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ABSTRACT: The 43-item TNO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire was developed to meet the need for a reliable
and valid instrument for measuring parent's perceptions of health-related quality of life (HRQoL) in preschool children. HRQoL
was defined as health status in 12 domains weighted by the impact of the health status problems on well-being. The aim of
this study was to evaluate the psychometric performance of the TAPQOL. A sample of 121 parents of preterm children completed
the TAPQOL questionnaire (response rate 88%) as well as 362 parents of children from the general population (response rate
60%). On the base of Cronbach's α, item-rest correlation, and principal component analysis, the TAPQOL scales were constructed
from the data for the preterm children sample. The psychometric performance of these scales was evaluated for both the preterm
children sample and the general population sample. Cronbach's α ranged from 0.66 to 0.88 for the preterm children sample and
from 0.43 to 0.84 for the general population sample. The unidimensionality of the separate scales was confirmed by principal
component analysis for both the preterm children sample and the general population sample. Spearman's correlation coefficients
between scales were, on average, low. T-tests showed that the very preterm children, the children with chronic diseases, the less healthy and the less happy children
had lower mean scores on the TAPQOL scales than healthy children, indicating a worse quality of life. This study shows that
the TAPQOL is a reliable and valid parent's perception of HRQoL in preschool children. More research is needed to evaluate
the psychometric performance of the TAPQOL in different clinical populations.
Quality of Life Research 04/2012; 9(8):961-972. · 2.30 Impact Factor
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ABSTRACT: The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention to use such drugs and also on their background characteristics and beliefs, such as their attitudes, social influences and self-efficacy. While all social psychological determinants correlated with intention to use these drugs, the most important predictors were personal norms, beliefs about performance outcomes and the perceived behavior of others. Non-users held more restrictive norms about using performance-enhancing drugs, were less optimistic about the performance-enhancing outcomes and believed that fewer significant others used performance-enhancing drugs than users and ex-users. The results of this study indicate that users attribute advantages to performance-enhancing drugs and are inclined to overlook the risks of using them. Preventive interventions should focus on influencing personal norms and social processes.
Health Education Research 03/2008; 23(1):70-80. · 1.66 Impact Factor
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ABSTRACT: This paper describes the development and initial psychometric evaluation of the Handicap Scale for Children (HSC). This questionnaire is based on the London Handicap Scale (LHS), a valid and reliable utility instrument for measuring social participation in adults.
A multidisciplinary research group was involved in developing the HSC. The questionnaire was tested in 114 children with a chronic disease and 239 healthy children in the 8-18 age range. Relating the Health Utility Index Mark 3 (HUI3) attributes to corresponding HSC scores tested the assumption that a negative health status would lead to participation problems.
Questionnaire development resulted in a five-dimension questionnaire: mobility, physical independence, daily activities, social integration and orientation. Each dimension included one item with a six-point response scale. A higher score indicates greater handicap. Feasibility testing with 10 children showed that none of the children experienced difficulties in filling in the questionnaire. Conceptual validity, measured by correlations between the dimensions of the HSC and HUI3, was satisfactory. As expected, moderate correlation coefficients between predefined pairs of HUI and HSC attributes were found; other correlation coefficients were low. Criterion validity was also satisfactory, as shown by large differences between the healthy and the chronically ill group and by several criteria within the chronically ill group.
Based on this initial evaluation, the questionnaire seems feasible and valid for use with children in the age range 8-18 years.
Clinical Rehabilitation 02/2005; 19(1):73-80. · 2.12 Impact Factor
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ABSTRACT: This study represents the development and validation of a cardiac-specific module of the generic health-related quality of life (HRQoL) instrument, the TAAQOL (TNO/AZL Adult Quality Of Life), for young adults with congenital heart disease (CHD). Items were selected based on literature, an explorative previous study in CHD patients, interviews with patients, and the advice of experts. The newly developed Congenital Heart Disease-TNO/AZL Adult Quality of Life (CHD-TAAQOL) was tested in 156 patients with mild or complex CHD and consisted of three hypothesised subject scales: 'Symptoms' (9 items), 'Impact Cardiac Surveillance' (7 items), and 'Worries' (10 items). Cronbach's alpha for the three scales were 0.77, 0.78, and 0.82, respectively. Scale structure was confirmed by Principal Component Analysis, corrected item-scale and interscale correlations. Overall, 55% of reported health status problems were associated with negative emotions, which is an argument for assessing HRQoL as a concept distinct from health status. Convergent validity with validated generic instruments (TAAQOL and Short Form-36, SF-36) showed satisfactory coefficients. Discriminant validity was proven by significantly higher scores for mild CHD patients compared with those with complex CHD. In conclusion, the CHD-TAAQOL module together with the generic TAAQOL can be used to assess group differences for cardiac-specific HRQoL in young adults with CHD. Testing psychometric properties of the CHD-TAAQOL shows satisfactory results. However, to detect changes in HRQoL over time, further research is needed.
