Carlos Alejandro Hidalgo-Rasmussen

Health-related quality of life measurement in children and adolescents in Ibero-American countries, 2000 to 2010.

OBJECTIVESnTo analyze the characteristics of instruments designed to assess the health-related quality of life (HRQOL) in children, developed or adapted from 2000 to 2010 in Argentina, Chile, Mexico, Spain, and Uruguay.nnnMETHODSnThe protocol-led literature review included database searching (e.g., Medline, ISI Science Citation Index) and manual searching to retrieve studies focused on measures of HRQOL, health status, or well-being addressed to children and adolescents. Country-specific filters were applied to identify studies carried out in the participating countries. The characteristics of the instruments and type of studies were analyzed. Descriptive characteristics and psychometric properties were analyzed following the guidelines of the Scientific Advisory Committee of the Medical Outcomes Trust.nnnRESULTSnNinety-nine documents were included. Thirty-one questionnaires were identified, 24 instruments were adapted, and the psychometric properties of 20 HRQOL instruments were reported in the study period. There was substantial variability in the number and characteristics of the dimensions included. Reliability was generally acceptable, and the majority of instruments provided data on internal consistency (n = 18) and, to a lesser extent, on test-retest reliability (n = 12). Nearly all studies reported construct validity, but only four analyzed sensitivity to change.nnnCONCLUSIONSnThere is a scarcity of instruments to measure HRQOL of children and adolescents in the countries analyzed. Certain psychometric characteristics have been reasonably well tested, but others, most notably sensitivity to change, have not been tested in most instruments. Extension of this study to other Latin American countries would help to further identify gaps in this area and promote the use of HRQOL measurement in children and adolescents in Spanish-speaking cultures.

Calidad de vida, según percepción y comportamientos de control del peso por género, en estudiantes universitarios adolescentes en México

El objetivo de este estudio fue analizar la calidad de vida (CV), segun auto percepcion del peso corporal y comportamientos de control de peso, por genero, en 2.401 estudiantes de 17 a 19 anos de primer ingreso en un centro universitario en Mexico del 2007 al 2009; 61,9% mujeres, 80,6% no trabajaban y 99,2% solteros. Se auto administro en linea un cuestionario generico de CV (YQOL-R) modulo perceptual, y siete items acerca del peso adaptados del YRBS 2007. Se observo que un 52% de mujeres y un 31,7% de hombres trataba de bajar de peso. CV mas alta para peso cercano al correcto, quienes trataban de mantenerse en su peso y los que hacian ejercicio; CV mas baja para quienes reportaron mucho sobrepeso, mujeres que trataban de bajar de peso, comian menos, dejaban de comer, hacian dieta sin supervision, vomitaban o tomaban laxantes. En mujeres la CV fue diferente si trataban de mantenerse, subir o bajar de peso; en hombres solo al tratar de subir. Esta informacion puede ser de utilidad para procesos educativos, programas de prevencion y para evaluar las intervenciones.

Adaptación transcultural y validación de un instrumento de calidad de vida relacionada con la salud en adolescentes chilenos

