Quality of Life in Adolescence: The Role of Perceived Control, Parenting Style, and Social Support

Witnessing Intimate Partner Violence as a Child and Associated Consequences

Intimate partner violence (IPV) continues to be a global problem. The increasing international research, focussing on children who witness IPV between their parents, indicates that these circumstances might influence children in different ways. Despite these efforts, little evidence stems from Germany. Using data from a German school student survey from 2017 and 2019 (N = 21,382), this paper aims to examine the consequences of witnessing IPV. The present paper takes a closer look at children's violent behaviour, attitudes and quality of life while controlling for other potential influences (e.g. physical and psychological child abuse). Results indicate that IPV has a significant negative effect on children's quality of life, in particular on children's sense of security at home and children's life satisfaction. No other effects were significant. In discussing these complex dynamics, the results of the present study highlight the importance of considering children who witness IPV as direct victims. A home with personal threats cannot provide emotional and physical security. Coping with this absence of a secure base at home may lead to the neglect of important developmental tasks during that time, which can have possible far-reaching implications on different areas of children's lives (e.g. social competence). Further research examining the severity and duration of witnessing IPV within the context of a longitudinal design is recommended.

Gloomy and out of control? Consequences of the COVID-19 pandemic on momentary optimism in daily live of adolescents

In the global COVID-19 pandemic, adolescents are regarded as especially burdened due to school closures and leisure activities being banned, often reducing peer contacts to zero. Experiencing restrictions while being uninvolved in decision-making processes left them with little control over their daily lives. Meanwhile, research highlights that optimism can act as a buffer against the impact of daily hassles and is considered an important resource for mental health. To understand the implications of the COVID-19 pandemic for adolescents' lives, this study examined how momentary perceived control and perceived personal and societal consequences of the COVID-19 pandemic relate to momentary optimism. Using experience-sampling data from N = 242 (M age = 15.89; 86% female) adolescents assessed during the second pandemic wave in Germany, multilevel modeling revealed positive associations between adolescents' momentary perceived control and their momentary optimism at both the within- and between-person level. Additionally, perceived consequences of the COVID-19 pandemic showed specific associations with momentary optimism: Whereas perceived societal consequences were directly related to lower momentary optimism, perceived personal consequences strengthened the relationship between momentary perceived control and optimism. These findings highlight the role of perceived control as an important resource for optimism both as a general tendency and within specific situations in daily life. This way, our results may shed light on how to support adolescent optimism during states of emergency, such as a worldwide pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03313-6.

The association between pubertal timing and quality of life among children and adolescents: a cross-sectional study in Chongqing, China

BACKGROUND

To determine the relationship between pubertal timing and quality of life (QOL) in children and adolescents and to provide a basis for QOL intervention in pubertal children in the future to promote good adaptation and healthy physical and mental development of children.

METHODS

The survey was conducted in one county using a stratified cluster sampling method. The five physiological change items of the Puberty Development Scale (PDS) were used to assess the timing of puberty in students. Compared to students of the same age and the same sex, students who scored higher than the mean + standard deviation (SD) of individual developmental scores were defined as an early pubertal timing group. A 39-item QOL Scale for Children in Puberty was used to assess the QOL of the respondents. Multiple linear regression models were fitted separately for boys and girls.

RESULTS

Of the 7223 students, 3754 (51.97%) were boys and 3469 (48.03%) were girls. The prevalence of early pubertal periods was 16.07%. The total QOL score in the early pubertal timing group (137.16 ± 18.67) was significantly lower than in the normal (on time) group (142.02 ± 17.98) and the late group (142.76 ± 18.35) (F = 37.311, P < 0.001). A multiple linear regression model showed that early pubertal timing was a risk factor for QOL (P < 0.0014), compared with normal and late pubertal timing.

CONCLUSIONS

The early pubertal timing was associated with poorer QOL in children and adolescents. More attention should be paid to children with early pubertal timing in intervening children's QOL during pubertal development. Future longitudinal studies are needed to confirm the association between pubertal timing and QOL.

