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Treier AK, Döpfner M, Ravens-Sieberer U, Görtz-Dorten A, Boecker M, Goldbeck C, Banaschewski T, Aggensteiner PM, Hanisch C, Ritschel A, Kölch M, Daunke A, Roessner V, Kohls G, Kaman A. Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders. Eur Child Adolesc Psychiatry 2024; 33:381-390. [PMID: 36800039 PMCID: PMC10869411 DOI: 10.1007/s00787-023-02166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is part of the comprehensive Diagnostic Tool for Affective Dysregulation in Children (DADYS-Screen), by analyzing relationships with comprehensive measures of AD and related mental disorders in a community sample of children with and without AD. The sample comprised 1114 children aged 8-12 years and their parents. We used clinical, parent, and child ratings for our analyses. Across all raters, the DADYS-Screen showed large correlations with comprehensive measures of AD. As expected, correlations were stronger for measures of externalizing symptoms than for measures of internalizing symptoms. Moreover, we found negative associations with emotion regulation strategies and health-related quality of life. In receiver operating characteristic (ROC) analyses, the DADYS-Screen adequately identified children with AD and provided an optimal cut-off. We conclude that the DADYS-Screen appears to be a reliable and valid measure to identify school-aged children at risk of AD.
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Affiliation(s)
- A-K Treier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - M Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - M Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Goldbeck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - P-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - C Hanisch
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - A Ritschel
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - M Kölch
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - A Daunke
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - G Kohls
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - A Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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2
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Reiß F, Erhart M, Kaman A, Devine J, Ravens-Sieberer U. Soziale Ungleichheit und psychische Gesundheit von Kindern und
Jugendlichen während der COVID-19 Pandemie. Ergebnisse der
längsschnittlichen COPSY-Studie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- F Reiß
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - M Erhart
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
- Alice-Salomon-Hochschule Berlin, Gesundheits- und
Rehabilitationswissenschaft mit Schwerpunkt angewandte Versorgungsforschung,
12627, Deutschland
| | - A Kaman
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - J Devine
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
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Beyer AK, Schlack R, Neuperdt L, Kuhnert R, Hölling H, Romanos M, Jans T, Berner A, Hetzke L, Weyrich S, Emser T, Hauer D, Scholz V, Ulsamer S, Wallau C, Ravens-Sieberer U, Kaman A, Gilbert M, Greiner W, Witte J, Seck K, Heuschmann PU, Fiessler C, Widmann J, Riederer C. Das Projekt INTEGRATE-ADHD: Vergleich und Integration administrativer
und epidemiologischer ADHS-Diagnosedaten durch klinisches Assessment bei Kindern
und Jugendlichen in Deutschland. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A-K Beyer
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Schlack
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - L Neuperdt
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Kuhnert
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - H Hölling
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - M Romanos
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Jans
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - A Berner
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - L Hetzke
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - S Weyrich
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Emser
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - D Hauer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - V Scholz
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
- Radboud University, Donders Institute for Brain, Cognition and
Behaviour, Nijmegen, Niederlande
| | - S Ulsamer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - C Wallau
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - A Kaman
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - M Gilbert
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - W Greiner
- Universität Bielefeld, Lehrstuhl für
Gesundheitsökonomie und Gesundheitsmanagement, Bielefeld,
Deutschland
| | - J Witte
- Vandage GmbH, Bielefeld, Deutschland
| | - K Seck
- Vandage GmbH, Bielefeld, Deutschland
| | - PU Heuschmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - C Fiessler
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - J Widmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
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Wüstner A, Otto C, Reiss F, Voss C, Meyrose AK, Hölling H, Ravens-Sieberer U. Mental health from childhood to adulthood: Results of the 11-year follow-up of the BELLA study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mental health problems in children, adolescents and young adults are highly prevalent and cause a significant burden for both individuals and society, resulting in a high relevance to public health. Longitudinal studies are needed to provide profound population-based data on mental health and well-being. In the present study, first results of the 11-year follow-up of the German BELLA study are presented. These include age- and gender-specific courses of general health and well-being, long-term health outcomes of mental health problems, and the utilisation of mental health services.
Methods
The longitudinal BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The BELLA study has gathered data since 2003 at five measurement points using standardised measures. In the most recent 11-year follow-up, N = 3,492 young people aged 7 to 31 years participated. Individual growth modeling, linear regression and descriptive analyses were conducted.
Results
Self-reported general health and well-being were both better in younger than older and in male compared to female participants using data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) were associated with adverse general, mental and physical health outcomes at 6-year and 11-year follow-ups. About 75 % of children and adolescents with a diagnosed mental disorder were under mental health treatment.
Conclusions
With its 11-year follow-up, the longitudinal BELLA study provides new data on mental health and well-being in German children, adolescents and young adults. Our findings are important for the development of targeted mental health promotion and early prevention strategies. Promising future analyses are planned.
Key messages
The BELLA study provides data on developmental trajectories of mental health from childhood to adulthood, on long-term health outcomes of mental health problems and on mental health care use. The findings of the present study are of great relevance for the development of targeted health promotion and prevention programs.
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Affiliation(s)
- A Wüstner
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Otto
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Reiss
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Voss
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A-K Meyrose
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Clinical Psychology, Helmut-Schmidt-University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - H Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wüstner A, Otto C, Klasen F, Westenhöfer J, Reiss F, Hölling H, Ravens-Sieberer U. Risk and resource factors for the development of depression during adolescence and young adulthood. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Depression is one of the most common mental disorders in adolescents and young adults worldwide, and causes severe impairments in psychological health, social functioning and employment. The identification of risk and resource factors for depression is an important research aim. The present study aims to investigate which individual, familial and social risk and resource factors in childhood and adolescence are associated with depressive symptoms five years later in a population-based cohort in Germany.
Methods
Analyses were performed using data from the longitudinal BELLA study. Data on risk and resource factors were collected among N = 632 children and adolescents aged 11 to 17 years. Depressive symptoms were measured five years later. The effects of risk and resource factors on depression were investigated using multivariate linear regression analyses. In subsequent models, we explored potential moderator effects of resource factors on the relationship between risk factors and depressive symptoms.
Results
A negative mother-child relationship was associated with stronger depressive symptoms in girls, while school stress was identified as a risk factor in boys. Peer competence was associated with fewer depressive symptoms in girls, and family cohesion served as a resource factor in boys. Moreover, self-efficacy moderated the association between negative mother-child relationship and depressive symptoms. Family cohesion acted as a moderator between peer problems and depressive symptoms.
