Table 3 Domains and Constructs of Forms for Two Pediatric Health Profile Systems
Instrument | CHQ: Child Health Questionnaire | PedsQL 4.0 | |||
|---|---|---|---|---|---|
Version | Parent Forms (PF) | Youth-Completion Form | Parent Form for Infants & Toddlers | Child Forms (3 versions: 5–7, 8–12, 13–18 yrs) | Parent Forms (4 versions: 2–4, 5–7, 8–12, 13–18 yrs) |
Domain Names | 1. Physical functioning – 6 items. - e.g., Child is greatly limited in performing all physical activities, including self-care, due to physical health. 2. Role (school and activities) limitations due to emotional.* 3. Role limitations due to behavioral problems* – 3 items. - e.g., Child is limited a lot in school work or activities with friends due to behavioral problems. 4. Role limitations due to physical problems – 2 items. - e.g., Child is greatly limited in school work or activities with friends due to physical health. 5. Bodily pain – 2 items. - e.g., Child has extremely severe, frequent and limiting body pain. 6. General behavior – 6 items. - e.g., Child very often exhibits aggressive, immature, delinquent behavior. 7. Mental health – 5 items. - e.g., Child has feelings of anxiety and depression all the time. 8. Self-esteem – 6 items. - e.g., Child is very dissatisfied with abilities, looks, family/peer relationships and life overall. 9. General health perceptions – 6 items. - e.g., Parent believes child's health is poor and likely to get worse. 10.Change in health – 1 item. - e.g., Child's health is much worse now than 1 year ago. | 1. Physical Functioning. 2. Behavior (perception). 3. Growth & Development. 4. Pain. 5. Behavior (getting along). 6. Temperament & Mood. 7. General Health. 8. Change in Health. | 1.. Physical Functioning – 8 items. - hard to walk more than one block, hard to run, hard to do sports or exercises, hard to lift something heavy, hard to take a bath, hard to do chores around the house, hurt or ache, low energy. 2. Emotional Functioning – 5 items. - feel afraid or scared, feel sad or blue, feel angry, trouble sleeping, worry about what will happen. 3. Social Functioning – 5 items. - trouble getting around, other kids not wanting to be friends, teased, doing things other peers do, hard to keep up when playing with others. 4. School Functioning – 5 items. - hard to concentrate, forget things, trouble keeping up with schoolwork, miss school because not well, miss school for doctor appointments. | ||