Preferencias en el formato de cuestionarios y en el uso de Internet en escolares / Preferences in the format of questionnaires and use of the Internet by schoolchildren

OBJETIVOS: Describir las preferencias para responder cuestionarios vía web en población infantil escolarizada; y analizar la actitud sobre el uso de Internet para comunicarse con los profesionales de salud. MÉTODOS: Estudio transversal de la población escolar de Palafolls (Barcelona, n=923) en octubre y noviembre de 2013. Los participantes contestaron las versiones web y en papel en un día de clase, en orden aleatorizado y con un intervalo mínimo de 2horas. Se recogieron las preferencias por una u otra versión, y la intención de compartir información con los profesionales de salud. Se calcularon porcentajes de uso y actitudes, y se ajustaron modelos de regresión logística. RESULTADOS: Participación de 77% (n=715). El 42,4% (38,7-46,0) declaró preferir la versión web y el 20,6% (17,6-23,6) prefirió la versión papel. Los de mayor edad (odds ratio [OR]=0,89; 0,84-0,95 para la edad), y los de familias con nivel de estudios secundarios (OR=0,63; 0,43-0,93) o universitarios (OR=0,61; 0,38-0,97) presentaron menor probabilidad de preferir la versión web. Los varones (OR=1,55; 1,10-2,16), y los que declararon hábitos sedentarios (OR=1,78; 1,06-3,0) presentaron mayor probabilidad de preferir la versión web. La puntuación más elevada (mejor) en calidad de vida (OR=1,03; 1,01-1,05) y no declarar hábitos sedentarios (OR=0,33; 0,15-0,73) se asoció con la actitud positiva para compartir información con los profesionales de salud. CONCLUSIONES: Los niños más jóvenes declaran preferir la versión web. Aunque el uso de Internet es muy generalizado, está poco extendido para comunicarse con los profesionales sanitarios

OBJECTIVES: To describe the preferences to complete questionnaires via the internet by schoolchildren, as well as to analyze the attitude towards the use of internet to communicate with health professionals. METHODS: Cross-sectional study of a school population in Palafolls (Barcelona, n=923) was conducted in October and November 2013. Participants completed both internet and paper versions on a single school day, in random order, and with at least an interval of 2hours. Preferences to answer internet vs paper version were recorded, along with the willingness to share information with health professionals. Percentages of use preferences and attitudes were estimated, and logistic regression models were fitted to analyze the association with the preferences and willingness to share information with health professionals. RESULTS: Participation rates were 77% (n=715), of whom 42.4% (38.7 to 46.0) preferred the internet version, and 20.6% (17.6 to 23.6) the paper version. Older children (odds ratio [OR] = 0.89, 0.84 to 0.95 for age), and those from families with secondary school (OR = 0.63, 0.43 to 0.93), and university degree (OR = 0.61, 0.38 to 0.97) were less likely to prefer the internet version, while boys (OR = 1.55, 1.10 to 2.16) and those children reporting sedentary habits (OR = 1.78, 1.06 to 3.0) were more likely to prefer the internet version. Those scoring higher quality of life (OR = 1.03, 1.01-1.05) and not reporting sedentary habits (OR = 0.33, 0.15 to 0.73) were factors associated with a positive attitude to share information with health professionals. CONCLUSIONS: Younger children prefer to use the internet. Although Internet use is very widespread, it is less used to communicate with health professionals

[Preferences in the format of questionnaires and use of the Internet by schoolchildren]. / Preferencias en el formato de cuestionarios y en el uso de Internet en escolares.