Adolescents' Understanding of What Causes Emotional Distress: A Qualitative Exploration in a Non-clinical Sample Using Ideal-Type Analysis

Background: There is increased interest in early intervention and prevention of mental health difficulties during adolescence; thus, we are seeing increased efforts to optimize well-being during this epoch. Positive emotional experiences are a central component of overall well-being. However, research exploring what adolescents perceive to be the cause(s) of their emotional difficulties is lacking. Improving understanding of this issue within non-clinical adolescent groups may provide useful insight into how to develop strategies to support young people as they navigate emotional difficulties.

Objectives: The aim of this research was to explore if meaningful categories of perceived cause(s) for emotional distress exist for non-clinical adolescent groups.

Methods: The data for this study were drawn from interviews across 6 sites in England conducted as part of the 5-year national evaluation of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years from the first annual wave of qualitative data collection in 2017. Ideal type analysis—a qualitative form of person-centered analysis—was used to construct a typology of adolescents perceived cause(s) for emotional distress.

Findings: We identified five distinct categories of perceived cause: (1) perceived lack of control; (2) unfair treatment; (3) others, their actions and judgements as the catalyst; (4) concerns for self and others; and, (5) self as cause.

Conclusions: Our findings illustrate that distinct categories for perceived cause of emotional distress exist among adolescents considered to be “at risk” of developing mental health difficulties, which provides a foundation for future necessary work seeking to investigate the possible link between perceived cause for emotional distress and help-seeking behavior among sub-clinical groups.

Contributions of Individual, Family, and School Characteristics to Chilean Students' Social Well-Being at School

Schools are an essential part of students’ lives and can promote and facilitate their well-being. Although research on well-being among school-aged children and adolescents has distinguished subjective well-being from social well-being, very few studies examined student’s social well-being at school (SWS). SWS is understood as students’ valuation of the circumstances and functioning of their school. This framework posits that the context of the schools can shape students’ perception of feeling integrated and making significant contributions to their schools. However, not much is known regarding the joint contribution of individual, family, and school characteristics to students’ SWS. This study analyzed these joint contributions in a nationally representative sample of 6,389 children and adolescents enrolled in 5th–11th grades. Findings show that being female and younger were individual predictors of SWS. Students’ satisfaction with their family and fewer changes of schools were also significant contributors. When students’ perceptions of their schools were incorporated, the individual and family characteristics decreased or lost significance. In the full model, the highest contribution to SWS was explained by the school-level aggregated perception of school climate. These findings call for integrated policies and practices to foster students’ sense of belonging, feeling integrated, and contribution to their schools, with a focus on school-level interventions to improve SWS through positive and engaging school climates that foster students’ sense of agency.

Perceived social support and quality of life among adolescents in residential youth care: a cross-sectional study

BACKGROUND

Residential youth care (RYC) institutions aim to provide care and stability for vulnerable adolescents with several previous and present challenges, such as disrupted attachments, wide-ranging adverse childhood experiences, mental health problems, and poor quality of life (QoL). To the best of our knowledge, the present study is the first to provide knowledge of the associations between perceived social support and QoL and to explore the potential moderating effect of perceived social support on QoL for adolescents who have experienced maltreatment and polyvictimization.

METHODS

All RYC institutions with adolescents between the ages 12-23 in Norway were asked to participate in the study. A total of 86 institutions housing 601 adolescents accepted the invitation, from which 400 adolescents volunteered to participate. The Child and Adolescent Psychiatric Interview was used to gather information on maltreatment histories and degree of victimization; the Kinder Lebensqualität Fragebogen was used to measure QoL through several domains (overall QoL, physical well-being, emotional well-being, and self-esteem); and the Social Support Questionnaire was used to measure perceived social support. Linear regression and independent samples t-test were used to study the associations between perceived social support and QoL as well as the potential moderating effect of perceived social support in the association between maltreatment history and QoL.

RESULTS

Perceived social support was positively associated with QoL for both girls and boys, with domain-specific findings. A higher number of different types of support persons was associated with overall QoL, emotional well-being, and self-esteem for boys, but only with self-esteem for girls. Individual social support from RYC staff and friends was associated with higher QoL for girls. However, perceived social support did not moderate the association between maltreatment history and reduced QoL for either sex.

