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Chapter 5
Questionnaires
HRQoL was examined using the generic reliable and validated Paediatric Quality of Life InventoryTMVersion 4.0 (PedsQLTM4.0) (23,24) and the generic Child Health Questionnaire (CHQ) (25). PedsQLTM4.0 assesses physical, emotional, social and school functioning while CHQ assesses physical, behavioural, mental and social functioning. The 23-item PedsQLTM4.0 questionnaire encompasses physical functioning (8 items), emotional functioning (5 items), social functioning (5 items) and school functioning (5 items). A 5-point Likert scale was used for response (0 = never a problem; 4 = almost always a problem). Items are reversed scored and linearly transformed to a 0-100 scale so that higher scores indicate better HRQoL. A total scale score and physical and psychosocial health summary scores were also calculated (23,25).
The psychometric properties of the Dutch translation of the PedsQLTM4.0 questionnaires have been well established by van Engelen et al. (26). Their study population consisted of 496 healthy schoolchildren aged 5-7 years (n=92), 8-12 years (n=219) and 13-18 years (n=185). There are no known data for weight or BMI (26). Reliability of the PedsQLTM4.0 was good in our sample (Total score: Cronbach’s α=0.87; Physical health score: Cronbach’s α=0.79; Psychosocial health score: Cronbach’s α=0.81).
The CHQ Child Form 87 questionnaire encompasses 12 domains of which each item contains 4, 5 or 6 response alternatives. Per scale, the items are summed up (some recoded/recalibrated) and transformed to a 0 (worst possible score) to 100 (best possible score) scale (25). In this study, a physical summary scale was computed, as the mean of the items in the CHQ-subscales of physical functioning, role/social limitations-physical, general health perceptions and bodily pain. Further, we computed a psychosocial summary scale, as the mean of the items in the CHQ-subscales of role/social limitations-emotional, role/social limitations-behavioural, self-esteem, mental health and general behaviour. The psychometric properties of the Dutch translation of the CHQ questionnaire have been well established in a population of 466 schoolchildren (age 9-17 years) by Raat et al. (27). In these children, allergies (17%), eczema (8%), migraines (6%) and asthma (5%) were the most prevalent reported conditions. Again, there is no known information about weight or BMI (27). Reliability of both the physical and psychosocial summary scales was good in our sample (Cronbach’s α=0.81 and 0.93).
- Body Esteem Scale
Body esteem is an essential part of psychosocial wellbeing in overweight adolescents but not covered in PedsQLTM4.0 nor CHQ. The Body Esteem Scale (BES) is a validated questionnaire (28) on general feelings of appearance, weight satisfaction and evaluations of attributions to others about one’s body and appearance. Mean scores range from 0 (worst possible score) to 4 (best possible score), with higher scores representing a better body esteem.
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