Conclusions
Our findings provide evidence of gender-specific risk and resource factors for depressive symptoms. Individuals who are exposed to one of the identified risk factors must be monitored during the transition from childhood to adolescence and young adulthood. Gender-sensitive health promotion and early prevention programs are needed.
Key messages
Information concerning risk and resource factors for the development of depressive symptoms during adolescence and emerging adulthood are of high interest for public health, research and practice. The findings of the present study are of great relevance for the development of gender-sensitive health promotion and early prevention programs.
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Affiliation(s)
- A Wüstner
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Otto
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Klasen
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Westenhöfer
- Department of Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
| | - F Reiss
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kunze B, Wang B, Isensee C, Schlack R, Ravens-Sieberer U, Klasen F, Rothenberger A, Becker A. Gender associated developmental trajectories of SDQ-dysregulation profile and its predictors in children. Psychol Med 2018; 48:404-415. [PMID: 28637519 DOI: 10.1017/s0033291717001714] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Severe mood dysregulation is common in childhood and can be highly impairing. The Dysregulation Profile (DP) can be considered as a broader phenotype of emotional dysregulation, including affect, cognition and behaviour. Since mood dysregulation may persist, but differently in boys and girls, the gender associated course needs to be considered longitudinally to gain a better insight in order to support the children more adequately. This study is focusing on gender associated subgroup trajectories of the Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) in middle childhood (9-13 years of age) and includes the potential impact of clinical and psychosocial characteristics. METHOD The data set was available from the BELLA study on mental health and well-being in children and adolescents, which is the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A representative epidemiological sample of 564 children living in Germany was examined at three assessment points over 2 years (data collection 2003-2006). The SDQ-DP of children aged 9-13 years was evaluated using Latent Class Growth Analysis (LCGA). RESULTS For both genders three trajectories with low (girls 67.0% and boys 59.5%), moderate (girls 28.0% and boys 31.7%) and high SDQ-DP (girls 5.0% and boys 8.8%) scores were detected. The courses of low and moderate subgroups were stable, while in the high SDQ-DP subgroup boys showed a decreasing and girls an increasing trend in symptom severity on a descriptive level. The results of the multinomial logistic regression analyses revealed a significant influence of mainly externalising but also internalising problems both increasing the risk of moderate and high SDQ-DP in both genders. Good quality of life was a protective factor for the SDQ-DP course in all subgroups. CONCLUSION In addition to the known clinical and scientific value of the SDQ-DP, three distinguishable trajectories of SDQ-DP in boys and girls could be found. High externalising problems at the beginning of the trajectory were associated with an undesirable course of SDQ-DP. These findings might be helpful for better psychoeducation, counselling and monitoring in clinical cases and public health.
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Affiliation(s)
- B Kunze
- Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany
| | - B Wang
- Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany
| | - C Isensee
- Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany
| | - R Schlack
- Robert Koch Institute,Department of Epidemiology and Health Monitoring,Berlin,Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Hamburg- Eppendorf,Germany
| | - F Klasen
- Department of Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Hamburg- Eppendorf,Germany
| | - A Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany
| | - A Becker
- Clinic for Child and Adolescent Psychiatry and Psychotherapy,University Medical Center Göttingen,Germany
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Klasen F, Meyrose AK, Otto C, Reiss F, Ravens-Sieberer U. Psychische Auffälligkeiten von Kindern und Jugendlichen in Deutschland. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0270-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Barthel D, Otto C, Nolte S, Meyrose AK, Fischer F, Devine J, Walter O, Mierke A, Fischer KI, Thyen U, Klein M, Ankermann T, Rose M, Ravens-Sieberer U. The validation of a computer-adaptive test (CAT) for assessing health-related quality of life in children and adolescents in a clinical sample: study design, methods and first results of the Kids-CAT study. Qual Life Res 2016; 26:1105-1117. [PMID: 27830512 DOI: 10.1007/s11136-016-1437-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2016] [Indexed: 01/06/2023]
Abstract
PURPOSE Recently, we developed a computer-adaptive test (CAT) for assessing health-related quality of life (HRQoL) in children and adolescents: the Kids-CAT. It measures five generic HRQoL dimensions. The aims of this article were (1) to present the study design and (2) to investigate its psychometric properties in a clinical setting. METHODS The Kids-CAT study is a longitudinal prospective study with eight measurements over one year at two University Medical Centers in Germany. For validating the Kids-CAT, 270 consecutive 7- to 17-year-old patients with asthma (n = 52), diabetes (n = 182) or juvenile arthritis (n = 36) answered well-established HRQoL instruments (Pediatric Quality of Life Inventory™ (PedsQL), KIDSCREEN-27) and scales measuring related constructs (e.g., social support, self-efficacy). Measurement precision, test-retest reliability, convergent and discriminant validity were investigated. RESULTS The mean standard error of measurement ranged between .38 and .49 for the five dimensions, which equals a reliability between .86 and .76, respectively. The Kids-CAT measured most reliably in the lower HRQoL range. Convergent validity was supported by moderate to high correlations of the Kids-CAT dimensions with corresponding PedsQL dimensions ranging between .52 and .72. A lower correlation was found between the social dimensions of both instruments. Discriminant validity was confirmed by lower correlations with non-corresponding subscales of the PedsQL. CONCLUSIONS The Kids-CAT measures pediatric HRQoL reliably, particularly in lower areas of HRQoL. Its test-retest reliability should be re-investigated in future studies. The validity of the instrument was demonstrated. Overall, results suggest that the Kids-CAT is a promising candidate for detecting psychosocial needs in chronically ill children.
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Affiliation(s)
- D Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - C Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - S Nolte
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
| | - A-K Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - F Fischer
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany
| | - J Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - O Walter
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - A Mierke
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - K I Fischer
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - U Thyen
- Hospital for Pediatrics and Adolescent Medicine, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - M Klein
- Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany
| | - T Ankermann
- Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany
| | - M Rose
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
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9
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Barthel D, Fischer KI, Nolte S, Otto C, Meyrose AK, Reisinger S, Dabs M, Thyen U, Klein M, Muehlan H, Ankermann T, Walter O, Rose M, Ravens-Sieberer U. Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany. Qual Life Res 2016; 25:585-94. [PMID: 26790429 DOI: 10.1007/s11136-015-1219-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the implementation process of a computer-adaptive test (CAT) for measuring health-related quality of life (HRQoL) of children and adolescents in two pediatric clinics in Germany. The study focuses on the feasibility and user experience with the Kids-CAT, particularly the patients' experience with the tool and the pediatricians' experience with the Kids-CAT Report. METHODS The Kids-CAT was completed by 312 children and adolescents with asthma, diabetes or rheumatoid arthritis. The test was applied during four clinical visits over a 1-year period. A feedback report with the test results was made available to the pediatricians. To assess both feasibility and acceptability, a multimethod research design was used. To assess the patients' experience with the tool, the children and adolescents completed a questionnaire. To assess the clinicians' experience, two focus groups were conducted with eight pediatricians. RESULTS The children and adolescents indicated that the Kids-CAT was easy to complete. All pediatricians reported that the Kids-CAT was straightforward and easy to understand and integrate into clinical practice; they also expressed that routine implementation of the tool would be desirable and that the report was a valuable source of information, facilitating the assessment of self-reported HRQoL of their patients. CONCLUSIONS The Kids-CAT was considered an efficient and valuable tool for assessing HRQoL in children and adolescents. The Kids-CAT Report promises to be a useful adjunct to standard clinical care with the potential to improve patient-physician communication, enabling pediatricians to evaluate and monitor their young patients' self-reported HRQoL.