CONCLUSIONS

This study emphasizes the importance of maintaining social support networks for adolescents living in RYC, the crucial contribution of RYC staff in facilitating social support, and the potential value of social skills training for these vulnerable adolescents. Furthermore, a wider range of initiatives beyond social support must be carried out to increase QoL among adolescents with major maltreatment and polyvictimization experiences.

Benefits of physical activity in children and adolescents with type 1 diabetes: A systematic review

AIMS

We performed a systematic review of clinical trials investigating the health benefits of physical activity in pediatric patients with type 1 diabetes.

METHODS

To perform this systematic review, search strategies were created and adapted to four databases. Only randomized controlled trials written in English before 1998 and that answered to the PICOS criteria were included. The PRISMA guidelines were followed to ensure highest scientific rigor within studies.

RESULTS

Seven studies out of 2655 were included in this systematic review according to the inclusion criteria. These studies showed positive gains on global health: blood lipid profile, physical fitness, quality of life and body size and body composition but only one demonstrated a positive effect on glycemic control.

CONCLUSION

Globally, physical activity exerts a positive impact on metabolic (i.e., decrease in total cholesterol, improvement of physical fitness, etc.) and psychological health in children with type 1 diabetes. Yet variations in study protocols or sample size restrict statistical power to reach the outcome of improving glycemic control in most studies. Here, we address the measured outcomes in individual trials and discuss potential key elements to consider for future clinical trials.

The impacts of peer education based on adolescent health education on the quality of life in adolescents: a randomized controlled trial

PURPOSE

During adolescence, adolescents are more susceptible to internalizing and externalizing problems influencing quality of life (QoL). The purpose of the study is to verify the effectiveness of a peer education on improving QoL of adolescents.

METHODS

A cluster randomized controlled trial (RCT) was conducted involving 1564 subjects who were divided into an intervention group (n = 714) and a control group (n = 850). The intervention group received 1-year peer education. Their QoL and basic information were assessed using a Adolescent Quality of Life Scale and a self-designed basic situation questionnaire.

RESULTS

After the intervention, significant increases were found in the psychological, and social, pubertal dimensions, and in total QoL (P < 0.05) in the intervention group relative to the control group. Significant decrease was found in physical dimension (P < 0.05), but the change in the intervention group (0.74 decrease) was much less than that in the control group (1.94 decrease). The improvements of physical (B = 1.215, SE = 0.305, P < 0.001), psychological (B = 1.496, SE = 0.598, P = 0.013), pubertal (B = 0.828, SE = 0.244, P = 0.001), and total (B = 3.455, SE = 1.429, P = 0.016) QoL in the intervention group were higher than in the control group in mixed model.

CONCLUSIONS

The peer education based on adolescent health education is effective in improving the physical, psychological, pubertal, and total QoL of adolescents, but no social QoL.

Changes in Self-Reported Well-Being: A Follow-Up Study of Children Aged 12-14 in Algeria

This article reports on a 2-year follow-up study (443 Algerian children). Using a variety of satisfaction measures, along with detailed questions relating to family, school, local area, material deprivation, and daily activities, we aim to explore changes in the self-reported well-being of children from age 12 to 14. Satisfaction with health and friends remained stable, meanwhile satisfaction with school decreased more for boys than for girls, but satisfaction with family, time use, and material possessions decreased for girls. This pattern was further confirmed by children's reports on the selected activities, experiences, and facilities provided to them. Regression analyses indicated that satisfaction with material possessions predicted satisfaction with life and positive affect, meanwhile satisfaction with family life and friends predicted eudaimonia.

Effectiveness of the BOOST-A™ online transition planning program for adolescents on the autism spectrum: a quasi-randomized controlled trial

BACKGROUND

The majority of existing transition planning programs are focused on people with a disability in general and may not meet the specific need of adolescents on the autism spectrum. In addition, these interventions focus on specific skills (e.g. job readiness or self-determination) rather than the overall transition planning process and there are methodological limitations to many of the studies determining their effectiveness. The Better OutcOmes & Successful Transitions for Autism (BOOST-A™) is an online program that supports adolescents on the autism spectrum to prepare for leaving school. This study aimed to determine the effectiveness of the BOOST-A™ in enhancing self-determination.