OBJECTIVES: To describe the preferences to complete questionnaires via the internet by schoolchildren, as well as to analyze the attitude towards the use of internet to communicate with health professionals. METHODS: Cross-sectional study of a school population in Palafolls (Barcelona, n=923) was conducted in October and November 2013. Participants completed both internet and paper versions on a single school day, in random order, and with at least an interval of 2 hours. Preferences to answer internet vs paper version were recorded, along with the willingness to share information with health professionals. Percentages of use preferences and attitudes were estimated, and logistic regression models were fitted to analyze the association with the preferences and willingness to share information with health professionals. RESULTS: Participation rates were 77% (n=715), of whom 42.4% (38.7 to 46.0) preferred the internet version, and 20.6% (17.6 to 23.6) the paper version. Older children (odds ratio [OR]=0.89, 0.84 to 0.95 for age), and those from families with secondary school (OR=0.63, 0.43 to 0.93), and university degree (OR=0.61, 0.38 to 0.97) were less likely to prefer the internet version, while boys (OR=1.55, 1.10 to 2.16) and those children reporting sedentary habits (OR=1.78, 1.06 to 3.0) were more likely to prefer the internet version. Those scoring higher quality of life (OR=1.03, 1.01-1.05) and not reporting sedentary habits (OR=0.33, 0.15 to 0.73) were factors associated with a positive attitude to share information with health professionals. CONCLUSIONS: Younger children prefer to use the internet. Although Internet use is very widespread, it is less used to communicate with health professionals.

La crisis económica afecta la salud infantil: ¿qué papel tienen los pediatras? / The economic crisis affects child health: What is the role of pediatricians?

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Papel del pediatra de atención primaria y coordinación con atención especializada / Role of paediatrics in primary care and coordination with specialist care

Objetivos: Conocer cómo asumen y desempeñan los médicos de asistencia infantil en Cataluña los atributos de la atención primaria (AP) (coordinación, globalidad y longitudinalidad). Material y métodos: Estudio cualitativo basado en grupos de discusión y entrevistas individuales semiestructuradas con pediatras cuyo perfil había sido definido previamente según características sociodemográficas y de formación. Se llevaron a cabo 2 grupos de discusión (5 y 4 personas respectivamente) y 5 entrevistas individuales. Los participantes respondieron dos preguntas: ¿cómo explicaríais vuestra función como pediatras de AP? y ¿cuál es vuestra opinión sobre la relación entre los pediatras de AP y los especialistas a los que deriváis a los pacientes? Se llevó a cabo un análisis de contenido temático. Resultados: Los pediatras asumen que la AP debe ser integral y tener en cuenta el contexto del niño/a. El vínculo que se establece con las familias es una característica definitoria de su función. Detectan deficiencias en su propia formación y escaso reconocimiento social e institucional de su trabajo. La coordinación con la atención especializada y la transferencia de información entre niveles no son satisfactorias. Se identifican como factores facilitadores el conocimiento personal, la formación común y las sesiones clínicas. Conclusión: A pesar de su formación hospitalaria, los pediatras asumen los atributos de la AP. Se propone abordar los aspectos deficitarios, como la falta de formación en AP, y tener en cuenta el escaso reconocimiento institucional y social, así como las dificultades en la coordinación, para mantener un nivel de calidad elevado en la atención primaria a la población infantil (AU)

Objectives: Primary care (PC) paediatricians are trained mainly in the hospital setting, with little contact with PC. This study aimed to find out what perceptions and experiences they have on the attributes of PC (first contact, comprehensiveness and continuity of care) that are assumed and performed by PC paediatricians. Material and methods: A qualitative study was performed based on focus groups and semi-structured individual interviews with paediatricians with pre-defined sociodemographic and speciality training characteristics. Two focus groups (5 and 4 people each) and 5 interviews were made. Participants responded to two questions: how would you explain your function as a primary care paediatrician? and what is your opinion on the relationship between primary care paediatricians and the specialists to whom your patients are referred? The conversations of the groups and interviews were recorded and transcribed, and a content analysis was performed. Results: Paediatricians assume that PC must be comprehensive, and take into account the context of the child. Paediatricians declare a lack in their training and poor social and institutional recognition. Coordination with specialists and the transfer of information are not satisfactory. Helpful factors are personal knowledge, the shared training and the face-to-face clinical sessions. Conclusion: Despite their hospital-based training, paediatricians assume the attributes of PC. Difficulties in performing their function include poor adaptation of their training to PC, and little institutional and social recognition. Coordination with specialists is not satisfactory. Approaching these difficulties can help maintaining a high quality level in the care of the paediatric population (AU)

[Role of paediatrics in primary care and coordination with specialist care]. / Papel del pediatra de atención primaria y coordinación con atención especializada.