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Affiliation(s)
- D Barthel
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - K I Fischer
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - S Nolte
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia
| | - C Otto
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - A-K Meyrose
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - S Reisinger
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - M Dabs
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - U Thyen
- Hospital for Pediatrics and Adolescent Medicine, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - M Klein
- Department of General Pediatrics, University Medical Center Schleswig-Holstein, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany
| | - H Muehlan
- Department Health and Prevention, Ernst-Moritz-Arndt University, Robert-Blum-Str. 13, 17487, Greifswald, Germany
| | - T Ankermann
- Department of General Pediatrics, University Medical Center Schleswig-Holstein, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany
| | - O Walter
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - M Rose
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - U Ravens-Sieberer
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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10
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Hölling H, Schlack R, Petermann F, Ravens-Sieberer U, Mauz E. [Psychopathological problems and psychosocial impairment in children and adolescents aged 3-17 years in the German population: prevalence and time trends at two measurement points (2003-2006 and 2009-2012): results of the KiGGS study: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:807-19. [PMID: 24950830 DOI: 10.1007/s00103-014-1979-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Child and adolescent mental health problems burden not only the individual, but also their families and their social environment and may, therefore, be regarded as a highly relevant public health issue. The data on mental health problems of children and adolescents from the KiGGS Wave 1 study (sample period 2009-2012) make it possible to report on both current prevalence rates and time trends over the 6-year period beginning with the KiGGS baseline survey (2003-2006). The assessment of emotional and behavioral problems in KiGGS Wave 1 was carried out with the symptoms questionnaire of the Strengths and Difficulties Questionnaire (SDQ) in a telephone interview with 10,353 guardians of children and adolescents aged 3-17 years. Moreover, using the SDQ impact supplement, the KIGGS Wave 1 data provide information on psychosocial impairment following child and adolescent mental health problems. Subjects with a borderline or abnormal SDQ score, according to German normative data, were considered at risk. A total of 20.2% (95% CI: 18.9-21.6%) of the study subjects were identified as being at risk for a mental health disorder, compared with 20.0% (19.1-20.9%) during the KiGGS baseline study (age-standardized based on population from 12 December 2010). Thus, no significant changes over time in the prevalence of mental health problems were detected. Also, there were no statistically significant differences in prevalence by sex, age group, or socioeconomic status between the KiGGS baseline survey and KiGGS Wave 1. The statistical comparison of the subscale mean values for both girls and boys showed higher values with respect to the subscales for emotional problems, behavioral problems, and prosocial behavior and lower mean values for the peer problems subscale in KiGGS Wave 1. These partly small temporal trends, however, may be due to possible mode effects (written questionnaire in the KiGGS baseline study versus telephone interview in KiGGS Wave 1). The hyperactivity subscale remained stable across the two sample periods. Regarding impairments following mental health problems at the second sample period, boys were more affected in the areas of chronicity, family burden, and impact score. The high and stable prevalence rates and magnitude of emotional and behavioral problems should prompt increased preventive efforts.
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Affiliation(s)
- H Hölling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62-66, 12101, Berlin, Deutschland,
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11
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Ellert U, Brettschneider AK, Ravens-Sieberer U. [Health-related quality of life in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:798-806. [PMID: 24950829 DOI: 10.1007/s00103-014-1978-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In recent years, there has been a change in the health and disease spectrum among children and adolescents, with an increase in mental health problems and a shift from acute to chronic illness. In this phase, the health-related quality of life (HRQoL) has increased in importance as a dimension of subjective health. The aim of this study is to describe the HRQoL of children and adolescents measured with the internationally standardized screening instrument KIDSCREEN-10. In the follow-up of the KiGGS study in 2009-2012 (KiGGS Wave 1), 2,567 parents of children aged 7-10 years and 4,878 adolescents aged 11 years or older completed the KIDSCREEN-10 questionnaire. In all, 94% of parents of 7- to 10-year-old girls and boys estimate the HRQoL of their children to be "very good" or "good." Of the 11- to 17-year-old adolescents, 96% report their HRQoL as "very good" or "good." Somatic diseases and pain as well as mental health problems and a low social status are included in the HRQoL in only a limited way. Potential differences in HRQoL by social status were not confirmed in multivariate models. The HRQoL of the examined children and adolescents is predominantly very good or good. Interventions to improve the HRQoL of children and adolescents with diseases and psychopathological problems are necessary, regardless of their social status.
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Affiliation(s)
- U Ellert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62, 12101, Berlin, Deutschland,
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12
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Ottova-Jordan V, Smith ORF, Gobina I, Mazur J, Augustine L, Cavallo F, Valimaa R, Moor I, Torsheim T, Katreniakova Z, Vollebergh W, Ravens-Sieberer U. Trends in multiple recurrent health complaints in 15-year-olds in 35 countries in Europe, North America and Israel from 1994 to 2010. Eur J Public Health 2015; 25 Suppl 2:24-7. [DOI: 10.1093/eurpub/ckv015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Kuntsche E, Ravens-Sieberer U. Monitoring adolescent health behaviours and social determinants cross-nationally over more than a decade: introducing the Health Behaviour in School-aged Children (HBSC) study supplement on trends. Eur J Public Health 2015; 25 Suppl 2:1-3. [DOI: 10.1093/eurpub/ckv009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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14
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Metzner F, Ravens-Sieberer U, Schwinn A, Lietz J, Pawils S. [Health Promotion and Child Protection in the Paediatric Practice - Paediatricians as Protagonists in an Invitation and Reporting System for Child Health Check-ups]. Gesundheitswesen 2014; 77:916-20. [PMID: 25268416 DOI: 10.1055/s-0034-1387745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Since 1971 routine child health check-ups allow the routine identification of dis-eases in children and adolescents. Paediatricians play a central role in health prevention in childhood and adolescence and are - on account of their acceptance and admission requirements - important actors in child protection. Thus, paediatric practitioners were actively involved in the invitation and reporting system for the routine child health check-ups (U6 and U7), which was introduced to increase participation rates and improve child protection in Hamburg. METHOD By means of a questionnaire survey, all paediatric practitioners practicing in Hamburg were asked a year after introduction of the invitation and reporting system to report on their practical experience, and to share their assessment and criticism of the system (response rate 73%). RESULTS Out of 110 participating pediatricians (M=19.5 years practical experience), 81% evaluated the invitation and reporting system as very useful, useful or rather useful; 83% supported an expansion of the system for routine child health check-ups, and about 18% observed an increased utilisation of routine child health check-ups especially from families with a migrant background and by socially-disadvantaged families. Criticism was made concerning ineffective procedures. CONCLUSION The invitation and reporting system for routine child health check-ups in Hamburg shows how pediatricians can be integrated into the network of prevention and child welfare. It also shows their support of this system. Paying more systematic attention and an interdisciplinary network connecting paediatricians may contribute to a more comprehensive prevention and child protection.