BACKGROUNDnKIDSCREEN-52 is an instrument to assess health related quality of life in children and adolescents.nnnAIMnTo culturally adapt and validate the KIDSCREEN-52 questionnaire in Chileans.nnnMATERIAL AND METHODSnTwo independent translations from the English Spanish language were conciliated and retranslated to English. The conciliated version was tested during a cognitive interview to adolescents of different socioeconomic levels. The final version was validated in 7,910 school attending adolescents.nnnRESULTSnIn the cross-cultural adaptation, 50 of the 52 items presented low or medium levels of difficulty and a high semantic equivalence. Distribution according to gender, grades and types of schools was similar to the sample. Single ages were not affected by sex distribution. The Confirmatory Factor Analyses were: X² (1229) = 20996.7, Root Mean Square Error of Approximation = .045 and Comparative Fit Index = .96. The instrument had a Cronbachs alpha of .93. The domains had scores over 0.70 points, with the exception of the Selfperception domain, with a score of 0.62.nnnCONCLUSIONSnThe Chilean version of KIDSCREEN-52 is culturally appropriate and semantically equivalent in its English and Spanish versions (from Spain). Its reliability and validity were adequate.RESUMEN Objetivo: Adaptar culturalmente y validar el Instrumento KIDSCREEN-52 para la poblacion adolescente chilena. Metodo: Se hizo dos traducciones independientes desde la version en ingles original.Estas traducciones fueron conciliadas y se retradujeron al ingles por una tercera traductora. La version conciliada y revisada por el equipo de investigacion se aplico en una pre-prueba de entrevistas cognitivas a adolescentes de diferentes niveles socioeconomicos para establecer la equivalencia cultural de los items del cuestionario. La validacion de la version final se realizo en una muestra nacional de 7.910 adolescentes escolares. Resultados: En la adaptacion transcultural, hubo 50 de los 52 items con bajo o mediano nivel de dificultad y alta equivalencia semantica. El cuestionario final tuvo 23 items (de 52) identicos a la version de Espana . La distribucion por sexo, cursos y tipos de establecimiento escolar se mantuvo a lo disenado en la muestra. La edades simples no se afectaron en la distribucion por sexo. El Analisis Factorial Confirmatorio fue de un X 2 (1229)=20996.7, RMSEA= 0,045 y CFI= 0,96 La fiabilidad del instrumento total obtuvo un alfa de Cronbach de 0,936 y los dominios mostraron puntuaciones mayores a 0,70 , con excepcion de la dimension que mide autopercepcion (0.61). Conclusiones: La version chilena del KIDSCREEN-52 es culturalmente apropiada y equivalente semanticamente a las versiones en ingles y espanol (de Espana). Su fiabilidad y validez fueron muy adecuadas y permite la comparacion internacional. Palabras claves: Calidad de Vida Relacionada con la Salud – Adolescentes - Adaptacion transcultural -Validacion Abstract Objective: To adapt, culturally and validate the KIDSCREEN-52 instrument in the Chilean adolescent population. Method: Two independent translations from the English Spanish lenguage were conciliated and retranslated to English. The conciliated version was proved with cognitive adolescent’s interview of different socioeconomic levels and validated in 7,910 school attending adolescents as a significant sample at national level. Resultsxad: In the cross-cultural adaptation, 50 of the 52 items presented low or medium levels of difficulty and a high semantic equivalence. The final survey had 23 identical items to the Spanish version. Distribution according to gender, grades and types of schools was similar to the sample. Singles ages were not affected by the sex distribution. The Confirmatory Factor Analysis were: c 2 (1229)=20996.7, RMSEA= .045 and CFI= .96 The total instrument reach a Cronbach’s alpha reliability of .936 with domains evincing over .70 points, with the exception of the “Self-perception” domain, with a score of .61 Conclusions: The Chilean version of KIDSCREEN-52 is culturally appropriate and semantically equivalent in its English and Spanish versions (from Spain). Its reliability and validity were very adequate and allow for international comparison. Key words: Health-related quality of Life. Adolescents. Cross Cultural Comparison

Actividad física, conductas sedentarias y calidad de vida en adolescentes universitarios de Ciudad Guzmán, Jalisco, México

With the aim of evaluating the association between physical activity and sedentary behavior with quality of life (QoL) in undergraduate students of Ciudad Guzman, state of Jalisco, Mexico, a total of 881 adolescents aged between 17 and 19 were studied. Online questionnaires were used, namely the research version of the Youth Quality of Life Instrument and the Youth Risk Behavior Survey. Odd ratios (OR) were obtained using simple and multivariate logistic regression analysis. The number of days with physical activity was related to a higher total perceptual score, higher general QoL domain, higher self domain as well as higher environment domain. Playing in > 2 sports teams was related to a higher total perceptual score, higher general QoL domain, higher self domain as well as higher environment domain. Having 4-5 physical education classes/week was related with a higher general QoL domain. Limiting recreational screen time to < 2 hours/day was related with a higher relationship domain. In conclusion, in Mexican undergraduate adolescent students, higher QoL was associated with: physical activity at least 4 days/week; physical education classes 4 or more days/week; playing in 2 or more sports teams and limiting recreational screen time to 2 hours or less.

