title: The quality of paediatric nursing care: developing the Child Care Quality at Hospital instrument for children.
abstract: OBJECTIVE
  This paper is a report of the development and psychometric evaluation of the Child Care Quality at Hospital (CCQH) instrument.
  
  
  BACKGROUND
  Recent years have shown a growing recognition of children's rights and the need to listen to and consult with children, especially at an international level, including in the hospital setting. Children's views should be considered in the planning and delivery of paediatric nursing care. However, previous work has tended to concentrate on medical rather than nursing care.
  
  
  METHODS
  The CCQH instrument was developed in three phases. First, in 2004 following a literature review and interviews/drawings by hospitalized children (n = 40), the items were designed and an expert panel (n = 7) assessed the instrument's content validity (phase I). Revisions were made based on children's interviews (n = 8), children's questionnaires (n = 41, 16) and nurses' evaluations (n = 19, 198) in phases II and III in 2004 and 2005 respectively. Construct validity was assessed in phase III by means of principal component analysis. The instrument's reliability was statistically tested in phases II and III.
  
  
  RESULTS
  The main quality categories were nurse characteristics, nursing activities and environment. For each category, Cronbach's alpha values improved during the development process. Principal component analysis supported the theoretical construct of the subcategories in the nursing activities and environment categories.
  
  
  CONCLUSIONS
  The CCQH questionnaire is a promising instrument for use among children. Future research is needed to evaluate its suitability for completion by children of varying ages and in different cultures and healthcare settings.
authors.affiliation: Department of Nursing Science, University of Turku, Finland. tiina.pelander@utu.fi
authors.forename: Tiina
authors.initials: T
authors.lastname: Pelander
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.forename: Jouko
authors.initials: J
authors.lastname: Katajisto
mesh_terms: D002648:Child; D002673:Child, Hospitalized; D006801:Humans; D010371:Pediatric Nursing / Q000592:standards*; D011594:Psychometrics / Q000379:methods; D011787:Quality of Health Care / Q000592:standards*; D015203:Reproducibility of Results