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Affiliation(s)
- F Metzner
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - U Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A Schwinn
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - J Lietz
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - S Pawils
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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15
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Gobina I, Villberg J, Villerusa A, Välimaa R, Tynjälä J, Ottova-Jordan V, Ravens-Sieberer U, Levin K, Cavallo F, Borraccino A, Sigmund E, Andersen A, Holstein BE. Self-reported recurrent pain and medicine use behaviours among 15-year olds: results from the international study. Eur J Pain 2014; 19:77-84. [PMID: 24807819 DOI: 10.1002/ejp.524] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries. METHODS The World Health Organization (WHO) collaborative international Health Behaviour in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. RESULTS More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were much higher for girls, the association between pain and medicine use was similarly strong for both genders. Adolescents with recurrent pain are more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across countries despite large-country differences in the prevalence of recurrent pain and medicine use. CONCLUSIONS Recurrent pain in adolescence is common cross-nationally. Adolescents with recurrent pain are more likely to use medicine in general. Recurrent pain and medicine use should be addressed in adolescent health policies.
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Affiliation(s)
- I Gobina
- Department of Public Health and Epidemiology, Riga Stradins University, Latvia
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16
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Dehn LB, Korn-Merker E, Pfäfflin M, Ravens-Sieberer U, May TW. The impact on family scale: psychometric analysis of long and short forms in parents of children with epilepsy. Epilepsy Behav 2014; 32:21-6. [PMID: 24463304 DOI: 10.1016/j.yebeh.2013.12.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 11/17/2022]
Abstract
Epilepsy in a child or adolescent can have severe psychosocial impact on the whole family and burdens them, especially the parents. As the familial background is essential for the child's coping and the progression of the epilepsy, parental burden should be considered within a comprehensive treatment approach. This study validated the applicability of the Impact on Family Scale (IOFS), a well-established instrument that assesses the strains of families with chronically ill or disabled children, in parents of children with epilepsy. In a sample of 219 parents, the psychometric properties of the original IOFS version (33 items) and two short forms (15 and 11 items, respectively) were examined. Both short forms revealed good reliability (Cronbach's alpha, test-retest reliability), and construct validity was verified by correlations with epilepsy- and burden-related variables. However, exploratory and confirmatory factor analyses indicated superior characteristics of the short form with 11 items (IOFS-11). In conclusion, the IOFS-11 as well as the IOFS-15 proved to be practicable, reliable, and valid tools to assess the impact of childhood epilepsy on family life in research and clinical practice.
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Affiliation(s)
- L B Dehn
- Society for Epilepsy Research, Epilepsy Centre Bethel, Bielefeld, Germany; Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - E Korn-Merker
- Section of Pediatric Epilepsy, Mara Hospital, Epilepsy Centre Bethel, Bielefeld, Germany
| | - M Pfäfflin
- Society for Epilepsy Research, Epilepsy Centre Bethel, Bielefeld, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T W May
- Society for Epilepsy Research, Epilepsy Centre Bethel, Bielefeld, Germany; Department of Psychology, Bielefeld University, Bielefeld, Germany.
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17
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Dehn L, Korn-Merker E, Pfäfflin M, Fischbach H, Frantz M, Hauser A, Ravens-Sieberer U, May T. Erfassung der Belastungen von Eltern anfallskranker Kinder. Z Epileptol 2013. [DOI: 10.1007/s10309-013-0327-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Ravens-Sieberer U, Klasen F, Bichmann H, Otto C, Quitmann J, Bullinger M. [Assessment of health-related quality of life in children and adolescents]. Gesundheitswesen 2013; 75:667-78. [PMID: 24129907 DOI: 10.1055/s-0033-1349555] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik
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19
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Ottová V, Staines A, Rigby MJ, Hjern A, Leonardi M, Bourek A, Blair M, Tamburlini G, Gaspar de Matos M, Alexander D, Rasche C, Rossi G, Ravens-Sieberer U. A roadmap for child health research in Europe. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V Ottová
- University Medical Center Hamburg-Eppendorf, Research Unit Child Public Health, Hamburg, Germany
| | - A Staines
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - MJ Rigby
- Nordic School of Public Health, Gothenburg, Sweden
| | - A Hjern
- Stockholm University, Centre for Health Equity Studies (CHESS), Stockholm, Sweden
| | - M Leonardi
- Foundation of the Carlo Besta Neurological Institute (IRCCS), Milano, Italy
| | - A Bourek
- Masaryk University, Center for Healthcare Quality, Faculty of Medicine, Brno, Czech Republic
| | - M Blair
- Department of Paediatrics, Imperial College London, London, United Kingdom
| | - G Tamburlini
- Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | | - D Alexander
- Nordic School of Public Health, Gothenburg, Sweden
| | - C Rasche
- University Medical Center Hamburg-Eppendorf, Research Unit Child Public Health, Hamburg, Germany
| | - G Rossi
- University Medical Center Hamburg-Eppendorf, Research Unit Child Public Health, Hamburg, Germany
| | - U Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Research Unit Child Public Health, Hamburg, Germany
| | - RICHE Project Group (in alphabetical order): A Staines (PI), M Blair, A Bourek, A Brand, A Colver, M Gaspar de Matos, M Gissler, E-K Groholt, G Gunnlaugsson, C Hennessy, A Hjern, C Kaposvari, K Polanska, M Leonardi, A McCarthy, R Mechtler, A Morgan, L Popescu, H Raat, U Ravens-Sieberer, MJ Rigby, G Tamburlini, P Truden-Dobrin, T Veidebaum
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20
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Menrath I, Prüßmann M, Müller-Godeffroy E, Prüßmann C, Ottova V, Ravens-Sieberer U, Thyen U. Überprüfung der Effektivität schulischer Gesundheitsprogramme bei Schülerinnen und Schülern der Sekundarstufe I mit besonderen sozialen Belastungen. Gesundheitswesen 2013; 77 Suppl 1:S76-7. [DOI: 10.1055/s-0033-1334890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- I. Menrath
- Klinik für Kinder- und Jugendmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein
