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Journal of Pediatric Psychology Advance Access originally published online on December 27, 2007
Journal of Pediatric Psychology 2008 33(6):630-639; doi:10.1093/jpepsy/jsm131
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Factorial Invariance of Child Self-report Across Healthy and Chronic Health Condition Groups: A Confirmatory Factor Analysis Utilizing the PedsQLTM 4.0 Generic Core Scales*

Christine A. Limbers, MS1, Daniel A. Newman, PhD1 and James W. Varni, PhD2,3

1Department of Psychology, College of Liberal Arts, 2Department of Pediatrics, College of Medicine, and 3Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University

All correspondence concerning this article should be addressed to James W. Varni, PhD, Professor of Architecture and Medicine, College of Architecture, Texas A&M University, 3137 TAMU, College Station, Texas 77843-3137, USA. E-mail: jvarni{at}archmail.tamu.edu.


  Abstract

Objectives The objective of the present study was to examine the factorial invariance of the PedsQLTM 4.0 Generic Core Scales for child self-report across 11,433 children ages 5–18 with chronic health conditions and healthy children. Methods Multigroup Confirmatory Factor Analysis was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed in order to compare the factor loadings across children with chronic health conditions and healthy children. Results Metric invariance (i.e., equal factor loadings) was demonstrated based on stability of the Comparative Fit Index (CFI) between the two models, and several additional indices of practical fit including the root mean squared error of approximation, the Non-normed Fit Index, and the Parsimony Normed Fit Index. Conclusions The findings support an equivalent five-factor structure on the PedsQLTM 4.0 Generic Core Scales across healthy and chronic health condition groups. These findings suggest that when differences are found across chronic health condition and healthy groups when utilizing the PedsQLTM, these differences are more likely real differences in self-perceived health-related quality of life, rather than differences in interpretation of the PedsQLTM items as a function of health status.

Key words: child self-report; confirmatory factor analysis; factorial invariance; health-related quality of life; patient-reported outcomes; PedsQLTM.

*The PedsQLTM is available at http://www.pedsql.org.

Received June 18, 2007; revision received December 3, 2007; accepted December 8, 2007


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