The psychometrics of the children's depression inventory when used with children who are chronically ill and matched community comparisons

The Children’s Depression Inventory (CDI) can be used to screen for childhood depression in children ages seven to sixteen. While the scale has exhibited reliability and validity with typically developing children, the psychometrics have not been examined in a large cohort of children who are chronically ill. The purpose of this study is to measure the psychometrics (reliability and validity) of the CDI when used with children who are chronically ill (N=350) and matched community comparison peers (N=357). This study endeavors to determine if the psychometrics of the CDI are similar in children who are chronically ill compared to children without a chronic illness. Data were aggregated from previous reports examining social and emotional functioning of children with six chronic diseases (cancer, sickle cell, hemophilia, juvenile rheumatoid arthritis, chronic migraine, and neurofibromatosis) and matched comparisons. CDI scores were collected in the homes of chronically ill children and in the homes of matched community comparison peers. Results showed no significant differences between groups on CDI scores, shapes of distributions, reliability, or validity. Findings suggest that the psychometrics of the CDI are similar for children with chronic diseases and typically developing children. The public health significance of this work suggests the CDI may be an effective screening tool for use in tertiary care pediatric settings, which could increase screening rates and improve mental health in children who are chronically ill

Content validity of the PROMIS® pediatric family relationships measure for children with chronic illness

Abstract Background Families play a critical role in supporting the health and well-being of children with chronic illnesses, who face a lifetime of responsibility for self-management of their condition. Our goal was to investigate whether the novel Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric Family Relationships measure, developed primarily within the general pediatric population, reflects the experiences of family relationships for chronically ill children and their parents. Methods We conducted semi-structured qualitative interviews with children (aged 8–17) with common chronic conditions: asthma (n = 6), type 1 diabetes (n = 5), or sickle cell disease (n = 5), and separately with one of their parents (n = 16). Interviews were recorded, and two team members independently coded the written transcripts facilitated by Nvivo 10. The systematic content analysis used a combination of: 1) pre-specified themes corresponding to the six facets of the domain identified during measure development and reflected in the content of the items (i.e., Sense of Family; Love and Caring; Value and Acceptance; Trust, Dependability, and Support; Communication; Enjoyment), as well as 2) open-coding, allowing participants to define important concepts (i.e., disease impact). Results Family relationships were conceptualized in a similar way to the general population, as evidenced by child and parent responses to open-ended questions about family relationships and to specific probes that corresponded with the item content in the Family Relationship 8-item short form. Children spontaneously discussed the impact of their disease on family relationships less often than parents did. Although participants described how living with a chronic illness positively and negatively impacted aspects of family relationships, nearly all participants believed their responses to the PROMIS® Family Relationships items would not change if they (or their child) did not have a chronic illness. Conclusions Among a sample of families of children with one of 3 chronic illnesses, participants described family relationships in a way that was consistent with the facets of the PROMIS® Family Relationship domain. This study adds to the content validity of the measure for children with chronic illness