| | - M. Prüßmann
- Klinik für Kinder- und Jugendmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein
| | - E. Müller-Godeffroy
- Klinik für Kinder- und Jugendmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein
| | - C. Prüßmann
- Klinik für Kinder- und Jugendmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein
| | - V. Ottova
- Klinik für Kinder- und Jugendpsychiatrie,-psychotherapie und –psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - U. Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie,-psychotherapie und –psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - U. Thyen
- Klinik für Kinder- und Jugendmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein
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21
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Moor I, Richter M, Ravens-Sieberer U, Ottova V, Pförtner TK. Trends in gesundheitlichen Ungleichheiten bei psychosomatischen Beschwerden im Jugendalter in Europa, Nordamerika und Israel, 1994 - 2010. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Porzsolt F, Bausch J, Geipel G, Huppertz E, Mühlbacher A, Otto T, Radic D, Schmidt P, Ravens-Sieberer U, Zimmermann T, Clouth J. Die angemessene Evidenz für Therapieentscheidungen: eine Diskussion des Methodenpluralismus in klinischen Studien. Gesundh ökon Qual manag 2013. [DOI: 10.1055/s-0032-1330555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- F. Porzsolt
- Klinische Ökonomik, Institut für Geschichte, Theorie und Ethik der Medizin, Universität Ulm
| | - J. Bausch
- Praxis Dr. med. Jürgen Bausch, Bad Soden-Salmünster
| | | | - E. Huppertz
- HE&RO (Consultant Health Economics & Research of Outcomes), Niedererbach
| | - A. Mühlbacher
- Stiftungsinstitut Gesundheitsökonomie und Medizinmanagement, Neubrandenburg
| | - T. Otto
- Health Economics, Lilly Deutschland GmbH, Bad Homburg
| | - D. Radic
- Universität Leipzig, Wirtschaftswissenschaftliche Fakultät, Fachbereich Betriebswirtschaftslehre
| | - P. Schmidt
- State Research University Higher School of Economics (HSE) International Laboratory for Socio-Cultural Research, Moskau
| | - U. Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Hamburg
| | - T. Zimmermann
- Health Economics, Lilly Deutschland GmbH, Bad Homburg
| | - J. Clouth
- Health Economics, Lilly Deutschland GmbH, Bad Homburg
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23
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Ravens-Sieberer U, Ottova V. [Child and adolescent health in Germany: findings from the Health Behaviour in School-aged Children (HBSC)-WHO-Youth Health Survey 2002-2010]. Gesundheitswesen 2012; 74 Suppl:S4-7. [PMID: 22836890 DOI: 10.1055/s-0032-1316340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
For many years, the HBSC-Study has provided important insight and information on the health situation and health behaviours of young people 11- through 15 years of age living in Germany. The papers in this supplement take a first look at the trends in selected indicators of health and health behaviour of this group and draw important conclusions about the association between prevention and health promotion measures and individual health across time. This short report gives an overview on the key results and findings of the 10 papers in the supplement.
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Affiliation(s)
- U Ravens-Sieberer
- Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Hamburg.
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Ravens-Sieberer U, Ottova V, Hillebrandt D, Klasen F. Gesundheitsbezogene Lebensqualität und psychische Gesundheit von Kindern und Jugendlichen in Deutschland: Ergebnisse aus der deutschen HBSC-Studie 2006-2010. Gesundheitswesen 2012; 74 Suppl:S33-41. [DOI: 10.1055/s-0032-1312641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- U. Ravens-Sieberer
- Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf
| | - V. Ottova
- Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf
| | - D. Hillebrandt
- Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf
| | - F. Klasen
- Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf
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Moor I, Pförtner T, Lampert T, Ravens-Sieberer U, Richter M. Sozioökonomische Ungleichheiten in der subjektiven Gesundheit bei 11- bis 15-Jährigen in Deutschland. Eine Trendanalyse von 2002-2010. Gesundheitswesen 2012; 74 Suppl:S49-55. [DOI: 10.1055/s-0032-1312633] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- I. Moor
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther Universität Halle-Wittenberg
| | - T. Pförtner
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther Universität Halle-Wittenberg
| | - T. Lampert
- Robert Koch-Institut, Abteilung Epidemiologie und Gesundheitsberichterstattung, Berlin
| | - U. Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf
| | - M. Richter
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther Universität Halle-Wittenberg
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Ottova V, Hillebrandt D, Kolip P, Hoffarth K, Bucksch J, Melzer W, Klocke A, Richter M, Ravens-Sieberer U. [The HBSC Study in Germany--study design and methodology]. Gesundheitswesen 2012; 74 Suppl:S8-S14. [PMID: 22836897 DOI: 10.1055/s-0032-1312642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of the HBSC-Study is to collect data on the physical and mental health and health behaviour of children and adolescents and to gain a deeper insight into their situation and the specific environment they grow up in. The HBSC-study is an international school-based cross-sectional survey conducted in collaboration with the World Health Organization (WHO). The survey takes place every 4 years since 1982 and is based on a standardised protocol. In Germany the survey was first conducted in 1994 as a pilot study in North Rhine-Westphalia. The German sample is based on a random sample of classes in all public schools in Germany. 11-, 13-, and 15-year-old pupils are surveyed by means of a paper and pencil questionnaire. The questionnaire comprises a broad selection of -topics, including sociodemographics, health and risk behaviours, family, school and peers. The reported trends in the supplement are based on the data from surveys in 2002 (N=5.650), 2006 (N=7.274) and 2010 (N=5.005). The representative samples for each of the survey years are defined as follows: in 2002 the data is based on information collected in 4 Federal States (Berlin, Hesse, North Rhine-Westphalia, Saxony); in 2006 5 states define the German data file (Berlin, Hamburg, Hesse, North Rhine-Westphalia, Saxony). The data from the 2010 survey comprises data from 15 Federal States. The HBSC-data contributes towards a better understanding of the relationship between health and living conditions of young people. The papers in this supplement deliver important insights into the living context of young people and in doing this they provide important information about their health and the long-term effectiveness of public-health-measures.
