[Validity and Reliability of the KIDSCREEN-27 Life Quality Questionnaire, Parents' Version, in Medellin, Colombia]

The Efficacy of Two Models of Intensive Upper Limb Training on Health-Related Quality of Life in Children with Hemiplegic Cerebral Palsy Mainstreamed in Regular Schools: A Double-Blinded, Randomized Controlled Trial

BACKGROUND

Children with hemiplegic cerebral palsy (CP) are at risk of reduced upper limb function and poorer quality of life than their typically developing peers. Although upper limb impairments have potential negative impact on the health-related quality of life (HRQOL) in children with hemiplegic CP, the efficacy of upper limb rehabilitation approaches aiming to improve upper limb impairments on HRQOL has not been adequately investigated.

OBJECTIVE

This study compares the efficacy of two modes of activity-based upper limb rehabilitation (modified constraint-induced movement therapy [mCIMT] and bimanual training [BIM]) on HRQOL outcomes in children with hemiplegic CP mainstreamed in regular schools.

METHODS

Thirty children with hemiplegic CP aged between 7 and 11 years (mean age 8.53 ± 1.54 years) who had functional ability levels of I-III according to the Manual Ability Classification System (MACS), Gross Motor Classification System (GMFCS), and Communication Function Classification System (CFCS) were randomly assigned to receive mCIMT or BIM training. Result: Both mCIMT and BIM yielded statistically significant improvements in all HRQOL domains immediately after the 10-week interventions (P < .001), which were retained at 16 weeks.

CONCLUSION

While there were some differences in the intervention effects, both of these upper limb rehabilitation approaches based on intensive unimanual or bimanual activity may be beneficial for improving perceived life satisfaction related to physical activity, general mood, family, friends, and school among children with hemiplegic CP mainstreamed in regular schools.

Family aspects, physical fitness, and physical activity associated with mental-health indicators in adolescents

Background

The objective of the study was to analyze the associations of family aspects, physical fitness, and physical activity with mental-health indicators in a sample of adolescents from Colombia.

Methods

A cross-sectional study carried out in a sample of 988 adolescents (11-17 years-old) from public schools in Montería. Mental-health indicators were evaluated: Stress, depression, anxiety, happiness, health-related quality of life (HRQL), and subjective wellness. Family aspects included family affluence, functionality, and structure. These variables, along with physical activity and screen time, were measured with questionnaires. A fitness score was established by assessing the components of fitness: Flexibility, cardiorespiratory fitness, grip strength, and lower-limb strength. Associations were analyzed by multivariate linear regression models.

Results

Nuclear family structure was associated with lower stress level (− 1.08, CI: − 1.98 - -0.18), and family functionality was associated with all the studied mental-health indicators (Stress: -0.11, CI: − 0.17 - -0.06; depression: -0.20, CI: − 0.25 - -0.16; trait anxiety: -0.13, CI: − 0.18 - -0.09; state anxiety: -0.12, CI: − 0.17 - -0.08; happiness: 0.09, CI: 0.07 - 0.1; HRQL: 1.13, CI: 0.99 - 1.27; subjective wellness: 1.67, CI: 1.39 - 1.95). Physical activity was associated (β, 95% Confidence Interval (CI)) with depression (− 0.27, − 0.57 - -0.02), trait anxiety (− 0.39, CI: − 0.65 - -0.13), state anxiety (− 0.30, CI: − 0.53 - -0.07), happiness (0.14, CI: 0.06 - 0.22), HRQL (3.63, CI: 2.86 – 4.43), and subjective wellness (5.29, CI: 3.75 – 6.83). Physical fitness was associated with stress (− 0.80, CI: − 1.17 - -0.43), state anxiety (− 0.45, CI: − 0.73 - -0.17), and HRQL (1.75, CI: 0.82 - 2.69); screen time was only associated with stress (0.06, CI: 0.02 - 0.11).

Conclusions

Family aspects were associated with mental health indicators, especially family functionality which was associated all mental-health indicators. Similarly, fitness, physical activity, and screen time were associated with the studied indicators of mental health. Particularly, physical activity was associated with all the mental-health indicators, except stress, which was only associated with screen time. Physical fitness was associated with stress, anxiety, and HRQL. Future studies could explore the causal relationships of fitness, physical activity and screen time with mental health in adolescents.