METHODS

A quasi-randomized controlled trial was conducted with adolescents on the autism spectrum enrolled in years 8 to 11 in Australian schools (N = 94). Participants had to have basic computer skills and the ability to write at a year 5 reading level. Participants were allocated to a control (n = 45) or intervention (n = 49) group and participants were blinded to the trial hypothesis. The intervention group used the BOOST-A™ for 12 months, while the control group participated in regular practice. Outcomes included self-determination, career planning and exploration, quality of life, environmental support and domain specific self-determination. Data were collected from parents and adolescents.

RESULTS

There were no significant differences in overall self-determination between groups. Results indicated significant differences in favor of the intervention group in three areas: opportunity for self-determination at home as reported by parents; career exploration as reported by parents and adolescents; and transition-specific self-determination as reported by parents.

CONCLUSIONS

Results provide preliminary evidence that the BOOST-A™ can enhance some career-readiness outcomes. Lack of significant outcomes related to self-determination at school and career planning may be due to the lack of face-to-face training and parents being the primary contacts in the study. Further research is needed to determine effectiveness of the BOOST-A™ related to post-secondary education and employment. Trial registration #ACTRN12615000119594.

Are Facebook "Friends" Helpful? Development of a Facebook-Based Measure of Social Support and Examination of Relationships Among Depression, Quality of Life, and Social Support

Greater social support is predictive of lower depression and higher quality of life (QOL). However, the way in which social support is provided has changed greatly with the expanding role of social networking sites (e.g., Facebook). While there are numerous anecdotal accounts of the benefits of Facebook-based social support, little empirical evidence exists to support these assertions, and there are no empirically validated measures designed to assess social support provided via this unique social networking medium. This study sought to develop an empirically sound measure of Facebook-based social support (Facebook Measure of Social Support [FMSS]) and to assess how this new measure relates to previously established measures of support and two outcome variables: depression and QOL. Following exploratory factor analysis, the FMSS was determined to assess four factors of social support on Facebook (Perceived, Emotional, Negative, Received/Instrumental). The Negative Support factor on the FMSS was most strongly related to both depression and QOL with magnitudes (and direction of relationships) comparable to a traditional measure of perceived social support. However, two FMSS factors (Received/Instrumental and Perceived) were unrelated to both mental health outcomes. Contrary to expectations, elevations in one FMSS factor (Emotional) was associated with worse symptoms of depression and poorer psychological QOL. When taken together, only the absence of negative social support on Facebook is significantly predictive of mental health functioning. Consequently, those hoping to use Facebook as a medium for reducing depression or improving QOL are unlikely to realize significant therapeutic benefits.

A prospective study of differential sources of school-related social support and adolescent global life satisfaction

This study examined the cross-sectional and prospective relationships between three sources of school-related social support (parent involvement, peer support for learning, and teacher-student relationships) and early adolescents' global life satisfaction. The participants were 597 middle school students from 1 large school in the southeastern United States who completed measures of school social climate and life satisfaction on 2 occasions, 5 months apart. The results revealed that school-related experiences in terms of social support for learning contributed substantial amounts of variance to individual differences in adolescents' satisfaction with their lives as a whole. Cross-sectional multiple regression analyses of the differential contributions of the sources of support demonstrated that family and peer support for learning contributed statistically significant, unique variance to global life satisfaction reports. Prospective multiple regression analyses demonstrated that only family support for learning continued to contribute statistically significant, unique variance to the global life satisfaction reports at Time 2. The results suggest that school-related experiences, especially family-school interactions, spill over into adolescents' overall evaluations of their lives at a time when direct parental involvement in schooling and adolescents' global life satisfaction are generally declining. Recommendations for future research and educational policies and practices are discussed.

The influence of supports strategies, environmental factors, and client characteristics on quality of life-related personal outcomes

The concept of quality of life (QOL) is increasingly being used as a support provision and outcomes evaluation framework in the field of intellectual disability (ID). The present study used a hierarchical multiple regression research design to determine the role that available supports strategies, environmental factors, and client characteristics play in assessed quality of life-related personal outcomes. Data were collected in Arduin Foundation in The Netherlands. Participants were 186 individuals with an intellectual disability. Results indicated that QOL-outcomes were significantly impacted by the availability of support strategies, living arrangement, status of employment and level of ID.