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Affiliation(s)
- V Ottova
- Zentrum für Psychosoziale Medizin, Klinik für Kinder und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Hamburg
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Ottova V, Hillebrandt D, Ravens-Sieberer U. Trends in der subjektiven Gesundheit und des gesundheitlichen Wohlbefindens von Kindern und Jugendlichen in Deutschland: Ergebnisse der Health Behaviour in School-aged Children (HBSC) Studie 2002 bis 2010. Gesundheitswesen 2012; 74 Suppl:S15-24. [DOI: 10.1055/s-0032-1312640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- V. Ottova
- Forschungssektion Child Public Health Universitätsklinikum Hamburg-Eppendorf
| | - D. Hillebrandt
- Forschungssektion Child Public Health Universitätsklinikum Hamburg-Eppendorf
| | - U. Ravens-Sieberer
- Forschungssektion Child Public Health Universitätsklinikum Hamburg-Eppendorf
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Flechtner-Mors M, Thamm M, Rosario AS, Goldapp C, Hoffmeister U, Mann R, Bullinger M, van Egmond-Fröhlich A, Ravens-Sieberer U, Reinehr T, Westenhöfer J, Holl RW. Hypertonie, Dyslipoproteinämie und BMI-Kategorie charakterisieren das kardiovaskuläre Risiko bei übergewichtigen oder adipösen Kindern und Jugendlichen: Daten der BZgA-Beobachtungsstudie (EvAKuJ-Projekt) und der KiGGS-Studie. Klin Padiatr 2011; 223:445-9. [DOI: 10.1055/s-0031-1280766] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Hoffmeister U, Molz E, Bullinger M, van Egmond-Fröhlich A, Goldapp C, Mann R, Ravens-Sieberer U, Reinehr T, Westenhöfer J, Wille N, Holl R. Evaluation von Therapieangeboten für adipöse Kinder und Jugendliche (EvAKuJ-Projekt). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:603-10. [DOI: 10.1007/s00103-011-1257-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Erhart M, Weimann A, Bullinger M, Schulte-Markwort M, Ravens-Sieberer U. Psychische Komorbidität bei chronisch somatischen Erkrankungen im Kindes- und Jugendalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2010; 54:66-74. [DOI: 10.1007/s00103-010-1190-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Walsh S, Molcho M, Harel-Fisch Y, Huynh Q, Kukaswadia A, Aasvee K, Varnai D, Ottova V, Ravens-Sieberer U, Pickett W. Physical and emotional health problems experienced by youth engaged in violent behaviour. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Schillmoeller Z, Erhart M, Ravens-Sieberer U. Violence experience and quality of life in primary schools in Hamburg, Germany. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Erhart M, Hagquist C, Auquier P, Rajmil L, Power M, Ravens-Sieberer U. A comparison of Rasch item-fit and Cronbach's alpha item reduction analysis for the development of a Quality of Life scale for children and adolescents. Child Care Health Dev 2010; 36:473-84. [PMID: 19702637 DOI: 10.1111/j.1365-2214.2009.00998.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study compares item reduction analysis based on classical test theory (maximizing Cronbach's alpha - approach A), with analysis based on the Rasch Partial Credit Model item-fit (approach B), as applied to children and adolescents' health-related quality of life (HRQoL) items. The reliability and structural, cross-cultural and known-group validity of the measures were examined. METHODS Within the European KIDSCREEN project, 3019 children and adolescents (8-18 years) from seven European countries answered 19 HRQoL items of the Physical Well-being dimension of a preliminary KIDSCREEN instrument. The Cronbach's alpha and corrected item total correlation (approach A) were compared with infit mean squares and the Q-index item-fit derived according to a partial credit model (approach B). Cross-cultural differential item functioning (DIF ordinal logistic regression approach), structural validity (confirmatory factor analysis and residual correlation) and relative validity (RV) for socio-demographic and health-related factors were calculated for approaches (A) and (B). RESULTS Approach (A) led to the retention of 13 items, compared with 11 items with approach (B). The item overlap was 69% for (A) and 78% for (B). The correlation coefficient of the summated ratings was 0.93. The Cronbach's alpha was similar for both versions [0.86 (A); 0.85 (B)]. Both approaches selected some items that are not strictly unidimensional and items displaying DIF. RV ratios favoured (A) with regard to socio-demographic aspects. Approach (B) was superior in RV with regard to health-related aspects. CONCLUSION Both types of item reduction analysis should be accompanied by additional analyses. Neither of the two approaches was universally superior with regard to cultural, structural and known-group validity. However, the results support the usability of the Rasch method for developing new HRQoL measures for children and adolescents.
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Affiliation(s)
- M Erhart
- Department of Psychosomatics in Children and Adolescents, University Hospital Hamburg-Eppendorf, Germany
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Hoffmeister U, Bullinger M, Egmond-Fröhlich AV, Goldapp C, Mann R, Ravens-Sieberer U, Reinehr T, Westenhöfer J, Holl R. Beobachtungsstudie der BZgA zur Adipositastherapie bei Kindern und Jugendlichen in Deutschland: Anthropometrie, Komorbidität und Sozialstatus. Klin Padiatr 2010; 222:274-8. [DOI: 10.1055/s-0030-1248318] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ottova V, Warich J, Erhart M, Ravens-Sieberer U. Der Zusammenhang zwischen Alkohol-, Tabak- und Cannabiskonsum und deren Auswirkung auf die Lebensqualität von Jugendlichen: Ergebnisse aus dem Deutschen HBSC Survey. Suchttherapie 2009. [DOI: 10.1055/s-0029-1242762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Finne E, Reinehr T, Schaefer A, Winkel K, Ravens-Sieberer U, Kolip P. Lebensqualität übergewichtiger Kinder und Jugendlicher: Haben TeilnehmerInnen eines Schulungsprogramms zur Gewichtsreduktion eine geringere Lebensqualität? Gesundheitswesen 2009. [DOI: 10.1055/s-0029-1239291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Barkmann C, Erhart M, Schulte-Markwort M, Wille N, Ravens-Sieberer U. Psychometric Evaluation of the German Version of the Centre for Epidemiological Studies Depression Scale for Children (CES-DC). Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Objectives:To examine the psychometric properties and test-theoretical quality of the German version of the Centre for Epidemiological Studies Depression Scale for Children (CES-DC), a 20 items comprising screening instrument which measures the frequency of parent- and self-reported depressive symptoms in children and adolescents.Methods:Using a population-based, representative sample of N=2.863 7 to 17 year old German children and adolescents, factorial validity by means of linear structural modelling, cross-sectional coefficients of reliability, inter-rater agreement and normative scores are determined.Results:In a population-based German sample, the 4-factor version of the CES-DC following Radloff (1977) is considered to have good factorial validity and stability across age and informant version. The main problems of the questionnaire are the high difficulties of the items, strong floor effects of the scales and low cross-sectional reliability, which is just acceptable for screening purposes. The low inter-rater agreement indicate that parental assessment can replace self-assessment only to a limited degree.Conclusion:The strengths and weaknesses of the CES-DC are discussed taking into consideration previous data and comparable tests. Particular advantages are the existence of the parent report form and the adult version, as well as its multifactorial structure. Parental assessment should be supplemented by self-report data whenever possible.
