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- Karling, Mats, et al.
(author)
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Behavioural changes after anaesthesia: validity and liability of the Post Hospitalization Behavior Questionnaire in a Swedish paediatric population.
- 2006
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 95:3, s. 340-346
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Journal article (peer-reviewed)abstract
- AIM: To study the validity and liability of a Swedish translation of the Post Hospitalization Behavior Questionnaire (PHBQ) in children in Sweden. METHODS: The PHBQ was translated using a back-translation method. The subjects were 340 children, ages 2-13 y, admitted for elective surgery or diagnostic procedure with anaesthesia. The results were analysed using exploratory factor analysis with principal component analysis with Oblimin rotation. The fit to data was examined using confirmative factor analysis with a good measure of fit for the model (p>0.09 for all factors). RESULTS: Five factors emerged as being most consistent: general anxiety-withdrawal, eating disturbances, separation anxiety, regression-aggression and sleep anxiety. A panel of child psychologists confirmed the face validity of factors. Internal consistency (Chronbach's alpha) was adequate (0.75-0.87) for subscales and excellent for total score (0.93). Children less than 5 y old had higher scores than older children (mean 0.046+/-0.018 vs -0.0089+/-0.014, p<0.001). There were no gender differences. CONCLUSION: The results support a conclusion that a five-factor model better fits data from Swedish children than the original six-factor model.
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- Karling, Mats, et al.
(author)
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Child behaviour after anaesthesia: associated risk factors
- 2007
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In: Acta Paediatr. ; 96:5, s. 740-7
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Journal article (peer-reviewed)abstract
- AIM: To identify hospital care factors which are associated with problematic behaviours in children after hospitalization. METHOD: A cohort of 340 children ages 2-13 was studied in connection with elective procedures which included anaesthesia. Data collected: sociodemographic, type of procedure, anaesthesia induction technique and premedication. Staff and parents assessed child anxiety at induction of anaesthesia, pain, anxiety and nausea in recovery room and hospital ward. Parents assessed their child's pain and nausea and the behaviour measured with the Post Hospital Behavioural Questionnaire two weeks after hospitalization. RESULTS: One-third (34.4 %) of the children developed at least one problematic behaviour, measured by the PHBQ subscales. Multiple logistic regression identified the following risk factors: age <5, pain at home but not at hospital, nausea, child anxiety at anaesthesia induction, postoperative nausea, postoperative distress, previous hospitalizations, living in a one adult family and having some previous problematic behaviours. Moderate-to-severe pain at home, but not at hospital, was associated with the greatest risk (OR 6.39 CI: 3.53-11.6). Previous anaesthesia, midazolam use in premedication and living in rural areas seemed to be protective factors. CONCLUSION: Pain at home but not in hospital is a strong risk factor for the onset or worsening of problematic behaviour after childhood hospitalization, which included anaesthesia. Proactive interventions are suggested to prevent this by improving pain treatment at home.
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- Petersen, Solveig, et al.
(author)
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Psychometric properties of the Swedish PedsQL, Pediatric Quality of Life Inventory 4.0 generic core scales
- 2009
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 98:9, s. 1504-1512
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Journal article (peer-reviewed)abstract
- Aim: To study the psychometric performance of the Swedish version of the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scales in a general child population in Sweden. Methods: PedsQL forms were distributed to 2403 schoolchildren and 888 parents in two different school settings. Reliability and validity was studied for self-reports and proxy reports, full forms and short forms. Confirmatory factor analysis tested the factor structure and multigroup confirmatory factor analysis tested measurement invariance between boys and girls. Results: Test-retest reliability was demonstrated for all scales and internal consistency reliability was shown with α value exceeding 0.70 for all scales but one (self-report short form: social functioning). Child-parent agreement was low to moderate. The four-factor structure of the PedsQL and factorial invariance across sex subgroups were confirmed for the self-report forms and for the proxy short form, while model fit indices suggested improvement of several proxy full-form scales. Conclusion: The Swedish PedsQL 4.0 generic core scales are a reliable and valid tool for health-related quality of life (HRQoL) assessment in Swedish child populations. The proxy full form, however, should be used with caution. The study also support continued use of the PedsQL as a four-factor model, capable of revealing meaningful HRQoL differences between boys and girls.
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