title: An acute cough-specific quality-of-life questionnaire for children: Development and validation.
abstract: BACKGROUND
  Patient-relevant outcome measures are essential for high-quality clinical research, and quality-of-life (QoL) tools are the current standard. Currently, there is no validated children's acute cough-specific QoL questionnaire.
  
  
  OBJECTIVE
  The objective of this study was to develop and validate the Parent-proxy Children's Acute Cough-specific QoL Questionnaire (PAC-QoL).
  
  
  METHODS
  Using focus groups, a 48-item PAC-QoL questionnaire was developed and later reduced to 16 items by using the clinical impact method. Parents of children with a current acute cough (<2 weeks) at enrollment completed 2 validated cough score measures, the preliminary 48-item PAC-QoL, and 3 other questionnaires (the State Trait Anxiety Inventory [STAI], the Short-Form 8-item 24-hour recall Health Survey [SF-8], and the Depression, Anxiety, and Stress 21-item Scale [DASS21]). All measures were repeated on days 3 and 14.
  
  
  RESULTS
  The median age of the 155 children enrolled was 2.3 years (interquartile range, 1.3-4.6). Median cough duration at enrollment was 3 days (interquartile range, 2-5). The reduced 16-item scale had high internal consistency (Cronbach α = 0.95). Evidence for repeatability and criterion validity was shown by significant correlations between the domains and total PAC-QoL scores and the SF-8 (r = -0.36 and -0.51), STAI (r = -0.27 and -0.39), and DASS21 (r = -0.32 and -0.41) scales on days 0 and 3, respectively. The final PAC-QoL questionnaire was sensitive to change over time, with changes significantly relating to changes in cough score measures (P < .001).
  
  
  CONCLUSIONS
  The 16-item PAC-QoL is a reliable and valid outcome measure that assesses QoL related to childhood acute cough at a given time point and reflects changes in acute cough-specific QoL over time.
authors.affiliation: Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia. Electronic address: s.andersonjames@uq.edu.au.
authors.forename: Sophie
authors.initials: S
authors.lastname: Anderson-James
authors.affiliation: Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia; School of Psychology, University of Queensland, Brisbane, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newcombe
authors.affiliation: Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Marchant
authors.affiliation: Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane, Australia.
authors.forename: Kerry-Ann F
authors.initials: KA
authors.lastname: O'Grady
authors.affiliation: Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia; Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Australia; Department of Emergency Medicine, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Acworth
authors.affiliation: Department of Emergency Medicine, Mater Children's Hospital, Brisbane, Australia.
authors.forename: D Grant
authors.initials: DG
authors.lastname: Stone
authors.affiliation: School of Nursing and Midwifery, University of Queensland, Brisbane, Australia.
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Turner
authors.affiliation: Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Children; acute cough; quality of life