it was include in. A classroom was selected for each educational level (8-16 years old) from three schools in Gerona and Barcelona. The Spanish Kindl was administered twice, one week apart. Internal consistency was assessed by computing Cronbach alpha and test-retest stability was assessed using intraclass correlation coefficients (ICC). Analysis of variance was performed according to age, sex, type of school, and self-perceived health status. RESULTS: Half of the items (12/24) required minor changes during the adaptation process. The response rate was 91 % (n = 447). Internal consistency was acceptable for most domains (alpha range = 0.40-0.88), as was test-retest stability (ICC range = 0.52-0.80). Girls and older teenagers scored worse in most domains (p < 0.01). No differences were found by type of school. CONCLUSIONS: The Spanish version of the Kindl showed adequate reliability and validity coefficients and represents a new HRQL instrument that can be applied in pediatric clinical practice and public health.
Subject(s)
Health Status Indicators , Quality of Life , Surveys and Questionnaires , Adolescent , Child , Female , Germany , Humans , Language , Male , Psychometrics , SpainABSTRACT
OBJECTIVES: To obtain a Spanish version of the CHIP-CE semantically and culturally equivalent to the original version. METHOD: The methodology used was based on the forward-backward method. Two translations into Spanish were performed. After the first reconciled version, 44 cognitive interviews were carried out with children aged 6-11 years old, selected from two schools in Barcelona. The interviews were recorded and transcribed. A qualitative content analysis of the textual data was carried out. A panel of experts developed the second reconciled version taking into account the children's comments. A back-translation into English was carried out and was compared with the original version. RESULTS: Of a total of 45 items induced in the first reconciled version, 21 were considered equivalent, 23 required changes and 1 was considered not equivalent. Comprehension of abstract concepts differed according to age. Older children differentiated among concepts and gave different examples of experiences related to these concepts, while younger children (6 to 7-year olds) provided similar examples for different concepts. The children's comments were used in the reformulation of the items. An illustrative figure reinforced understanding. Children aged 7 or more started to use an adequate recall period and used the response options correctly. CONCLUSIONS: The Spanish version of the CHIP-CE seems appropriate for children aged 6-11 in Spain. The present study shows that children from the age of 6 years onwards are able to describe the health concepts included in the CHIP-CE.
Subject(s)
Health Status Indicators , Quality of Life , Surveys and Questionnaires , Child , Cross-Cultural Comparison , Humans , Psychometrics , SpainABSTRACT
Objetivos: Obtener una versión española del Perfil de Salud Infantil (Child Health and Illness Profile-Child Edition, CHIP-CE), semántica y culturalmente equivalente a la versión original. Método: Se ha seguido la metodología de traducción directa e inversa. Se obtuvieron dos traducciones iniciales al español. Tras la primera versión consensuada se realizaron 44 entrevistas cognitivas a niños/as de 6 a 11 años de dos colegios de Barcelona. Las entrevistas fueron grabadas y transcritas. Se realizó un análisis cualitativo de contenido temático de los datos textuales. Con los comentarios de los niños, y tras un panel de expertos, se obtuvo la segunda versión consensuada. Se realizó la retrotraducción al inglés y se comparó con la versión original. Resultados: De los 45 ítems de la primera versión consensuada, 21 se consideraron equivalentes, 23 requirieron modificaciones y uno fue considerado no equivalente. Se observó una diferencia según la edad en la comprensión de los conceptos abstractos. Los niños/as de más edad diferenciaban los conceptos y daban ejemplos distintos de experiencias relacionadas con ellos, los de menor edad (6-7 años) describieron ejemplos similares para conceptos diferentes. Los comentarios de los niños/as ayudaron a la reformulación de las preguntas. La figura representó un refuerzo para la comprensión. A partir de los 7 años enmarcaron sus respuestas en un período recordatorio adecuado, y utilizaron correctamente las opciones de respuesta. Conclusiones: La versión española del CHIP-CE parece adecuada para los niños de 6-11 años de edad en nuestro medio. El presente estudio ha mostrado que los niños/as son capaces de describir los aspectos de su salud que se incluyen en el CHIP-CE (AU)
Subject(s)
Humans , Child , Surveys and Questionnaires , Health Status Indicators , Quality of Life , Psychometrics , Spain , Cross-Cultural ComparisonABSTRACT