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Erhart M, Wille N, Ravens-Sieberer U. [Empowerment of children and adolescents--the role of personal and social resources and personal autonomy for subjective health]. Gesundheitswesen 2008; 70:721-9. [PMID: 19085667 DOI: 10.1055/s-0028-1103261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM Scientific research on empowerment so far is nearly exclusively focused on the adult population. Nevertheless, it is possible to show a link between empowerment and a) the developmental psychology concepts of resilience, b) autogenetic concepts and c) concepts of risks and resources. This paper aims to study the role of personal, familial and other social resources as well as personal autonomy for subjective health-ratings. METHODS A secondary analysis of the health data of 7,000 children and adolescents aged 10-17 years of the German health behaviour in school-aged children (HBSC) study as well as 1,700 children aged 11-17 years of the mental health module (BELLA Study) within the German health interview and examination survey for children and adolescents (KiGGS) was performed. Statistical analyses encompassed analyses of variance and linear regression. RESULTS Analyses of the HBSC study showed a protective effect for school-class climate as well as parental support, whereby school was associated with fewer self-reported health complaints. Analyses of the BELLA/KiGGS study showed personal, familial and other social resources as well as personal autonomy as unique predictors for a better health-related quality of life (KINDL-R). This was true even if psychological problems were observed. CONCLUSION The results confirm the importance of strengthening personal, familial and other social resources as well as the principal importance of personal autonomy for coping with health risks and health impairments. Future research explicitly focussed on empowerment could relate to the role of personal resources within children's and adolescents' contact with the medical and health care system. It can be expected that strengthening personal resources benefits and improves the communication and active participation of children and adolescents within treatment-decision and -evaluation.
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Affiliation(s)
- M Erhart
- Klinik und Poliklinik für Kinder- und Jugendpsychosomatik, Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Erhart M, Hölling H, Bettge S, Ravens-Sieberer U, Schlack R. [The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): risks and resources for the mental development of children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:800-9. [PMID: 17514466 DOI: 10.1007/s00103-007-0243-5] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Along with the salutogenetic approach in health sciences, the quest for factors exerting a protective effect on mental development and health has increasingly gained importance, complementing the study of risk factors. A total of 6,691 children and adolescents aged 11 to 17 years answered questionnaires on personal, social and family resources as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Children with low socioeconomic status (SES) more frequently show deficits in their personal, social and family resources. Similarly, in children with migration background a higher percentage with poorly developed personal and social protective factors is found. Older children report less family resources but more social resources than younger children; in comparison to boys, girls have more social but less personal resources at their disposal. Clear connections are observed between protective factors and health-related risk-taking behaviour. Deficits in personal and family resources are associated with an increased risk for smoking. Although an increased percentage of smoking and alcohol consuming children and adolescents is found to be associated with well-developed social resources, the risk for drug experiences is not increased. The results prove the necessity to build up protective factors as a preventative measure. Especially in children and adolescents with weak protective factors, an increased risk of mental health problems can be expected in the presence of stressful events.
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Affiliation(s)
- M Erhart
- Robert Koch-Institut, Berlin, BRD.
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Ravens-Sieberer U, Ellert U, Erhart M. [Health-related quality of life of children and adolescents in Germany. Norm data from the German Health Interview and Examination Survey (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:810-8. [PMID: 17514467 DOI: 10.1007/s00103-007-0244-4] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study investigates the health-related quality of life of children and adolescents in Germany, using the internationally employed KINDL-R questionnaire for measuring the health-related quality of life of children and adolescents. In the National Health Interview and Examination Survey for Children and Adolescents (KiGGS) the parents of 14,836 children and adolescents aged 3-17 years completed the KINDL-R, as well as 6,813 children and adolescents (11-17 years old). The reliability (Cronbach's alpha = 0.85) and validity of the measurements using the KINDL-R were confirmed. The differences in health-related quality of life of children and adolescents from different social backgrounds and with different health statuses, which were to be expected on theoretical grounds, were demonstrated by the KINDL-R scores (size of effect "d" up to 1.52). The means and percentiles were calculated for the total sample as well as stratified by age group, sex, geographical region (East/West), migratory status and socio-economic status. The results of this study can be used as representative, normative data for the population of children and adolescents in Germany in general, as well as stratified for sociodemographic and socio-economic subpopulations, in order to interpret test scores on health-related quality of life (KINDL-R).
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Ravens-Sieberer U, Wille N, Bettge S, Erhart M. [Mental health of children and adolescents in Germany. Results from the BELLA study within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:871-8. [PMID: 17514473 DOI: 10.1007/s00103-007-0250-6] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Mental Health Module (BELLA study) examines emotional well-being and behaviour in a representative sub-sample of 2,863 families with children aged 7 to 17 from the National Health Interview and Examination Survey for Children and Adolescents (KiGGS). The prevalence of mental health problems was determined using the Strengths and Difficulties Questionnaire (SDQ) and additional standardised screening measures. Of children and adolescents, 21.9 % (95 %CI: 19.9-24.0) showed signs of mental health problems. The psychiatric disorders observed included anxiety (10.0 %; 95 % CI: 8.7-11.6), conduct disorder (7.6 %; 95 % CI: 6.5-8.7) and depression (5.4 %; 95 % CI: 4.3-6.6). Of the risk factors examined, adverse family climate and low socioeconomic status stand out particularly as negative contributors. When several risk factors occur simultaneously, the prevalence of mental health problems increases markedly. Conversely, positive individual, family and social resources coincide with an absence of mental health problems. Children and adolescents with mental health problems display distinctly impaired health-related quality of life, and far from all of them are receiving treatment. Identifying high risk groups therefore requires the assessment of available resources in addition to the usual risk factors for mental and subjective health. Strengthening these resources should be a key objective, both in prevention and in interventions.
