The KIDSCREEN-52 HRQoL questionnaire includes ten dimensions covering physical, psychological and social domains of quality of life. The main objective of the present study was to describe the psychometric properties of the Greek KIDSCREEN-52 in a sample of adolescents derived from schools. The analysis confirmed the dimension structure with sufficient psychometric properties.
The internal consistency reliability of the KIDSCREEN scales can be considered satisfactory with a Cronbach α coefficient of 0.73 or above for all dimensions. The internal consistency is similar to that reported from other studies referring to the reliability of KIDSCREEN [8
There has been an increasing use of CFA for the exploration of psychometric properties of QoL questionnaires during recent years [24
]. In the present study CFA confirmed the construct validity of the ten-dimensional measurement model a result consistent with other studies [8
]. The RMSEA value was less than 0.05 and the CFI and GFI values were more than 0.95. The χ2
test of the model was significant, but this can be explained since χ2
statistics are sensitive to large sample sizes [22
The convergent and discriminant validity analysis indicated that the KIDSCREEN-52 model showed a reasonable pattern of associations. With respect to the relationships between the generic HRQoL dimensions of the KIDSCREEN-52 and the mainly psychologically-oriented SDQ scales, it can be said that correlations between the two instruments were as predicted. The most significant correlations emerged in general between scales and dimensions tapping similar aspects of behavioral and emotional problems. For example, the correlation between the KIDSCREEN-52 moods and emotions dimension with SDQ emotional symptoms was -0.58 and the correlation between KIDSCREEN-52 peers and social support with SDQ peer problems was -0.40. Additionally, lower correlations between non-comparable scales support the construct validity in the form of discriminant validity (that is, low correlations were found between financial resources and SDQ scales).
High versus low FAS significantly differentiated adolescents in terms of all KIDSCREEN-52 dimensions except for autonomy and social acceptance (bullying). Previous studies have generally shown that HRQoL instruments are capable of discriminating between children and adolescents with different socioeconomic status [25
The KIDSCREEN-52 questionnaire discriminated well in the hypothesized dimension of physical well-being between healthy adolescents and those with chronic physical or mental health problems. Also, differences in psychological well-being, school environment and social acceptance (bullying) were found between healthy adolescents and those with chronic health problems, but no differences between the aforementioned groups were found in the rest of the KIDSCREEN-52 dimensions. More research using the KIDSCREEN-52 questionnaire in clinical conditions is required in order to identify response patterns associated with those conditions.
Strengths and limitations
The main strength of this study is its large and representative sample size. Also, the strength of our findings is that they are based on several goodness of fit criteria and associations of the measurement model.
However, there are several limitations to this study. Firstly, the identification of the group with chronic health problems was performed with a screening instrument, and no clinical information was available for physical and mental health problems. Thus, future studies should be provided in groups so that the severity of clinical conditions will be available.
Furthermore, because of the cross-sectional design of the study it was not possible to test the sensitivity of the KIDSCREEN-52 instrument to change. Changes over time should be evaluated with a longitudinal study design in future research. Pilot test in Spanish adolescents [26
] has shown that KIDSCREEN follow up instrumentation seems adequate for collecting factors with potential influence on HRQoL.