Calidad de vida relacionada con características sociodemográficas y clínicas en niños con parálisis cerebral

La parálisis cerebral  (PC) es la causa más frecuente de discapacidad en la infancia. El objetivo fue determinar  la calidad de vida relacionada con la salud (CVRS)  de niños y niñas entre 8 y 12 años con PC y relacionarlo con características sociodemográficas y clínicas. Estudio descriptivo correlacional; se aplicó cuestionario con información sociodemográfica y clínica y el Kidscreen 27 a una población de 100 niños con PC o a sus cuidadores principales, para el caso de aquellos con dificultades cognitivas o comunicativas. La dimensión de entorno escolar y estado de ánimo y sentimientos fueron mejor percibidas. En los niños más pequeños (8 a 9 años) se encontró una mejor percepción sobre la actividad física y la vida familiar y el tiempo libre, mientras que los niños mayores (10 a 12 años) en el dominio de apoyo social y amigos. Los niños de estrato socioeconómico alto dieron mayor  puntuación en todos los dominios de calidad de vida al igual que los niños menos comprometidos en su función motora gruesa.  El más alto nivel educativo de los cuidadores, estrato socioeconómico alto y menor severidad en el compromiso motor en los niños con PC, se relaciona con una mejor calidad de vida.

Adaptación transcultural para Colombia de la Escala KidsLife para personas con discapacidad intelectual y múltiple

Introducción. La calidad de vida, como constructo multidimensional, considera aspectos físicos, sociales y culturales de las personas con discapacidad intelectual; por ello, se hace necesario contar con instrumentos adaptados y validados que permitan reconocer las necesidades específicas de esta población.Objetivo. Adaptar transculturalmente para Colombia la Escala KidsLife para personas con discapacidad intelectual.Materiales y métodos. Estudio instrumental hecho por fases: se hizo una revisión preliminar de la escala por parte de los investigadores; se comprobó la validez de contenido por juicio de siete expertos, quienes valoraron importancia, influencia, observancia y adecuación gramatical, y se realizó un estudio piloto con 30 personas para determinar confiabilidad y poder discriminativo.Resultados. En cuanto a la validez de contenido, los coeficientes de concordancia ponderados para concordancia entre jueces y concordancia de las dimensiones resultaron buenos. Respecto a la confiabilidad y poder discriminativo, se halló consistencia interna muy buena para la escala total (alfa de Cronbach 0.95) y 52 ítems bajo poder discriminativo (p>0.1).Conclusiones. La adaptación y validez para Colombia de la Escala KidsLife permitirá fortalecer procesos de atención desde las diferentes dimensiones de calidad de vida centrados en las necesidades de la persona con discapacidad intelectual y múltiple, las familias y los profesionales de apoyo.

Correlación entre discapacidad y calidad de vida en niños con trastorno por déficit de atención con hiperactividad

Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) genera limitaciones en las actividades y restricciones en la participación, de allí que deba abordarse desde un modelo biopsicosocial que considere la dimensión calidad de vida (CV).Objetivo. Correlacionar el grado de discapacidad a nivel escolar con la CV en niños con TDAH.Materiales y métodos. Se realizó un estudio correlacional en una muestra no probabilística de 106 niños de 8 a 12 años de Cali, Colombia. Se utilizaron los instrumentos MINIKID, KIDSCREEN-27 versiones padres y niños y el Cuestionario para Limitaciones en Actividad y Restricciones en Participación TDAH Versión Profesores. Se hizo un análisis descriptivo de características sociodemográficas y CV y un análisis correlacional entre grado de discapacidad con CV.Resultados. El promedio de edad de los niños estudiados fue de 9.6±1.19 años, predominó el género masculino y TDAH de tipo combinado. La CV es bien valorada por padres y niños, pero los puntajes bajos se presentan en la dimensión “El colegio”. No se encontró correlación entre CV y grado de discapacidad.Conclusión. Los padres y niños con TDAH valoran positivamente la CV, pero hay tendencia a una valoración menor en la dimensión colegio. No existe correlación entre CV y grado de discapacidad a nivel escolar.

[Reproducibility, internal consistency, and construct validity of KIDSCREEN-27 in Brazilian adolescents]

: The objective of this two-part study was to estimate the reproducibility, internal consistency, and construct validity of KIDSCREEN-27, a questionnaire to measure health-related quality of life, in Brazilian adolescents. One study component estimated reproducibility (176 adolescents, 59.7% females, 64.7% 10 to 12 years of age), and another estimated internal consistency and validity (1,321 adolescents, 53.7% females, 56.9% 10 to 12 years of age). The studies were conducted with adolescents of both sexes in public schools in the municipality of João Pessoa, Paraíba State, Brazil. KIDSCREEN-27 consists of 27 items distributed across five domains (physical well-being, 5 items; psychological well-being, 7 items; parents and social support, 7 items; autonomy and relationship with parents, 4 items; school environment, 4 items). Reproducibility was estimated by intra-class correlation coefficient (ICC). Confirmatory factor analysis was used to assess construct validity, and composite reliability index (CRI) was used to verify the questionnaire's internal consistency. ICCs were greater than or equal to 0.70 (0.70 to 0.96). Factor loads were greater than 0.40, except for five items (0.28 to 0.39). The model's goodness-of-fit indices were adequate (χ2/df = 2.79; RMR = 0.035; RMSEA = 0.037; GFI = 0.951; AGFI = 0.941; CFI = 0.908; TLI = 0.901). CRI varied from 0.65 to 0.70 in the domains and was 0.90 for the questionnaire. KIDSCREEN-27 reached satisfactory levels of reproducibility, internal consistency, and construct validity and can be used to assess health-related quality of life in Brazilian adolescents 10 to 15 years of age.