Quality of Life Research 06/2004; 13(4):735-45. · 2.30 Impact Factor
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ABSTRACT: This study represents the development and validation of a cardiac-specific module of the generic health-related quality of life (HRQoL) instrument, the TAAQOL (TNO/AZL Adult Quality Of Life), for young adults with congenital heart disease (CHD). Items were selected based on literature, an explorative previous study in CHD patients, interviews with patients, and the advice of experts. The newly developed Congenital Heart Disease-TNO/AZL Adult Quality of Life (CHD-TAAQOL) was tested in 156 patients with mild or complex CHD and consisted of three hypothesised subject scales:Symptoms(9 items), Impact Cardiac Surveillance(7 items), and Worries(10 items). Cronbach''s for the three scales were 0.77, 0.78, and 0.82, respectively. Scale structure was confirmed by Principal Component Analysis, corrected item-scale and interscale correlations. Overall, 55% of reported health status problems were associated with negative emotions, which is an argument for assessing HRQoL as a concept distinct from health status. Convergent validity with validated generic instruments (TAAQOL and Short Form-36, SF-36) showed satisfactory coefficients. Discriminant validity was proven by significantly higher scores for mild CHD patients compared with those with complex CHD. In conclusion, the CHD-TAAQOL module together with the generic TAAQOL can be used to assess group differences for cardiac-specific HRQoL in young adults with CHD. Testing psychometric properties of the CHD-TAAQOL shows satisfactory results. However, to detect changes in HRQoL over time, further research is needed.
Quality of Life Research 04/2004; 13(4):735-745. · 2.30 Impact Factor
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ABSTRACT: An extended re-assessment of the psychometric properties of the LSPPK, an instrument aimed at identifying children with emotional and behavioural problems.
Data came from a national sample in The Netherlands of parents of 1248 children (aged 5-6 years) interviewed by child health professionals (CHP). Data were obtained regarding psychosocial problems, treatment status and scores on the LSPPK (Parent and CHP Index), and on the Child Behavior Checklist (CBCL). The scale structure, reliability, criterion and content validity and added value of the LSPPK were assessed using the CBCL and treatment status as criteria.
The scale structure corresponded with that found originally; the LSPPK improved the prediction of problems according to the CBCL, compared to predictions using readily available risk indicators alone. Reliability varied between 0.55 and 0.69. For the LSPPK Parent Index, sensitivity varied between 0.42 and 0.50. For the CHP Index sensitivity varied between 0.60 and 0.96, but specificity varied between 0.76 and 0.79. Both indices were very sensitive for attention and social problems, but less so for other problems.
The LSPPK Parent Index cannot distinguish sufficiently between children with or without serious problems. Either too many children with problems remain unnoticed or too many children without problems are labelled as a case. The LSPPK CHP Index, reflecting the CHP's interpretation of the Parent Index after interviewing the parents does not compensate adequately for the weaknesses of the Parent Index. Better assessment procedures and strategies need to be developed.
The European Journal of Public Health 01/2004; 13(4):353-60. · 2.73 Impact Factor
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ABSTRACT: To examine the impact of previously operated complex congenital heart disease on health related quality of life and subjective health status and to determine the relation between these parameters and physical status.
Cross sectional; information on medical follow up was sought retrospectively.
Patients were randomly selected from the archives of the paediatric cardiology department, Leiden University Medical Centre, Leiden, The Netherlands, and approached irrespective of current cardiac care or hospital of follow up.
