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Measuring health-related quality of life in young children with physical illness: psychometric properties of the parent-reported KIDSCREEN-27

Quality of Life Research
Mark A. Ferro, Christiane Otto, Ulrike Ravens-Sieberer
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Supplementary Information

The online version contains supplementary material available at https://​doi.​org/​10.​1007/​s11136-021-03054-2.

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This study examined whether the KIDSCREEN-27 was reliable and valid in young children 2–7 years with chronic physical illnesses which included estimating inter-domain correlations and internal consistency; measurement invariance testing; and, discriminant and convergent validity assessments.


Data come from the Multimorbidity in Children and Youth across the Life-course; a longitudinal study of individuals aged 2–16 years with physical illness. The parent-reported KIDSCREEN-27 was administered. Children (2–7 years; n = 106) were compared to adolescents (8–16 years; n = 157). Reliability was estimated using Cronbach α for internal consistency. Multiple group confirmatory factor analysis tested for measurement invariance. Cohen’s d and Pearson coefficient were used to assess discriminant validity by sex and age. Convergent validity was tested using Pearson coefficients with the WHODAS 2.0 (child functioning/impairment). Multiple regression examined associations between multimorbidity (co-occurring physical and mental illness) and HRQL.


Internal consistency reliabilities were α = 0.74–0.88 (children) and α = 0.77–0.88 (adolescents). Inter-domain correlations were relatively low (children: r = 0.18–0.59; adolescents: r = 0.30–0.62) indicating that each KIDSCREEN-27 domain was measuring a unique aspect of health-related quality of life. Measurement invariance was demonstrated (scalar level). Parameter estimates of the invariant models were similar for children and adolescents. Small, non-significant correlations were found for sex and age for children and adolescents. Medium, significant correlations were found for both groups between the KIDSCREEN-27 and WHODAS 2.0. Children and adolescents with multimorbidity had significantly lower physical well-being, psychological well-being, and school environment scores compare to those without multimorbidity. Regression coefficients were similar between groups.


Findings provide evidence of adequate psychometrics for the KIDSCREEN-27 in young children with chronic physical illness.

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