OBJECTIVES: Primary care (PC) paediatricians are trained mainly in the hospital setting, with little contact with PC. This study aimed to find out what perceptions and experiences they have on the attributes of PC (first contact, comprehensiveness and continuity of care) that are assumed and performed by PC paediatricians. MATERIAL AND METHODS: A qualitative study was performed based on focus groups and semi-structured individual interviews with paediatricians with pre-defined sociodemographic and speciality training characteristics. Two focus groups (5 and 4 people each) and 5 interviews were made. Participants responded to two questions: how would you explain your function as a primary care paediatrician? and what is your opinion on the relationship between primary care paediatricians and the specialists to whom your patients are referred? The conversations of the groups and interviews were recorded and transcribed, and a content analysis was performed. RESULTS: Paediatricians assume that PC must be comprehensive, and take into account the context of the child. Paediatricians declare a lack in their training and poor social and institutional recognition. Coordination with specialists and the transfer of information are not satisfactory. Helpful factors are personal knowledge, the shared training and the face-to-face clinical sessions. CONCLUSION: Despite their hospital-based training, paediatricians assume the attributes of PC. Difficulties in performing their function include poor adaptation of their training to PC, and little institutional and social recognition. Coordination with specialists is not satisfactory. Approaching these difficulties can help maintaining a high quality level in the care of the paediatric population.

Social inequalities in health among adolescents in a large southern European city.

BACKGROUND: Numerous health problems are initiated in childhood and adolescence. For example, obesity, which has increased significantly in recent years, often begins in early life. The objective of this study is to describe social inequalities in obesity and other health problems among adolescents, by sex. METHODS: Data were from a cross-sectional study conducted in a representative sample of 903 adolescents aged 12-16 years old, from secondary schools in Barcelona, Spain. Associations between socioeconomic indicators and health outcomes (perceived health status, and overweight and obesity) were examined through generalised estimating equation models. All analyses were stratified by sex. RESULTS: Boys were more likely to report very good perceived health status than girls (64.1% and 46.3%, respectively). Some of the less privileged socioeconomic position indicators were associated with the presence of overweight and obesity (prevalence ratio 2.41 for low family affluence scale in girls), and with a lower probability of reporting very good perceived health status among boys (prevalence ratio 0.75 for primary level of paternal education). CONCLUSIONS: This study suggests that there are social inequalities in perceived health status, overweight and obesity, measured by different socioeconomic indicators among the adolescent population of Barcelona, and that these inequalities were distributed differently among boys and girls. Gender differences in the impact of socioeconomic variables in health need to be considered in epidemiological and intervention studies.

Desigualdades sociales en la salud mental infantil en Cataluña / Socio-economic inequalities in children's mental health in Catalonia

Objetivos: Analizar los factores socioeconómicos y de salud asociados a la salud mental infantil en una muestra representativa de población de 4–14 años de edad de Cataluña. Métodos: Los datos provienen de la submuestra infantil de la Encuesta de Salud de Cataluña 2006 (n=1.821). La madre, el padre o la persona encargada del menor respondió el cuestionario de salud mental infantil Strengths and Difficulties Questionnaire (SDQ). Se analizaron las puntuaciones de cada dimensión del SDQ y las dificultades totales según los factores socioeconómicos y de salud del niño/a. Se ajustaron modelos de regresión lineal múltiple. Resultados: En general, pertenecer a una familia de clase social desfavorecida, monoparental, con nivel de estudios de la madre menor que universitario y declarar problemas de salud fueron los factores asociados a una peor salud mental infantil en la mayoría de las dimensiones del SDQ. Los factores asociados a las dificultades totales fueron ser chica (coeficiente β: −1,6), pertenecer a las clases sociales menos favorecidas (grupo IV-V: 1,6), con menor nivel de estudios materno (nivel de estudios primario o menos: 1,2), pertenecer a una familia monoparental (1,5) y declarar más problemas de salud (3 o más problemas: 3,9). Conclusiones: Los niños y las niñas de familias con nivel socioeconómico menos favorecido y de familias monoparentales se encuentran a riesgo de presentar peor salud mental. El estudio aporta información útil para la monitorización y el abordaje de los problemas de salud mental infantil (AU)