Seventy eight patients with previously operated complex congenital heart disease (now aged 18-32 years) were compared with the general population.
Health related quality of life was determined with a specifically developed questionnaire (Netherlands Organisation for Applied Scientific Research Academic Medical Centre (TNO-AZL) adult quality of life (TAAQOL)) and subjective health status was assessed with the 36 item short form health survey (SF-36). Physical status was determined with the objective physical index, Somerville index, and New York Heart Association functional class.
Health related quality of life of the patients was significantly worse than that of the general population in the dimensions gross motor functioning and vitality (p < 0.01). Correlations between health related quality of life and physical status were poor. Patients had significantly worse subjective health status than the general population in the dimensions physical functioning, role functioning physical, vitality, and general health perceptions (p < 0.01). Correlations between subjective health status and physical indices were weak.
Adult survivors with previously operated complex congenital heart disease experienced limitations only in the physical dimensions of health related quality of life and subjective health status. Objectively measured medical variables were only weakly related to health related quality of life. These results indicate that, when evaluating health related quality of life, dedicated questionnaires such as the TAAQOL should be used.
Heart (British Cardiac Society) 04/2002; 87(4):356-62. · 4.22 Impact Factor
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ABSTRACT: The 43-item TNO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire was developed to meet the need for a reliable and valid instrument for measuring parent's perceptions of health-related quality of life (HRQoL) in preschool children. HRQoL was defined as health status in 12 domains weighted by the impact of the health status problems on well-being. The aim of this study was to evaluate the psychometric performance of the TAPQOL. A sample of 121 parents of preterm children completed the TAPQOL questionnaire (response rate 88%) as well as 362 parents of children from the general population (response rate 60%). On the base of Cronbach's alpha, item-rest correlation, and principal component analysis, the TAPQOL scales were constructed from the data for the preterm children sample. The psychometric performance of these scales was evaluated for both the preterm children sample and the general population sample. Cronbach's alpha ranged from 0.66 to 0.88 for the preterm children sample and from 0.43 to 0.84 for the general population sample. The unidimensionality of the separate scales was confirmed by principal component analysis for both the preterm children sample and the general population sample. Spearman's correlation coefficients between scales were, on average, low. T-tests showed that the very preterm children, the children with chronic diseases, the less healthy and the less happy children had lower mean scores on the TAPQOL scales than healthy children, indicating a worse quality of life. This study shows that the TAPQOL is a reliable and valid parent's perception of HRQoL in preschool children. More research is needed to evaluate the psychometric performance of the TAPQOL in different clinical populations.
Quality of Life Research 02/2000; 9(8):961-72. · 2.30 Impact Factor
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ABSTRACT: School dropouts are considered an important target group for AIDS prevention. They are expected to be less knowledgeable about AIDS and to show a higher degree of risky behavior as compared with their school-attending peers. Several small-scale studies among specific groups of dropouts seem to confirm such expectations. However, due to differences in methodology, it is often difficult to compare the results of such studies with findings for youths who have not dropped out of school. The present study sought to remedy this by examining AIDS-related knowledge, attitudes, and behavior among comparable samples of Dutch secondary school students and dropouts (excluding homeless and drug-addicted adolescents). The two groups were compared with regard to knowledge about AIDS prevention, attitude toward condom use, intention to use condoms, sexual history, and condom use. Contrary to expectations, few differences were found. It was concluded that, in most respects, dropouts are similar to those who have remained in school.
Adolescence 02/1999; 34(134):369-79. · 0.64 Impact Factor
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ABSTRACT: Health-related quality of life (HRQoL), conceptualized as patients' own evaluations of their health status, is an important criterion in evaluation health and health care and in the treatment of individual patients. Until now, few systematic attempts have been made to develop instruments to assess the HRQoL of children using such a conceptualization. This article describes the conceptualization and results of a study aiming to develop such an instrument for children aged 6-15 years using their parents as a proxy. The feasibility and psychometric performance of the instrument were evaluated in a study of 77 patients of the paediatric out-patient clinic of Leiden University Hospital. For each of the a priori-defined domains, a parent form scale could be constructed with satisfactory reliability and moderate correlations with the other scales. Only some of the parents indicating health status problems also signalled negative reactions to these problems. This is, in our view, a strong argument for the distinction between health status and quality of life (QoL). The correlation coefficients between the parent form and a children's questionnaire were low. Overall, the psychometric performance of the TACQOL parent form looks promising, which suggests that this instrument--with some modifications--can indeed be used to assess group differences in HRQoL in children. The results, however, should be replicated in larger samples, currently under study. The relation between parents' proxy reports on the HRQoL of their children and children's self-reports needs further investigation.
