The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy

dc.contributor.advisorJelsma, Jennifer
dc.contributor.advisorRamma, Lebogang
dc.contributor.authorVerstraete, Janine
dc.date.accessioned2018-09-04T09:46:13Z
dc.date.available2018-09-04T09:46:13Z
dc.date.issued2018
dc.date.updated2018-09-03T06:40:09Z
dc.description.abstractBackground and Aims: There is an increasing awareness that, in order to monitor health outcomes both mortality and morbidity need to be assessed. A common metric used to measure morbidity and functional limitation is the quality adjusted life year or QALY, which incorporates time spent in a health condition and Health-Related Quality of Life (HRQoL) into the measure. This is of increasing importance in Low Income Countries (LIC) where programmes have been adopted and implemented to address the high burden of child mortality. The ‘first 1000 days’ is one such initiative which has been adopted by the WHO to improve nutritional support, health care and social support for both the mother and child. One of the aims is to improve quality of life during this vulnerable period. As there is currently no appropriate measure of HRQoL in this age group, we set out to develop a valid and reliable, HRQoL instrument for children from 1 month to 3 years old, amenable to the elicitation of preference weights. Methods: The new HRQoL instrument, HRQoL-6D-IT, was based firstly on a mapping review of HRQoL measures for children. The next stage involved eliciting options through cognitive review from caregivers of very young children regarding HRQoL dimensions included in the EQ-5D-Y an existing validated HRQoL measure for older children. The care-givers were requested to identify items to be considered for inclusion, the wording and layout of the new measure. The item pool generated from the literature reviews and cognitive interviews were then assessed through a Delphi study with experts in the field. These items were further reduced through subsequent testing of items and retesting of a preliminary measure. The final items on the HRQoL-6D-IT included: movement, play, pain, relationships, communication and eating and, apart from pain, the descriptors referenced the behaviour of the child to age appropriate behaviour. The HRQoL-6D-IT was then tested for validity and reliability in a group of acutely-ill (AI), chronically-ill (CI) and typically developing (TD) children in two provinces in South Africa: Western and Eastern Cape. Results: The methodology used to identify candidate items was rigorous and yielded items which were developed to be observable with dimension descriptors referring to ‘age appropriate behaviour’. Caregivers were able to reliably report on HRQoL of their very young children from age 1-36 months. The content validity had been established during the development of the instrument. Concurrent validity of the different items (dimensions) was tested between the HRQoL-6D-IT and relevant items from the ASQ, FLACC and NIPS pain scale and Diet History.
dc.identifier.apacitationVerstraete, J. (2018). <i>The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy. Retrieved from http://hdl.handle.net/11427/28366en_ZA
dc.identifier.chicagocitationVerstraete, Janine. <i>"The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy, 2018. http://hdl.handle.net/11427/28366en_ZA
dc.identifier.citationVerstraete, J. 2018. The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Verstraete, Janine AB - Background and Aims: There is an increasing awareness that, in order to monitor health outcomes both mortality and morbidity need to be assessed. A common metric used to measure morbidity and functional limitation is the quality adjusted life year or QALY, which incorporates time spent in a health condition and Health-Related Quality of Life (HRQoL) into the measure. This is of increasing importance in Low Income Countries (LIC) where programmes have been adopted and implemented to address the high burden of child mortality. The ‘first 1000 days’ is one such initiative which has been adopted by the WHO to improve nutritional support, health care and social support for both the mother and child. One of the aims is to improve quality of life during this vulnerable period. As there is currently no appropriate measure of HRQoL in this age group, we set out to develop a valid and reliable, HRQoL instrument for children from 1 month to 3 years old, amenable to the elicitation of preference weights. Methods: The new HRQoL instrument, HRQoL-6D-IT, was based firstly on a mapping review of HRQoL measures for children. The next stage involved eliciting options through cognitive review from caregivers of very young children regarding HRQoL dimensions included in the EQ-5D-Y an existing validated HRQoL measure for older children. The care-givers were requested to identify items to be considered for inclusion, the wording and layout of the new measure. The item pool generated from the literature reviews and cognitive interviews were then assessed through a Delphi study with experts in the field. These items were further reduced through subsequent testing of items and retesting of a preliminary measure. The final items on the HRQoL-6D-IT included: movement, play, pain, relationships, communication and eating and, apart from pain, the descriptors referenced the behaviour of the child to age appropriate behaviour. The HRQoL-6D-IT was then tested for validity and reliability in a group of acutely-ill (AI), chronically-ill (CI) and typically developing (TD) children in two provinces in South Africa: Western and Eastern Cape. Results: The methodology used to identify candidate items was rigorous and yielded items which were developed to be observable with dimension descriptors referring to ‘age appropriate behaviour’. Caregivers were able to reliably report on HRQoL of their very young children from age 1-36 months. The content validity had been established during the development of the instrument. Concurrent validity of the different items (dimensions) was tested between the HRQoL-6D-IT and relevant items from the ASQ, FLACC and NIPS pain scale and Diet History. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy TI - The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy UR - http://hdl.handle.net/11427/28366 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/28366
dc.identifier.vancouvercitationVerstraete J. The development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy. []. University of Cape Town ,Faculty of Health Sciences ,Division of Physiotherapy, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/28366en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Physiotherapyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherchild
dc.subject.otherInfant
dc.subject.othertoddler
dc.subject.otherpre-schooler
dc.subject.otherHealth
dc.subject.otherHealth-Related Quality of Life
dc.subject.otherHRQoL
dc.subject.otherproxy
dc.titleThe development of an English Health-Related Quality of Life (HRQoL) measure for very young children, to be completed by proxy
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
uct.type.filetypeText
uct.type.filetypeImage
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Verstraete_development_an_2018.pdf
Size:
8.66 MB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Collections