Objectives: To analyse socio-economic and health status factors associated with poor mental health in a representative sample of children 4 to 14 years old in Catalonia. Methods: The data comes from a subsample of the Catalan Health Interview Survey 2006 (CHIS) (n=1821). Proxy-respondents, mainly mothers, answered the Strengths and Difficulties Questionnaire (SDQ). The SDQ dimension scores and the Total difficulties score were analysed by socio-demographics and health status factors. Multivariate linear regression models were fitted to analyse the influence of socio-economic and health status factors on mental health. Results: In general, being in a disadvantaged family, single-parent families, a family whose mother had lower level of education, and those children reporting physical health problems, have been factors associated with worse child mental health in most of SDQ dimension scores. Factors associated with Total difficulties were, being a girl (beta coefficient: −1.6), from disadvantaged social classes (group IV–V: 1.6), at lower level of maternal education (mother's educational primary level or less: 1.2), being in a single-parent family (1.5), and reporting health problems (3 or more health problems: 3.9). Conclusions: Children from disadvantaged families, and single-parent families are at higher risk of worse mental health than their counterparts in the advantaged groups. The study contributes to collecting information for monitoring and approaching mental health in children (AU)

[Socio-economic inequalities in children's mental health in Catalonia]. / Desigualdades sociales en la salud mental infantil en Cataluña.

OBJECTIVES: To analyse socio-economic and health status factors associated with poor mental health in a representative sample of children 4 to 14 years old in Catalonia. METHODS: The data comes from a subsample of the Catalan Health Interview Survey 2006 (CHIS) (n=1821). Proxy-respondents, mainly mothers, answered the Strengths and Difficulties Questionnaire (SDQ). The SDQ dimension scores and the Total difficulties score were analysed by socio-demographics and health status factors. Multivariate linear regression models were fitted to analyse the influence of socio-economic and health status factors on mental health. RESULTS: In general, being in a disadvantaged family, single-parent families, a family whose mother had lower level of education, and those children reporting physical health problems, have been factors associated with worse child mental health in most of SDQ dimension scores. Factors associated with Total difficulties were, being a girl (beta coefficient: -1.6), from disadvantaged social classes (group IV-V: 1.6), at lower level of maternal education (mother's educational primary level or less: 1.2), being in a single-parent family (1.5), and reporting health problems (3 or more health problems: 3.9). CONCLUSIONS: Children from disadvantaged families, and single-parent families are at higher risk of worse mental health than their counterparts in the advantaged groups. The study contributes to collecting information for monitoring and approaching mental health in children.

A comparison of Rasch item-fit and Cronbach's alpha item reduction analysis for the development of a Quality of Life scale for children and adolescents.

OBJECTIVE: This study compares item reduction analysis based on classical test theory (maximizing Cronbach's alpha - approach A), with analysis based on the Rasch Partial Credit Model item-fit (approach B), as applied to children and adolescents' health-related quality of life (HRQoL) items. The reliability and structural, cross-cultural and known-group validity of the measures were examined. METHODS: Within the European KIDSCREEN project, 3019 children and adolescents (8-18 years) from seven European countries answered 19 HRQoL items of the Physical Well-being dimension of a preliminary KIDSCREEN instrument. The Cronbach's alpha and corrected item total correlation (approach A) were compared with infit mean squares and the Q-index item-fit derived according to a partial credit model (approach B). Cross-cultural differential item functioning (DIF ordinal logistic regression approach), structural validity (confirmatory factor analysis and residual correlation) and relative validity (RV) for socio-demographic and health-related factors were calculated for approaches (A) and (B). RESULTS: Approach (A) led to the retention of 13 items, compared with 11 items with approach (B). The item overlap was 69% for (A) and 78% for (B). The correlation coefficient of the summated ratings was 0.93. The Cronbach's alpha was similar for both versions [0.86 (A); 0.85 (B)]. Both approaches selected some items that are not strictly unidimensional and items displaying DIF. RV ratios favoured (A) with regard to socio-demographic aspects. Approach (B) was superior in RV with regard to health-related aspects. CONCLUSION: Both types of item reduction analysis should be accompanied by additional analyses. Neither of the two approaches was universally superior with regard to cultural, structural and known-group validity. However, the results support the usability of the Rasch method for developing new HRQoL measures for children and adolescents.

Brief report: The KIDSCREEN follow-up study on Health-related Quality of Life (HRQoL) in Spanish children and adolescents. Pilot test and representativeness.