A Web-Based Tool for Automatic Data Collection, Curation, and Visualization of Complex Healthcare Survey Studies including Social Network Analysis

There is a great concern nowadays regarding alcohol consumption and drug abuse, especially in young people. Analyzing the social environment where these adolescents are immersed, as well as a series of measures determining the alcohol abuse risk or personal situation and perception using a number of questionnaires like AUDIT, FAS, KIDSCREEN, and others, it is possible to gain insight into the current situation of a given individual regarding his/her consumption behavior. But this analysis, in order to be achieved, requires the use of tools that can ease the process of questionnaire creation, data gathering, curation and representation, and later analysis and visualization to the user. This research presents the design and construction of a web-based platform able to facilitate each of the mentioned processes by integrating the different phases into an intuitive system with a graphical user interface that hides the complexity underlying each of the questionnaires and techniques used and presenting the results in a flexible and visual way, avoiding any manual handling of data during the process. Advantages of this approach are shown and compared to the previous situation where some of the tasks were accomplished by time consuming and error prone manipulations of data.

Calidad de vida percibida por los escolares con sobrepeso y obesidad, de sectores populares de Medellín, Colombia

Obesity in children affects physical-and mental health and can develop anxiety, depression, as well as other disorders. The objective was to evaluate the Health-Related Quality of Live (HRQOL) in schoolchildren, according to the nutritional status, and to compare our results with those of the European Union. A cross-sectional study was conducted with 679 schoolchildren, 10-14 years, in a public school of Medellin. The KIDSCREEN -27 questionnaire was used to asses HRQOL. Women, especially with obesity, had a less favorable perception of their physical activity, health, mood and family life, while men perceived less social support from friends; they were mocked by their peers and also felt harassed. Our results are consistent with those found in the European study. The Health-Related Quality of Live in schoolchildren is not homogenous, is affected by age, sex and by the cultural constraints about the construction of the body image. Key words: Bullying, obesity, schoolchildren, overweight, quality of life, social acceptance Health Psychology, Quality of Life La obesidad afecta la salud física y mental de niños/niñas. Se evaluó la calidad de vida relacionada con la salud (CVRS) en escolares, de acuerdo al estado nutricional y se compararon los resultados con los de la Unión Europea. Se realizó un estudio transversal con 679 escolares, 10 a 14 años, de una escuela pública de Medellín, Colombia. Se empleó el KIDSCREEN-27 para medir CVRS. Las mujeres, especialmente con obesidad, tuvieron una percepción menos favorable de la actividad física, salud, estado de ánimo y vida familiar, mientras que los hombres perciben más desfavorablemente el apoyo de amigos y la aceptación social, sintiéndose objeto de burla e intimidación. Los resultados son consistentes con los encontrados en el estudio europeo. La percepción de CVRS de los escolares no es homogénea, está afectada por la edad, el sexo y los condicionantes culturales alrededor de la construcción de la imagen corporal. Palabras claves autores Aceptación social, acoso escolar, calidad de vida, obesidad escolar, sobrepeso, Palabras claves descriptores Calidad de Vida, Psicología de la Salud,

Colombian Rasch validation of KIDSCREEN-27 quality of life questionnaire

BACKGROUND

The family of KIDSCREEN instruments is the only one with trans-cultural adaptation and validation in Colombia. These validations have been performed from the classical test theory approach, which has evidenced satisfactory psychometric properties. The aim of this study was to evaluate psychometric properties of KIDSCREEN-27 children and parent-proxy versions, through Rasch analysis.

METHODS

The participants in the present study were two different sets of populations, 321 kids with a mean age of 12.3 (SD 2.6), 41 % 8 to 11 years old and 59 % 12 to 18 years old; and 1150 parent-proxy with an average age of 45.5 (SD 18.9). Psychometric properties were assessed using the partial credits model in the Rasch approach. Unidimensionality, fitting of person and item, response form, and differential item functioning (DIF) were measured.

RESULTS

The Infit MNSQ in child self-reported version that ranges between 0.71-1.76, and 0.69-1.31 in the parent-proxy version. Scores gathered on Likert forms of 5-response options, person separation was 2.08 for child self-reported version and 2.40 for parent-proxy; reliability was 0.81 and 0.85, respectively. Items reliability was 0.99 on both versions, with separations of 11.92 for child self-reported and 10.83 for parent-proxy. There was not DIF according to the variables sex and age but was present according to socioeconomic status.

CONCLUSION

There was a good fit for items and individuals to the Rasch model. Item separation was adecuate, and person separation improved when the response form was re-codified to four options. The presence of DIF according to socioeconomic status implies a scale's bias in the measure of HRQoL of Colombian children.