The psychometric properties of the Childhood Health Assessment Questionnaire (CHAQ) in children with cerebral palsy

Abstract

BackgroundThe evaluation of children with cerebral palsy (CP) focuses on activity level measurement to examine the effect of health-care interventions on their physical functioning in the home, school, and community settings. This study aimed to identify the psychometric properties of the Korean version of the Childhood Health Assessment Questionnaire (CHAQ) by applying the Rasch model. The use of the Rasch model has an advantage in that item characteristic curve estimation is not affected by the characteristics of subject groups.MethodsData were collected from 65 children with CP aged 75–190 months using the Korean version of the CHAQ. Response data were analyzed according to the Rasch model, and item fitness and difficulty and the appropriateness and reliability of the rating scale were evaluated.ResultsAmong the 30 items of the Korean version of the CHAQ, two items (nail-cutting and opening a bottle cap that was already opened) were shown to be misfit items with low fitness. The analysis results for item difficulty indicated the requirement for modification of item difficulty, pointing out the need for the addition of question items with both higher and lower difficulty. The use of 4-point rating scale in the evaluation questionnaire was shown to be appropriate. With respect to analysis outcomes, the subjects’ separation reliability value and separation index were 0.97 and 5.92, respectively. In contrast, the separation reliability value and separation index for the question items were 0.95 and 4.51, respectively.ConclusionsThe results of this study suggest the need for the modification of item fitness and difficulty. The psychometric properties of the Korean version of the CHAQ were identified using the item response theory-based Rasch analysis.

Rasch Analysis of the Disability Acceptance Scale for Individuals With Cerebral Palsy

“…The 1-point response was deleted, and the measure was changed to a 4-point Likert scale. The results of the analysis showed that the 4-point rating scale was appropriate in that the fit indices for each response category were below 1.5 (22). The range of infit MnSq according to category level was from 0.87 (category level 3) to 1.13 (category level 5), and outfit MnSq range was from 0.87 (category level 3) to 1.14 (category level 4), indicating that the conditions for appropriateness were satisfied by the DAS and the 4-point scale reflected the characteristics of the item responses.…”

“…Because the individual attribute scores and the item difficulties were converted equally by using the logit scale, it was possible to have a direct comparison. When the ranges of two different distributions were consistent, that is, when the distribution ranges of the item difficulties were similar enough that the item difficulties could measure all ranges of the individual attribute scores and difficulties, the distribution was considered adequate (22).…”

“…A strength of Rasch analysis is that the item characteristic estimation is not influenced by the characteristics of the target group (20,21). Another strength of Rasch analysis is that it can be used to estimate the real ability of a participant based on the results of the analysis (22). Since the advent of IRT, studies that verify the psychometric properties of instruments have utilized IRT, and scales that have been previously standardized using Classical Test Theory have been revalidated using IRT (23).…”

<p>Application of Rasch Analysis for Development and Psychometric Properties of Adolescents’ Quality of Life Instruments: A Systematic Review</p>

“…Dabaghi et al 24,[28][29][30][31][32][33][34][35][36] Regarding target groups of patients, 9.4% of studies were related to adolescents with Cerebral Palsy (CP), accounting for the highest number of patients. [37][38][39] Other disorders studied, including kyphosis, skin diseases, diabetes, cancer, glaucoma, bladder dysfunction, visual impairment, Life-Threatening Conditions (LTC), Duchenne muscular dystrophy, cystic fibrosis, mental health, idiopathic scoliosis, spine deformity, mental health, underweight, obesity and overweight have also been the focus of interest. Also, 22.6% of the studies (n = 7) were cross-cultural surveys, with the highest share among European countries ( Table 2).…”

“…29,30,41 In the present review, studies used the short (10, 19, 27 items) and long versions (52 items) of the questionnaire. 29,31,[33][34][35][36][39][40][41][42] It was used as a self-report questionnaire in most studies, while telephoneinterview, 41,43 proxy interview, 33,34,[37][38][39]43 and face-to face interview versions 33,44 have also been reported.…”