The Spanish KIDSCREEN follow-up study reassessed the Spanish baseline sample (n=840) of the European KIDSCREEN study 3 years later (2006). The aims of this paper were to describe the KIDSCREEN follow-up study and the pilot test, and to analyze participation rates and representativeness. Instruments included the KIDSCREEN-52 HRQoL measure and a set of scales including the possible explanatory variables. Focus groups and individual interviews were carried out in a pilot test. Participants were compared with non-participants at baseline, and also with Eurostat census data. Twenty-two out of 24 subjects were interviewed in the pilot test. Fifteen items needed to be modified after the pilot test. Participation rate reached 54% (n=454). Participants (mean age=12.71 years old) were on average 6 months younger than non-participants (p=0.03), and from more educated families. KIDSCREEN follow-up instrumentation seems adequate for collecting factors with potential influence on HRQoL. Follow-up respondents' representativeness seems to be acceptable.

Concordancia entre padres e hijos en la calidad de vida relacionada con la salud en niños con trastorno por déficit de atención con hiperactividad: estudio longitudinal / Parent-child agreement in the health related quality of life (HRQOL) of children with attention-deficit/hyperactivity disorder (ADHD): A longitudinal study

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)

[Parent-child agreement in the health related quality of life (HRQOL) of children with attention-deficit/hyperactivity disorder (ADHD): a longitudinal study]. / Concordancia entre padres e hijos en la calidad de vida relacionada con la salud en niños con trastorno por déficit de atención con hiperactividad: estudio longitudinal.

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.

Changes in health-related quality of life (HRQoL) in a population-based sample of children and adolescents after 3 years of follow-up.

OBJECTIVES: To assess changes in health-related quality of life (HRQoL) in children and adolescents over a 3-year period and to examine factors associated with change. METHODS: A representative sample of Spanish children and adolescents aged 8-18 years and their parents completed the KIDSCREEN-52 questionnaire at baseline and again after 3 years. Data were also collected on gender, pubertal development (PD), and family socio-economic status (SES). Change in HRQOL over time was evaluated using effect sizes (ES). Generalized estimating equations (GEE) were used to analyze associations among changes in KIDSCREEN scores, socio-demographic factors, and pubertal development. RESULTS: Response rate at follow-up was 54% (n = 454). Overall, HRQoL worsened in eight out of the ten KIDSCREEN dimensions, with ES ranging from -0.10 (Moods and Emotions) to -0.34 (Psychological Well-being). The decrease was most marked in the intermediate age group (13-17 years of age at follow-up) and in girls. In the GEE models, pubertal development more strongly impacted changes in girls than in boys. CONCLUSIONS: In this representative, population-based sample of children and adolescents, moderate decrements in HRQoL were observed after 3 years. Changes were particularly important among girls and in relation to pubertal development. These results could provide useful reference data for other longitudinal studies in population sub-groups.

[Spanish version of the TNO-AZL preschool children quality of life questionnaire (TAPQOL)]. / Versión española del TAPQOL: calidad de vida relacionada con la salud en niños de 3 meses a 5 años.

OBJECTIVES: To obtain a Spanish version of the TNO-AZL Preschool Children Quality of Life Questionnaire (TAPQOL) that would be both semantically and culturally equivalent to the original. MATERIAL AND METHODS: The TAPQOL questionnaire was designed to measure health-related quality of life in children aged 3 months to 5 years and contains 43 questions distributed in 12 subdimensions. The Spanish version was obtained by using the forward/back-translation method with expert, bilingual translators. Cognitive debriefing interviews were carried out with the parents of healthy children and with those of children with respiratory disease. RESULTS: During the adaptation phase, four items were modified after input from the authors of the original version to retain the meaning of the original. At the end of the adaptation process, 37 of the 43 items were classified as A, i.e. without difficulty in the adaptation. Four mothers and two fathers participated in the cognitive debriefing interviews. Four had secondary level education, and two had university level education. Their children were aged between 16 and 60 months. The average time taken to complete the questionnaire was 13.5 minutes. No comprehension problems regarding the questionnaire's content were found, and no items were modified after this phase of the study. The mothers of children with respiratory disease considered the questions related to their children's symptoms to be appropriate. CONCLUSIONS: The Spanish version of the TAPQOL has proven to be acceptable and culturally equivalent to the original version. Future studies should investigate the psychometric properties of this questionnaire and compare them with those of the original version.