Propiedades psicométricas del cuestionario de calidad de vida relacionada con la salud KIDSCREEN-27 en adolescentes chilenos

BACKGROUNDnKIDSCREEN-52, which assesses health related quality of life in adolescents, has been adapted and validated in Chile showing excellent psychometric properties. There is a shorter version of the instrument, whose psychometric properties must be assessed.nnnAIMnTo evaluate the psychometric properties of the instrument KIDSCREEN-27 in Chilean adolescents.nnnMATERIAL AND METHODSnA secondary analysis of the database obtained for the adaptation and validation of KIDSCREEN-52.nnnRESULTSnThe reliability, calculated through Cronbachx92s alpha, for the entire instrument (five dimensions) was 0.89. For physical well-being, psychological well-being, autonomy and relationship with parents and peer social support dimensions, scores were higher than 0.75 while for school environment, the score was 0.69. The confirmatory factor analysis showed that the indices obtained to assess the goodness of fit in this study were a χ2 (314) = 10521.4, a Root Mean Square Error of Approximation = 0.064 and a Comparative Fit index = 0.96. KIDSCREEN-27 scores were higher among men in the physical well-being, psychological well-being, autonomy and relationship with parents dimensions and among women in social support and peers and school environment dimensions. Scores were higher in younger age groups.nnnCONCLUSIONSnThe Chilean version of KIDSCREEN-27 instrument has adequate reliability and validity.The reliability, calculated through Cronbach’s alpha, for the entire instru-ment (five dimensions) was 0.89. For physical well-being, psychological well-being, autonomy and relationship with parents and peer social support dimensions, scores were higher than 0.75 while for school environment, the score was 0.69. The confirmatory factor analysis showed that the indices obtained to assess the goodness of fit in this study were a

Adaptación transcultural del cuestionario KIDSCREEN para medir calidad de vida relacionada con la salud en población mexicana de 8 a 18 años

The scope of this study was to develop the culturally-adapted version of the KIDSCREEN-52 questionnaire for Mexican adolescents aged 8 to 18, and to analyze its reliability and validity. A translation and back translation was carried out from English to Spanish and vice versa. Cognitive interviews were conducted and confirmatory factor analysis (CFA) was used to verify the content validity of the questionnaire. Based on previous studies (i.e. the Argentinian version) mean scores of dimensions were compared to assess construct validity. Reliability was also analyzed. The results showed that the content validity of the version retained the original concepts, duly adapted to the Mexican culture and language. The AFC confirmed the structure of the 10 original dimensions. Two scales achieved the ceiling effect. The instruments internal consistency was acceptable (ranged from 0.5 to 0.86), and reproducibility obtained low coefficients in 5 dimensions (0.22 to 0.78). The Mexican KIDSCREEN-52 version is equivalent to the original in terms of content, structure, and construct validity. The conclusion was that theKIDSCREEN -52 tool is suitable for application in the Mexican population aged 8 to 18. Further studies are needed to explore its application in clinical settings.

Bullying y calidad de vida relacionada con la salud en adolescentes escolares chilenos

BACKGROUNDnBullying has a negative impact on the perception of adolescents of their quality of life.nnnAIMnTo analyze the association between being bullied and health related quality of life in Chilean adolescents.nnnMATERIAL AND METHODSnThe bullying module of the KIDSCREEN 52 survey and the KIDSCREEN 10 survey to assess health related quality of life were applied to 7737 students aged 10 to 18 years. Social and demographic data, information about disability and type of school were also gathered.nnnRESULTSnFifteen percent of surveyed students were bullied. A lower quality of life perception increased by a factor of 2.6 among bullied students. It also increased by a factor of 4.4 among students with a low self-esteem, by a factor of 3.1 among those who perceived their health status as regular or bad and by a factor of 1.4 among women.nnnCONCLUSIONSnBullying is associated with a lower quality of life perception among Chilean students.BACKGROUND: Bullying has a negative impact on the perception of adolescents of their quality of life. AIM: To analyze the association between being bullied and health related quality of life in Chilean adolescents. MATERIAL AND METHODS: The bullying module of the KIDSCREEN 52 survey and the KIDSCREEN 10 survey to assess health related quality of life were applied to 7737 students aged 10 to 18 years. Social and demographic data, information about disability and type of school were also gathered. RESULTS: Fifteen percent of surveyed students were bullied. A lower quality of life perception increased by a factor of 2.6 among bullied students. It also increased by a factor of 4.4 among students with a low self-esteem, by a factor of 3.1 among those who perceived their health status as regular or bad and by a factor of 1.4 among women. CONCLUSIONS: Bullying is associated with a lower quality of life perception among Chilean students. Language: es