Gesundheitsbezogene Lebensqualität und soziale Unterstützung von Kindern psychisch kranker Eltern

Eine psychische Erkrankung der Eltern kann Beeinträchtigungen im Wohlergehen ihrer Kinder zur Folge haben, die mit einer schlechteren gesundheitsbezogenen Lebensqualität einhergehen. Aktuelle Studien belegen eine schlechtere gesundheitsbezogene Lebensqualität dieser Kinder als die der Normalbevölkerung. Etwa ein Drittel der Familien mit psychisch kranken Eltern erleben auch eine mangelhafte soziale Unterstützung. Im Projekt CHIMPs (Children of mentally ill parents) wurde ein Interventionsprogramm entwickelt und manualisiert, das unter anderem auf die Verbesserung der gesundheitsbezogenen Lebensqualität der Kinder und eine verbesserte soziale Unterstützung abzielt. Die Befunde dieser Studie (n=53 Interventionsgruppe; n=14 Wartelistenkontrollgruppe) belegen Verbesserungen der gesundheitsbezogenen Lebensqualität und der sozialen Unterstützung nach der Intervention im Vergleich zu einer Wartelistenkontrollgruppe, die über ein Jahr stabil bleiben. Mit diesen Befunden liegen im deutschsprachigen Raum erstmals Evaluationsergebnisse vor, die die Angemessenheit gezielter Interventionen für diese Kinder belegen.

Adolescents' wellbeing and functioning: relationships with parents' subjective general physical and mental health

BACKGROUND

This study aimed at examining the relationship between parental subjective health status and adolescents' health-related quality of life (HRQoL) as well as the role of gender, socioeconomic status, presence of chronic health care needs and social support on the above interaction.

METHODS

Questionnaires were administered to a Greek nation-wide random sample of adolescents (N = 1,194) aged 11-18 years and their parents (N = 973) in 2003. Adolescents' and parents' status was assessed, together with reports of socio-economic status and level of social support. Various statistical tests were used to determine the extent to which these variables were related to each other.

RESULTS AND DISCUSSION

Parental subjective mental health status was significantly correlated with adolescents' better physical and psychological wellbeing, moods and emotions, parent-child relationships, school environment and financial resources. Parental subjective physical health status was strongly associated with more positive adolescents' self-perception. Adolescents' male gender, younger age, absence of chronic health care needs, high social support, and higher family income were positively associated with better HRQoL.

CONCLUSIONS

This study reinforces the importance of parental subjective health status, along with other variables, as a significant factor for the adolescents' HRQoL.

Pedometers and text messaging to increase physical activity: randomized controlled trial of adolescents with type 1 diabetes

OBJECTIVE

To assess whether pedometers and text messaging increase physical activity in adolescents with type 1 diabetes.

RESEARCH DESIGN AND METHODS

A 12-week randomized controlled trial was conducted. A total of 78 subjects participated in the trial (mean +/- SD age 14.4 +/- 2.37 years, 36 [47%] male). Intervention participants wore an open pedometer and received regular motivational text messages. Control participants received usual care. Primary outcomes were daily step count (4-day closed pedometer) and physical activity questionnaire.

RESULTS

Baseline median step count was 11,063 steps/day (range 1,541-20,158). At 12 weeks, mean daily step count reduced by 840 (95% CI -1,947 to 266) in the control group and by 22 (-1,407 to 1,364) in the intervention group (P = 0.4). Mean self-reported moderate or vigorous physical activity increased by 38.5 min/week in the control group and by 48.4 in the intervention group (P = 0.9).

CONCLUSIONS

A 12-week intervention using pedometers and text messaging as motivational tools in adolescents with type 1 diabetes did not increase physical activity.