Quality of Life Research 08/1998; 7(5):457-65. · 2.30 Impact Factor
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ABSTRACT: The aim of the study was to test the hypothesis that daily administration of growth hormone using the Medi-Jector results in fewer adverse psychological responses than needle injection with a multidose injection pen. The Medi-Jector is a needle-free injection device that can deliver growth hormone subcutaneously through jet injection. The group studied consisted of 18 children aged 10 y or over who were participating in a study of the bioequivalence and bioequipotence of the administration of growth hormone through jet injection or needle injection. Previously, all subjects had received growth hormone therapy with commercially available multidose injection pens. The study was designed as a prospective, randomized, two-period cross-over trial. A questionnaire was used to assess psychological responses such as non-compliance, opinion on ease of preparation, affective responses to administration and local side-effects, as well as overall preference. In addition, the subjects kept a diary during the study. The subjects found the Medi-Jector less offputting (p < 0.01), less painful with respect to both frequency (p < 0.04) and intensity (p < 0.01) and less unpleasant (p < 0.05) than a multidose injection pen with a 28G needle (p < 0.01). No difference in compliance was detected. Most subjects preferred the Medi-Jector for future use (p < 0.05). The mean score on a 1-10 point scale (10 is excellent) was 7.9 (SD 1.4) for the Medi-Jector and 6.8 (SD 2.3) for the multidose injection pen (p < 0.08). The prevalence of visible bruises each day was higher (p < 0.01) with the Medi-Jector (2.5, SD 2.1) than with the multidose injection pen (0.7, SD 1.1), but children showed indifferent affective responses to bruising. Thirteen out of 18 subjects decided to continue therapy with the Medi-Jector (p < 0.06). It is concluded that use of the Medi-Jector in growth hormone therapy tends to lead to fewer adverse psychological responses than a multidose injection pen with 28G needles.
Acta Paediatrica 02/1998; 87(2):154-8. · 2.07 Impact Factor
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ABSTRACT: Health-related quality of life (HRQoL), conceptualized as patients' own evaluations of their health status, is an important criterion in evaluating health and health care and in the treatment of individual patients. Until now, few systematic attempts have been made to develop instruments to assess the HRQoL of children using such a conceptualization. This article describes the conceptualization and results of a study aiming to develop such an instrument for children aged 6–15 years using their parents as a proxy. The feasibility and psychometric performance of the instrument were evaluated in a study of 77 patients of the paediatric out-patient clinic of Leiden University Hospital. For each of the a priori-defined domains, a parent form scale could be constructed with satisfactory reliability and moderate correlations with the other scales. Only some of the parents indicating health status problems also signalled negative reactions to these problems. This is, in our view, a strong argument for the distinction between health status and quality of life (QoL). The correlation coefficients between the parent form and a children's questionnaire were low. Overall, the psychometric performance of the TACQOL parent form looks promising, which suggests that this instrument– with some modifications–can indeed be used to assess group differences in HRQoL in children. The results, however, should be replicated in larger samples, currently under study. The relation between parents' proxy reports on the HRQoL of their children and children's self-reports needs further investigation.
Quality of Life Research 01/1998; 7(5):457-465. · 2.30 Impact Factor
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ABSTRACT: The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention to use such drugs and also on their background characteristics and beliefs, such as their attitudes, social influences and self-efficacy. While all social psychological determinants correlated with intention to use these drugs, the most important predictors were personal norms, beliefs about performance outcomes and the perceived behavior of others. Non-users held more restrictive norms about using performance-enhancing drugs, were less optimistic about the performance-enhancing outcomes and believed that fewer significant others used performance-enhancing drugs than users and ex-users. The results of this study indicate that users attribute advantages to performance-enhancing drugs and are inclined to overlook the risks of using them. Preventive interventions should focus on influencing personal norms and social processes.
