Starting from Scratch: The Development of the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS)

Abstract

This article documents the initial development of a Spanish mental health quality of life (QOL) instrument based on the adolescents’ own assessment of important domains to their QOL. Using a grounded theory approach, we targeted five mental health disorders: Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD). In-depth interviews (n=40) and three focus groups (n=20) were conducted and analyzed using qualitative methods to guide the development of items. A convenient sample of island Puerto Rican adolescents aged 12–18 was recruited from outpatient mental health clinics. Qualitative analysis revealed a total of 87 themes. They were distributed based on core QOL domains such as (1) Self (2) Peers, (3) Family (4) School, and (5) Environment. Items were written based on prevailing themes and using as closely as possible, words and phrases used by the adolescents to describe their views and perceptions of quality of life. The goal for the AQOL-MHS is to pinpoint specific areas of health related QOL for each psychiatric diagnostic group that will provide valuable information to assist both patients and providers set, define and evaluate adequate mental health treatment goals.

Measurement properties of the Adolescent Quality of Life Mental Health Scale (AQOL-MHS)

“…We believe this furthers our evidence for the Content validity of the items given that they were defined by the adolescents themselves and were written keeping as faithfully as possible to the adolescents’ own words and expressions [4]. …”

“…To our knowledge, there are no other instruments specifically designed to assess Quality of Life in adolescents with psychiatric disorders. Our earlier work has yielded a new Spanish language instrument that focuses on the QOL of adolescents (12–18 years old) with mental health problems [4]. We sought to create specificity during instrument development by drafting items that used, whenever possible, the same words articulated by the adolescents when expressing their feeling toward quality of life.…”

“…Chavez et al [4] provide a detailed description of the construct of QOL on which this instrument is based and the theoretical foundation that informed the methodology used in the development of the items. The purpose of this study is to evaluate the psychometric properties of the AQOL-MHS using established guidelines for measurement development [5, 6].…”

Measurement Invariance of the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS) across Gender, Age and Treatment Context

“…We previously developed the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS), a Spanish language instrument that focuses on the QOL of adolescents (12–18 years old) with mental health problems. The AQOL-MHS was developed in Spanish with adolescents living on the island of Puerto Rico, with promising results (Chavez et al 2012; 2014). …”

Applying generalizability theory methods to assess continuity and change on the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS)

“…In the spirit of focusing on specific populations and disorders, we developed a QOL instruments for adolescents with mental health problems, the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS) [1, 9]. This instrument differs from other QOL instruments developed for children or adolescents (e.g.…”