Objetivos: Obtener una versión española del cuestionario Kindl semántica y culturalmente equivalente a la versión original alemana, y evaluar sus propiedades psicométricas. Material y métodos: Para la adaptación se siguió la metodología de traducción directa e inversa. Para la evaluación de las propiedades psicométricas se realizó el análisis de la fase piloto del proyecto "Medida de la CVRS en niños/as y adolescentes. Una perspectiva de promoción de la salud y de salud pública europeas (Kidscreen)". Se seleccionó un aula de cada nivel educativo desde los 8 a los 16 años en 3 colegios de Girona y Barcelona. Se administró el Kindl 2 veces, con una semana de diferencia. La consistencia interna se analizó mediante alfas de Cronbach, y el test-retest mediante coeficientes de correlación intraclase (CCI). Se realizó un análisis de la varianza según la edad, el sexo, el tipo de colegio y la salud autopercibida. Resultados: En la mitad de los ítems (12/24) se necesitaron cambios mínimos durante la fase de adaptación. La proporción de respuesta fue de 91 por ciento (n=447). La consistencia interna fue aceptable en la mayoría de dimensiones (rango alfa=0,40-0,88), así como la estabilidad test-retest (rango CCI=0,52-0,80). Las chicas y los de más edad puntuaron peor en la mayoría de dimensiones (p < 0,01). No se encontraron diferencias en las puntuaciones según la titularidad del colegio. Conclusiones: La versión española del Kindl presentó coeficientes de fiabilidad y validez aceptables y permite disponer de un nuevo instrumento para aplicar en la práctica clínica pediátrica y en salud pública (AU)
Subject(s)
Child , Adolescent , Male , Humans , Female , Quality of Life , Surveys and Questionnaires , Health Status Indicators , Psychometrics , Spain , Language , GermanyABSTRACT
AIM: The Child Health and Illness Profile (CHIP-AE) is a generic health status instrument for adolescents aged 12-19 years adapted for use in Spain. The aim of this study was to obtain reference population values of the Spanish version of the CHIP-AE. METHODS: The CHIP-AE was administered to a representative sample of adolescents from schools in Barcelona. The sample was selected by using cluster-sampling, stratified by type of school (public or private) and an ecological socioeconomic index (Indice de Capacidad Familiar: low, middle, and high). The CHIP-AE scores were standardized to a mean of 20 and a standard deviation (SD) of 5. Means and percentiles were computed. Means were compared by age, gender, and socioeconomic status using analysis of variance. RESULTS: The response rate was 81% (n = 902). The distribution of the CHIP-AE scores presented a wide range with scores generally skewed toward positive health status. Nevertheless, the results suggest that the sample selected from a general population was not free of health problems. Twenty-five percent of adolescents presented scores below 17.2 in the domain of discomfort, indicating an effect size of 0.56 standardized SD units. The distribution of scores in the reference samples from Barcelona was similar to the original results in Baltimore (USA), with some marginal differences in individual risks. CONCLUSIONS: The CHIP-AE systematically gathers information on health domains in adolescents. The results from this reference sample will allow comparisons with adolescents from other regions, and/or with different health problems, as well as description of inequalities in health during adolescence.
Subject(s)
Health Status Indicators , Adolescent , Child , Female , Humans , Male , Reference Values , SpainABSTRACT
Objetivo: El perfil de salud CHIP-AE (Child Health and Illness Profile, Adolescent Edition) es un instrumento genérico para adolescentes de 12 a 19 años que ha sido adaptado para uso en España. El objetivo del estudio fue obtener los valores poblacionales de referencia de la versión española del CHIP-AE. Métodos: Se administró el CHIP-AE a una muestra representativa de adolescentes escolarizados de Barcelona, mediante muestreo por conglomerados, estratificado según la titularidad del centro (público o concertado) y el índice de capacidad económica familiar (bajo, medio y alto). Se estandarizaron las puntuaciones a una media de 20 y desviación estándar (DE) de 5. Se calcularon las medias y los percentiles. Las medias se compararon por edad, género y nivel socioeconómico mediante análisis de la varianza. Resultados: Las proporción de respuesta fue del 81 por ciento (n = 902). Las puntuaciones presentaron un amplio rango de distribución, y aunque en general fueron algo sesgadas hacia las puntuaciones de buena salud, sugieren que la muestra de población general no está exenta de problemas de salud. El 25 por ciento presentó puntuaciones por debajo de 17,2 en la dimensión de bienestar, lo que indica un tamaño de efecto de 0,56 unidades estandarizadas de DE. La distribución de las puntuaciones de las muestras de referencia de Barcelona fueron muy similares a las originales de Baltimore (Estados Unidos), con diferencias mínimas en riesgo individual. Conclusiones: El CHIP-AE recoge de manera sistemática las dimensiones propias de la salud de los adolescentes. Los resultados permitirán establecer comparaciones con adolescentes de otras regiones, y/o con diferentes problemas de salud y analizar las desigualdades en salud durante la adolescencia (AU)
Aim: The Child Health and Illness Profile (CHIP-AE) is a generic health status instrument for adolescents aged 12-19 years adapted for use in Spain. The aim of this study was to obtain reference population values of the Spanish version of the CHIP-AE. Methods: The CHIP-AE was administered to a representative sample of adolescents from schools in Barcelona. The sample was selected by using cluster-sampling, stratified by type of school (public or private) and an ecological socioeconomic index (Índice de Capacidad Familiar: low, middle, and high). The CHIP-AE scores were standardized to a mean of 20 and a standard deviation (SD) of 5. Means and percentiles were computed. Means were compared by age, gender, and socioeconomic status using analysis of variance.Results: The response rate was 81% (n = 902). The distribution of the CHIP-AE scores presented a wide range with scores generally skewed toward positive health status. Nevertheless, the results suggest that the sample selected from a general population was not free of health problems. Twenty-five percent of adolescents presented scores below 17.2 in the domain of discomfort, indicating an effect size of 0.56 standardized SD units. The distribution of scores in the reference samples from Barcelona was similar to the original results in Baltimore (USA), with some marginal differences in individual risks. Conclusions: The CHIP-AE systematically gathers information on health domains in adolescents. The results from this reference sample will allow comparisons with adolescents from other regions, and/or with different health problems, as well as description of inequalities in health during adolescence (AU)