Exploring response shift in the quality of life of healthy adolescents over 1 year

BACKGROUND

The assessment of child and adolescent quality of life (QoL) is increasingly incorporated into practice and research within health and social care. However, little is known about the stability of the conceptualisation of QoL in the face of normative developmental processes against which to compare changes in response to non-normative events, such as chronic illness. The present study examined the stability of the QoL construct over 1 year in a cohort of healthy community-dwelling adolescents through applying the response shift (RS) model.

METHOD

A cohort of 356 adolescents (M age = 14.05 years) completed the Kidscreen QoL measure on two occasions, 1 year apart. Both research-design and statistical techniques were employed to assess three types of RS: recalibration, reprioritisation and reconceptualisation.

RESULTS

A significant recalibration of small effect size was found for three QoL domains using a then-test, which was confirmed in the domain of autonomy through statistical modelling. No evidence was found for reprioritisation or reconceptualisation RS using either analytical approach.

CONCLUSION

The findings support the assumption that the conceptualisation of QoL is stable during adolescence in the absence of significant health threats. However, researchers and clinicians should be aware of potential recalibration effects of some life domains.

Inequalities of quality of life in unemployed young adults: a population-based questionnaire study

Background

It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and life-satisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups.

Methods

The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by χ² test. Multivariate analysis was carried out by means of a logistic regression model.

Results

Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making.

Conclusion

Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development.

Quality of life in high-functioning adults with autism spectrum disorder: The predictive value of disability and support characteristics

Although the concept of quality of life has increasingly been used in the field of intellectual disabilities over the past three decades, the factors contributing to quality of life of persons with autism spectrum disorder (ASD) have received relatively little attention. In this study, disability and support characteristics associated with variations in the level of quality of life among adults with ASD are identified, using self-report measures. Fifty-eight high-functioning adults with ASD participated in the study. The results of a multiple linear regression analysis reveal that support characteristics are related to quality of life in adults with ASD, whereas disability characteristics are not. The R2 effect size (0.620) is large and significant. The results reinforce the significance of an available supportive social network, the importance of a substantial needs assessment and effective professional support.

Secondary control reviewed and defined

Conclusions about secondary control have been hindered by researchers' disparate interpretations of the construct. The current review offers a definition that reflects commonality among researchers and the spirit of the original article (F. Rothbaum, J. R. Weisz, & S. S. Snyder, 1982): Secondary control refers to the process by which people adjust some aspect of the self and accept circumstances as they are. The authors also identify a "fit versus control" dimension, along which secondary control research can be classified and reviewed. The authors conclude that fit-focused secondary control is adaptive for coping, is relatively preferred in interdependent cultural contexts, and may serve the motivation for relatedness. Control-focused definitions lead to different interpretations of the function and cultural nature of secondary control. The proposed definition and dimension should enable researchers to articulate assumptions about the function and correlates of secondary control.

Preliminary evidence on the measurement properties of the Chinese version of the child health questionnaire, parent form (CHQ-PF50) and child form (CHQ-CF87)

The objective of this study was to evaluate the reliability and construct validity of the Chinese parent form (PF50) and child form (CF87) of the Child Health Questionnaire (CHQ).

METHODS

To assess the construct validity and reliability of the Chinese versions, we invited 1099 parents of healthy children and 816 school children to complete the Chinese CHQ-PF50 and CHQ-CF87, respectively.

RESULTS

Psychometric analysis on item convergent validity and discriminant validity showed > or = 99% rates of success for all 10 scales in the CF87 and > or = 94% for all but one scale in the PF50, the exception being general health scale (86%). We observed minimal floor effects for both questionnaires, but substantial ceiling effects for five scales in both the PF50 and CF87 (physical functioning, role-emotional/behavioral, role-physical, bodily pain and family activities). A substantially lower ceiling effect was observed for the physical scale and bodily pain in the CF87 (19% and 25%, respectively) relative to the PF50 (46% and 42%, respectively). The median alpha coefficient for CF87 and PF50 was 0.90 (range, 0.80-0.94) and 0.78 (range, 0.44-0.88), respectively.

CONCLUSIONS

Our findings suggest that the Chinese CHQ-PF50 and CHQ-CF87 are robust and sufficiently reliable for group comparisons and perhaps also for use in other Chinese populations.