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Hölling H, Erhart M, Ravens-Sieberer U, Schlack R. Verhaltensauffälligkeiten bei Kindern und Jugendlichen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:784-93. [PMID: 17514464 DOI: 10.1007/s00103-007-0241-7] [Citation(s) in RCA: 192] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mental health problems in children and adolescents constitute health impairments with major implications regarding individual wellbeing as well as daily and social functioning. In addition, these problems often burden the social partners of the individual. Within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 14478 children and adolescents aged 3-17 answered the Strengths and Difficulties Questionnaire (SDQ) which assesses behavioral problems and strengths in the areas emotional problems, hyperactivity, behavioral problems, peer problems and prosocial behavior. According to the results of the Total Difficulties Score (SDQ) 11,5 % girls (G) and 17,8 % boys (B) are classified borderline or abnormal, respectively. 92,5 % (G) and 86,3 % (B) display an adequate pro social behavior. Most prevalent problem areas are behavioral problems (G = 11,9 %, B = 17,9 %), emotional problems (G = 9,7 %, B = 8,6 %) and hyperactivity problems (G = 4,8 %, B = 10,8 %). The test-data of approximately 8,1 % of the respondents with high socio-economic status (SES), 13,4 % of those with middle SES and 23,2 % of those with low SES hinted at mental health problems. Migrants are more frequently affected than non-migrants. Results point at the need for early detection and prevention of commencing mental health problems. Especially the noneasily accessible groups like those with low socioeconomic status or migrants have to be considered.
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Detmar SB, Bruil J, Ravens-Sieberer U, Gosch A, Bisegger C. The use of focus groups in the development of the KIDSCREEN HRQL questionnaire. Qual Life Res 2006; 15:1345-53. [PMID: 16826436 DOI: 10.1007/s11136-006-0022-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2006] [Indexed: 11/25/2022]
Abstract
There is increasing interest in the public health sector in the health-related quality of life (HRQL) of healthy children. However, most HRQL instruments are developed for children with a chronic illness. In addition, existing questionnaires are mostly based on expert opinion about what constitutes HRQL and the opinions and views of healthy children are seldom included. In the European project KIDSCREEN, a generic questionnaire was developed for children between the ages of 8 and 18 on the basis of children's opinions about what constitutes HRQL. Focus group discussions were organised in six European countries to explore the HRQL as perceived by children. There were six groups in each country, stratified by gender and age. The age groups were 8-9 years, 12-13 years, and 16-17 years, with 4-8 children in each group. Experienced moderators guided the discussions. The full discussions were audiotaped, transcribed and content-analysed. The discussions went smoothly, with much lively debate. For the youngest group, the most important aspect of their HRQL was family functioning. For both younger and older adolescents, social functioning, including the relationship with peers, was most important. Children in all groups considered physical and cognitive functioning to be less important than social functioning. These key findings were taken into account when designing the KIDSCREEN HRQL questionnaire for healthy children and adolescents, with more emphasis being placed on drawing up valid scales for family and social functioning. In addition, items were constructed using the language and lay-out preferred by the youngsters themselves. We conclude that focus groups are a useful way of exploring children's views of HRQL, showing that an emphasis should be placed on constructing valid social and family scales.
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Affiliation(s)
- S B Detmar
- Child Health Unit, Prevention and Physical Activity, TNO Quality of Life, 2215, 2301, CE, Leiden, Netherlands.
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Abstract
There have long been reservations about measuring quality of life of children and adolescents, but those have been largely overcome by the development of validated methods such as the KINDL(R) Life Quality Questionnaire. There is a consensus nowadays about the most important dimensions of children's quality of life. Reliable data can be obtained also in dimensions other than those known in adults (self-esteem, satisfaction of relations with those of similar age, school performance). Quality of life can now be examined in relation to age and developmental stage. As judgments made by parents and children differ, opinions given by others may provide additional information, but can replace self-assessment to only a small extent. In therapeutic decisions involving older children or adolescents their own pronouncements are used in preference. Examples are given to show that also in paediatrics investigations of quality of life can contribute to assessing needs, decision-making and quality control in medical care. Paying attention to aspects concerning quality of life represents a changed attitude within medicine. Subjective estimates of their health given by young persons may in future provide a yardstick for medical action.
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Bettge S, Ravens-Sieberer U, Wille N, Erhart M, Wiegandt S, Barkmann C, Schulte-Markwort M. Einflüsse auf die psychische und subjektive Gesundheit von Kindern und Jugendlichen. Psychother Psych Med 2006. [DOI: 10.1055/s-2006-934231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Erhart M, Ravens-Sieberer U, Nickel J. School and School Environment as a Determinant for Psychosomatic Complaints. Psychother Psychosom Med Psychol 2006. [DOI: 10.1055/s-2006-934245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ravens-Sieberer U, Bettge S, Erhart M, Nickel J, Wille N, Hölling H, Kurth BM, Barkmann C, Schulte-Markwort M. Seelische Gesundheit von Kindern und Jugendlichen–Ergebnisse der BELLA Studie für Deutschland. Psychother Psych Med 2006. [DOI: 10.1055/s-2006-934296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ellert U, Lampert T, Ravens-Sieberer U. Messung der gesundheitsbezogenen Lebensqualität mit dem SF-8. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2005; 48:1330-7. [PMID: 16270186 DOI: 10.1007/s00103-005-1168-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The SF-8, a relatively new instrument for measuring health-related quality of life, was used in the German National Telephone Health Survey 2003. The SF-8 provides results which are comparable to those of the SF-36, the instrument most commonly used internationally. The German National Telephone Health Survey provides nationally representative data for the residential population in Germany aged 18 and older. In addition to the measurement of health-related quality of life, comprehensive information on chronic illnesses and complaints, health care needs, utilisation of health care, risk factors, risk behaviour and social status is also collected, making differentiated analyses possible. According to the data collected, men rate their quality of life in all dimensions higher than women. With increasing age, quality of life for both men and women decreases in the physical dimensions, while increasing in the mental health dimensions. Apart from chronic disease and pain having a negative impact on health-related quality of life, social differences are also observable, in that worse health-related quality of life is reported by respondents with lower socioeconomic status.
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Affiliation(s)
- U Ellert
- Robert Koch-Institut, Berlin, Germany.
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Ravens-Sieberer U, von Rüden U, Erhart M, Gosch A, Nickel J. Messung des sozio-ökonomischen Status in epidemiologische Studien mit Kindern und Jugendlichen – Ergebnisse aus 12 europäischen Ländern. Gesundheitswesen 2005. [DOI: 10.1055/s-2005-920557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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