Versión española del TAPQOL: calidad de vida relacionada con la salud en niños de 3 meses a 5 años / Spanish version of the TNO-AZL preschool children quality of life questionnaire (TAPQOL)

Objetivos: Obtener una versión española del cuestionario TNO-AZL Preschool Children Quality of Life (TAPQOL) semántica y culturalmente equivalente a la versión original. Material y métodos: El cuestionario TAPQOL ha sido diseñado para medir la calidad de vida relacionada con la salud en niños de 3 meses a 5 años y contiene 43 preguntas incluidas en 12 subdimensiones. Para obtener la versión en español se ha seguido la metodología de traducción directa e inversa con traductores expertos bilingües. Se llevaron a cabo entrevistas cognitivas con madres y padres de niños sanos y con patología respiratoria. Resultados: Durante la fase de adaptación se modificaron cuatro ítems a partir de los comentarios de los autores originales para retener el sentido de los conceptos de la versión original. Al final del proceso, 37 de los 43 ítems del cuestionario fueron clasificados como A, sin dificultad en la adaptación. En las entrevistas cognitivas, contestaron cuatro madres y dos padres, cuatro de ellos con nivel de estudios secundarios y dos de nivel universitario, de niños de entre 16 y 60 meses. El promedio para contestar el cuestionario fue de 13,5 min. No hubo problemas en la comprensión de los contenidos del cuestionario y no se modificó ningún ítem después de esta fase del estudio. Las madres de niños con patología respiratoria consideraron adecuadas las preguntas relacionadas con los síntomas de sus hijos. Conclusiones: La versión española del cuestionario TAPQOL es aceptable y equivalente culturalmente a la versión original. Futuros estudios deberán comprobar sus propiedades psicométricas y compararlas con la versión original (AU)

Objectives: To obtain a Spanish version of the TNO-AZL Preschool Children Quality of Life Questionnaire (TAPQOL) that would be both semantically and culturally equivalent to the original. Material and methods: The TAPQOL questionnaire was designed to measure health-related quality of life in children aged 3 months to 5 years and contains 43 questions distributed in 12 subdimensions. The Spanish version was obtained by using the forward/back-translation method with expert, bilingual translators. Cognitive debriefing interviews were carried out with the parents of healthy children and with those of children with respiratory disease. Results: During the adaptation phase, four items were modified after input from the authors of the original version to retain the meaning of the original. At the end of the adaptation process, 37 of the 43 items were classified as A, i.e. without difficulty in the adaptation. Four mothers and two fathers participated in the cognitive debriefing interviews. Four had secondary level education, and two had university level education. Their children were aged between 16 and 60 months. The average time taken to complete the questionnaire was 13.5 minutes. No comprehension problems regarding the questionnaire’s content were found, and no items were modified after this phase of the study. The mothers of children with respiratory disease considered the questions related to their children’s symptoms to be appropriate. Conclusions: The Spanish version of the TAPQOL has proven to be acceptable and culturally equivalent to the original version. Future studies should investigate the psychometric properties of this questionnaire and compare them with those of the original version (AU)

The adaptation into Spanish of the Coddington Life Events Scales (CLES).

AIMS: To obtain a conceptually and psychometrically equivalent Spanish version of the Coddington Life Events Scales (CLES) for children and adolescents and to test their psychometric properties. METHODS: Forward and backward translations were performed. Comprehension, acceptability, and alternative translations were tested in focus groups and semi-structured interviews. An expert panel and the copyright holders of the original version were actively involved. Test-retest reliability [Intraclass Correlation Coefficient (ICC)] was assessed by administering the questionnaire on two occasions 3 months apart to children aged 12-14 years (n = 30). Construct validity was assessed by comparing children's responses with those of their parents (n = 19). The methods replicated those of the validation of the original version. RESULTS: Of the 53 CLES items translated, ten were found to be difficult to understand. Following back-translation, seven items were modified and a final version was obtained. Test-retest ICC reliability for total scores was 0.63. The ICC between children and parents was 0.42. Both results were very similar to those reported for the original version. CONCLUSIONS: These preliminary findings suggest that the Spanish version of the CLES is understandable and acceptable and that it is similar to the original in terms of validity and reliability. Although further validation is needed, it is recommended for use in research settings in Spain.