The PedsQL™ 3.0 Healthcare Satisfaction Generic Module, a module of the PedsQL™ Measurement Model, is an instrument to measure the parents’ satisfaction with the healthcare for their children with chronic diseases and has been adapted for use in other countries
. This study aimed to develop a Chinese version of the PedsQL™ 3.0 Healthcare Satisfaction Generic Module and evaluate the psychometric properties of the scale. To our knowledge, this is the first report of psychometric properties of the PedsQL™ 3.0 Healthcare Satisfaction Generic Module in a pediatric chronic diseases sample in China.
In the standard procedure of cross-culture adaptation, we strictly followed the PedsQL™ Measurement Model Translation to finalize the Chinese version. The result showed that the scale was a feasible and practical instrument with high response rate and short completing time. Most of the items had few not applicable values except the items in the Emotional Needs subscale, such as “The amount of time given to your child to play, talk about her/his feelings, and any questions she/he may have”, “The amount of time spent helping your child with going back to school” and “The amount of time spent attending to your child’s emotional needs.” The higher percentage of not applicable values was found to be primarily from the lower age groups, with parents reasoning that their children were too young to go to school. Young pediatric patients also had difficulty talking about their feelings or emotional needs. In addition,some parents found the item “The amount of time spent helping your child with going back to school” hard to understand. This finding was consistent with the results seen in the Brazilian version of the scale
. The results indicated that some suitable modifications were necessary for the items of Emotional Needs subscale. Future studies may develop different age-group scales according to their own characteristics.
Additionally, the study results showed that the Chinese version of PedsQL™ 3.0 Healthcare Satisfaction Generic Module was a reliable and valid instrument to assess the parents’ satisfaction with the healthcare for their children with chronic diseases. The internal consistency reliability of the scale was evaluated by Cronbach’s alpha coefficients. All Cronbach’s alpha coefficients exceeded the recommended standard of 0.70 in all subscales, indicating adequate reliability of the Chinese version scale. This finding was roughly consistent with the results reported by a prior study
. Test-retest reliability was examined using ICC s. All ICC s of the subscales were higher than 0.80, which demonstrated a good test-retest reliability of the scale.
The results of Spearman’s rank correlation coefficients between items and subscale scores indicated good scaling success since items had high correlations with their hypothesized subscales, which were stronger than those with other subscales.
The CFA was performed and the results indicated that the model fit the data well according to all the Goodness of Fit Statistics. The RMSEA, CFI and SRMR all reached the recommended standards. The adequate construct validity confirmed the premeditated hypothesis of the Chinese version scale.
Our study has several potential limitations. Firstly, this study was conducted only in the highest level hospitals and the results may not be generalized to other level hospitals in China. We recommend future studies to evaluate the psychometric properties of the Chinese version scale in the samples of other level hospitals in China. Secondly, convenience sampling was used in this study, and there may be sampling bias. Thirdly, the variety of chronic diseases was limited in the present study. Parents of pediatric patients with other chronic diseases should be recruited in future studies. Fourthly, only 35 children were 13–18 years old, therefore, the results of this study may have little generalizability for those high school students. Fifthly, the responsibility to change (sensitivity) of the scale was not evaluated. Intervention for the healthcare service can be implemented to assess the responsibility to change (sensitivity) of the Chinese version scale in future studies. Moreover, the parental satisfaction was assessed to reflect the healthcare satisfaction, but to some extent, it may be different from the patient’s satisfaction. In order to evaluate the healthcare satisfaction comprehensively, the scale of pediatric patient’s satisfaction (especially the older pediatric patient’s satisfaction) could be developed in the future studies.