Subject(s)
Child , Adolescent , Male , Female , Humans , Health Status Indicators , Spain , Reference ValuesABSTRACT
The aim of the study was to obtain a conceptually equivalent Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), and to test its feasibility, reliability and preliminary construct validity. The methodology used for adaptation was forward-back translation, including two focus groups with adolescents and a panel of experts. Reliability and validity were assessed in healthy convenience samples from school settings (n = 417). Three different illness groups (n = 67) were used to examine differences in health status between healthy, acutely ill, chronically ill and mentally ill adolescents. Preliminary construct validity was examined by comparing mean scores for each of the subdomains to determine if they differed in predicted ways according to age, gender and illness group. The majority of items (154 out of 203) were conceptually equivalent to the original version. Some items (46) had to be modified to increase clarity and/or to adapt them for use in Spain and 3 items were considered not applicable. Single construct subdomains achieved alpha coefficients between 0.65 and 0.92, and intraclass correlation coefficients (ICC) between 0.57 and 0.93. The mentally ill group presented the worst scores in most domains. The Spanish CHIP-AE is acceptable for Spanish adolescents and shows adequate metric characteristics, which are similar to those reported in the US version.
Subject(s)
Health Status , Language , Quality of Life , Self-Assessment , Sickness Impact Profile , Surveys and Questionnaires/standards , Activities of Daily Living , Adolescent , Attitude to Health , Disease/classification , Disease/psychology , Female , Humans , Male , Psychology, Adolescent , Psychometrics , Self Concept , Spain , Students/psychologyABSTRACT
Los objetivos del presente trabajo fueron revisar de forma sistemática los instrumentos genéricos de calidad de vida relacionada con la salud (CVRS) en la infancia y adolescencia publicados en la bibliografía, y aquellos, ya sean genéricos o específicos, que han sido adaptados o creados en España. Se consideraron los cuestionarios que presentaban versiones infantiles y/o para adolescentes. Las bases de datos consultadas fueron Medline, HealthSTAR y PsycLIT (1980-agosto 2001). La estrategia combinó diferentes palabras clave sin exclusión de ningún idioma. Las principales características analizadas fueron el contenido de los instrumentos y sus propiedades psicométricas. En el caso de los instrumentos adaptados en España, se analizó, además, la calidad del proceso de adaptación. Se localizaron y analizaron 15 instrumentos genéricos de CVRS. El rango de edades de los instrumentos genéricos es de 4-18 años. Existe gran variabilidad en el número y características de las dimensiones y en el número de ítems. La mitad de los instrumentos ha evaluado la fiabilidad test-retest. Todos los autores han analizado al menos un tipo de validez. Dos genéricos y cinco específicos han sido creados o adaptados en España. El proceso de adaptación ha sido, en general, aceptable. De todos los instrumentos analizados, sólo dos (uno genérico y otro específico) han evaluado la sensibilidad a los cambios. Las medidas de la CVRS en niños y adolescentes se encuentran en fase inicial de desarrollo. En los próximos años se espera la evaluación de su utilidad en la práctica clínica y en salud pública (AU)
The aims of this study were to systematically review the availability and characteristics of generic instruments of health-related quality of life (HRQOL) for use in childhood and adolescence published in the literature, and to revise generic or disease-specific measures adapted or developed for use in Spain. Questionnaires were selected if they had been developed specifically for use in children and/or adolescents. The data bases consulted were Medline, HealthSTAR and PsycLIT (1980-August 2001). Combinations of key words were used with no restriction on language. The main characteristics analyzed were the content and psychometric properties of the questionnaires retrieved. For instruments adapted for use in Spain, the quality of the adaptation process was also reviewed. Fifteen generic HRQOL instruments for use in children and adolescents were found. The measures were designed for the age range 4-18 years. The number and content of domains, and the number of items included in each measure varied greatly. Test-retest reliability was analyzed in half of the instruments, and all authors analyzed at least one aspect of validity. Two generic and five specific instruments have been developed or adapted in Spain. The adaptation process was generally acceptable. Sensitivity to change has been assessed only in two of the instruments analyzed (one generic and one specific). HRQOL measurement in children and adolescents is in initial stages. The next step will be to investigate the utility of these measures in clinical practice and public health (AU)
