Quality of life in children and adolescents with HIV/Aids: instrument\'s validity and reability

Author(s)

Luciana Scarlazzari Costa

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2007-09-17

Examining board members

Maria do Rosário Dias de Oliveira Latorre; Maria Zilda de Aquino; Katia Cristina Bassichetto; Ivan Franca Júnior; Michael Eduardo Reichenheim

• Advisor: Maria do Rosário Dias de Oliveira Latorre; Heloísa Helena de Sousa Marques

Abstract

Background - Health related quality of life and adherence to anti-retroviral therapy among children and adolescents are important questions that have been studied in developed countries, using fundamental questionnaires that were not yet translated or validated in Brazil. Objectives - 1) to translated and to validate the Quality of Life Assessment (QLA) questionnaire, specific to HIV/Aids children and adolescents, and to measure its reliability. 2) to validate a scale of self efficacy expectancy (SE) for antiretroviral therapy among HIV/ Aids children and adolescents and to measure its reliability. Methods - The study was conducted in the Centro de Referência e Treinamento em DST/AIDS de São Paulo (CRT/SP). The study was conducted within 90 children and adolescents aging from 6 months old to 20 years old that attended to this health service. The quality of life data were collected by using the Avaliação da Qualidade de Vida (AQV) questionnaire which has 3 versions for 3 specific age levels (6 months old to 4 years old, 5 to 11 years old and 12 to 20 years old) and the SE data were collected using the SE scale for anti-retroviral therapy. The transcultural equivalency of the QLA questionnaire was performed. The internal consistency of the questionnaires was verified using the α Cronbach\'s coefficient. The confirmatory factorial analysis of the AQV questionnaire and the exploratory analysis of the SE were done. The construct validity was verified by comparing the mean of the scores among Center for Disease Control groups (Mann-Whitney test) for the AQV, and among adherent and non-adherent to the anti-retroviral groups for the SE scale, and also, by the correlation analysis among the AQV scores and the SE scores with clinical markers, and the utilization health services markers. The reliability was verified by the mean comparing test among scores in two moments (paired), by the interclass correlation coefficient (ricc) and by the Bland-Altman method. Results -The Portuguese version of the QLA is available as a first product of this work. The AQV questionnaire has showed best internal consistency in the 5 to 11 and 12 to 20 years old age levels. The SE scale internal consistency was good in all age levels and in the total sample. The confirmatory factorial analysis has shown that is possible a reduction of the AQV questionnaire question\'s numbers. In the 6 months to 4 years old age level, the AQV has discriminated groups only in the physical state domain; significant correlations were obtained with clinical and the utilization health services markers in the domains: Physical Resistance, Social and Role Functioning, Health Services Utilization and Symptoms. The 5 to 11 years old age level has discriminated groups in the General Health Ratings, Physical State, Psychological Well-Being and Symptoms domains. Significant statistic correlations were obtained among the number of visits to the doctor and The Health Care Utilization Domain. ln the AQV 12 to 20 years old age levels the discriminate capacity has occurred in the Symptom domain and significant correlations have occurred with clinical markers and health services utilization markers in the domains: General Health Ratings, Social and Role Functioning, Health Care Utilization and Symptoms. The SE scale has reached to discriminate clinical different groups. There was obtained good reliability for the AQV questionnaire and for the AE scale. Conclusions - The AQV questionnaire and the SE scale can be use to measure quality of life and self efficacy in children and adolescents with HIV/Aids, but others studies should be done to improve the AQV questionnaire. (AU)