Carolina Lunde

Assessing the quality of life of health-referred children and adolescents with short stature: development and psychometric testing of the QoLISSY instrument

BackgroundWhen evaluating the outcomes of treatment in paediatric endocrinology, the health-related quality of life (HrQoL) of the child is to be taken into consideration. Since few self–reported HrQoL instruments exist for children with diagnosed short stature (dSS), the objective of this study was to develop and psychometrically test a targeted HrQoL instrument for use in multinational clinical research.MethodsThe target population were short stature (height < −2 SDS) children and adolescents (age 8–12 and 13–18 years) with a diagnosis of growth hormone deficiency (GHD) or idiopathic short stature (ISS), differing in growth hormone treatment status. Focus group discussions for concept and item generation, piloting of the questionnaire with cognitive debriefing, and instrument field testing with a retest were conducted simultaneously in five countries. After qualitative and preliminary quantitative analyses, psychometric testing of field test data in terms of reliability and validity including confirmatory factor analyses (CFA) was performed.ResultsFollowing item generation from focus group discussions, 124 items were included in a pilot test with a cognitive debriefing exercise providing preliminary feedback on item and domain operating characteristics. A field test with 268 participants showed high internal consistency reliabilities (alpha 0.82 – 0.95), good correlations with generic measures (up to r = .58), significant known group differences (e.g. in height: F = 32, df 244, p < 0.001) and an acceptable CFA model fit suggesting construct validity of the three-domain core structure with 22 items, supplemented by three mediator domains with 28 items.ConclusionsThe QoLISSY questionnaire is a promising step forward in assessing the impact of dSS on HrQoL. It is based on items generated from the subjective experience of short stature children referred for endocrine investigation, is validated for use in five languages and it is easy to administer in clinical and research settings.

Peer victimisation and its relationships with perceptions of body composition

The present study examined the links between childrens exposure to peer victimisation, in terms of type and frequency, their body composition and subjective perceptions of body composition. A total of 960 Swedish 10‐year‐olds (515 girls and 445 boys) completed questionnaires about their peer victimisation experiences, weight and height, and perceptions of shape and stature. Results showed that whereas overweight girls reported exposure to both appearance‐teasing and bullying, overweight boys mainly reported repeated experiences of appearance‐teasing. When examining the relative importance of body composition (weight and height) and perceptions of body composition on peer victimisation experiences, childrens negative body perceptions were more strongly associated with the outcome than were body composition. This study hence stresses that children who are victimised also seem to battle unfavourable attitudes towards their physical selves, which may cause increasing concern as the child enters adolescence.