Psychometric properties of the Child Health Assessment Questionnaire (CHAQ) applied to children and adolescents with cerebral palsy.

BACKGROUND: Cerebral palsy (CP) patients have motor limitations that can affect functionality and abilities for activities of daily living (ADL). Health related quality of life and health status instruments validated to be applied to these patients do not directly approach the concepts of functionality or ADL. The Child Health Assessment Questionnaire (CHAQ) seems to be a good instrument to approach this dimension, but it was never used for CP patients. The purpose of the study was to verify the psychometric properties of CHAQ applied to children and adolescents with CP. METHODS: Parents or guardians of children and adolescents with CP, aged 5 to 18 years, answered the CHAQ. A healthy group of 314 children and adolescents was recruited during the validation of the CHAQ Brazilian-version. Data quality, reliability and validity were studied. The motor function was evaluated by the Gross Motor Function Measure (GMFM). RESULTS: Ninety-six parents/guardians answered the questionnaire. The age of the patients ranged from 5 to 17.9 years (average: 9.3). The rate of missing data was low (<9.3%). The floor effect was observed in two domains, being higher only in the visual analogue scales (< or = 35.5%). The ceiling effect was significant in all domains and particularly high in patients with quadriplegia (81.8 to 90.9%) and extrapyramidal (45.4 to 91.0%). The Cronbach alpha coefficient ranged from 0.85 to 0.95. The validity was appropriate: for the discriminant validity the correlation of the disability index with the visual analogue scales was not significant; for the convergent validity CHAQ disability index had a strong correlation with the GMFM (0.77); for the divergent validity there was no correlation between GMFM and the pain and overall evaluation scales; for the criterion validity GMFM as well as CHAQ detected differences in the scores among the clinical type of CP (p < 0.01); for the construct validity, the patients' disability index score (mean:2.16; SD:0.72) was higher than the healthy group (mean:0.12; SD:0.23)(p < 0.01). CONCLUSION: CHAQ reliability and validity were adequate to this population. However, further studies are necessary to verify the influence of the ceiling effect on the responsiveness of the instrument.

Psychometric properties of the initial Brazilian version of the CHQ-PF50 applied to the caregivers of children and adolescents with cerebral palsy.

GOALS: To evaluate the psychometric properties of the initial Brazilian version of the Child Health Questionnaire(CHQ-PF50) in children and adolescents with cerebral palsy(CP). METHODS: The caregivers of 5- to 18-year-old children and adolescents with CP answered the self-administered CHQ-PF50 questionnaire. Data quality, reliability and validity were studied. The Gross Motor Function Measure was used to assess physical function. RESULTS: Ninety-six caregivers answered the questionnaire. Patient age ranged from 5 to 17.9 years (mean: 9.3 years). Missing data rate was low. Floor effect occurred in 3 scales and was substantial for quadriplegia group (63.6-77.3%). Ceiling effect occurred in 9 scales. Reliability was adequate for all scales except for the general health perception scale (Cronbach alpha coefficient = 0.24). The validity was adequate in general, but the role/social limitations-emotional behavioral scale was not satisfactory for discriminant and divergent validity. CONCLUSION: The initial Brazilian version of the CHQ-PF50 showed, in general, adequate psychometric properties for application in patients with CP. Although floor and ceiling effects are expected in heterogeneous group as a limitation inherent to generic assessment instruments, they must be carefully considered in further studies. The general health perception and role/social limitations-emotional behavioral scale must be further reviewed for this population.