Comportamientos de riesgo de suicidio y calidad de vida, por género, en adolescentes mexicanos, estudiantes de preparatoria

The study of pre-suicidal behaviors is important not only because of their association with suicide but also because of their impact on quality of life (QOL). Given the scarcity of information regarding this relationship in adolescence, the objective of this study was to analyze the association between suicidal-related behavior and QOL according to gender in adolescent Mexican high school students. This cross-sectional study was conducted with participants between 14 and 18 years of age. A translated version of the Youth Risk Behavior Survey and the Spanish version of the Youth Quality of Life Research - Instrument version were used. Non-parametric tests were applied. Informed consent was obtained from parents and students, and ethical committee approval was sought. The developmental-transactional model of suicidal behavior in adolescents by Bridge et al. was used. Separate analyses were conducted for males and females to show the suicidal-related behaviors associated with QOL. The behavior of having felt sad or hopeless generally presented the greatest effect sizes. The regression models showed that some suicidal-related behaviors increase the probability of a lower QOL even after adjusting for covariates.The study of pre-suicidal behaviors is important not only because of their association with suicide but also because of their impact on quality of life (QOL). Given the scarcity of information regarding this relationship in adolescence, the objective of this study was to analyze the association between suicidal-related behavior and QOL according to gender in adolescent Mexican high school students. This cross-sectional study was conducted with participants between 14 and 18 years of age. A translated version of the Youth Risk Behavior Survey and the Spanish version of the Youth Quality of Life Research - Instrument version were used. Non-parametric tests were applied. Informed consent was obtained from parents and students, and ethical committee approval was sought. The developmental-transactional model of suicidal behavior in adolescents by Bridge et al. was used. Separate analyses were conducted for males and females to show the suicidal-related behaviors associated with QOL. The behavior of having felt sad or hopeless generally presented the greatest effect sizes. The regression models showed that some suicidal-related behaviors increase the probability of a lower QOL even after adjusting for covariates.

Diferencias de género en la calidad de vida relacionada con la salud en adolescentes escolarizados chilenos

BACKGROUNDnHealth-related quality of life (HRQOL) refers to individuals perception of their subjective well-being, considering various aspects of their life and the impact on their health.nnnAIMnTo analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence.nnnMATERIAL AND METHODSnAnalytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed.nnnRESULTSnIn total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the x93Peers and Social Supportx94 and x93School Environmentx94 dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed.nnnCONCLUSIONSnThis study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.Background: Health-related quality of life (HRQOL) refers to individuals´ perception of their subjective well-being, considering various aspects of their life and the impact on their health. Aim: To analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence. Material and methods: Analytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed. Results: In total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the “Peers and Social Support” and “School Environment” dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed. Conclusions: This study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.

Health-related quality-of-life model in adolescents with different body composition

The purpose of the present study was to develop and evaluate a causal model of health-related quality of life (HRQoL) in adolescents with different body composition. The participants were 209 adolescents (107 women and 102 men) ranging from 10 to 15xa0years of age. A model based on that proposed by Wilson and Cleary (JAMA 273(1):59–65, 1995) was elaborated. The body composition of the participants was analyzed. They were asked to complete a battery of questionnaires composed of the following factors: biological status (BS; included body mass index and weight), symptomatic psychological status (SPS; included the variables of drive for thinness and food concerns), functional status (FS; composed of physical activity, food consumption estimation, and socioeconomic status), and HRQoL, which included the dimensions of psychological well-being, autonomy and relationship with parents, social support and peers, and the academic environment. Structural equation modeling produced a model, which obtained an adequate fit for the prediction of HRQoL (χ2(38)u2009=u200951.88, pu2009=u2009.07; NNFIu2009=u20090.97, CFIu2009=u20090.98, GFIu2009=u20090.95, and RMSEAu2009=u20090.04). The main outcome demonstrated the indirect effect of BS (0.44) and SPS (− 0.45) as well as a direct effect of FS (0.21) on HRQoL. In addition, a second path was observed, BS has an indirect effect on FS (0.34) and FS on HRQoL (0.21). These results provide empirical support for the evaluated model.Level of evidence: Level V, Descriptive study.