Short health scale: a valid, reliable, and responsive measure of health-related quality of life in children with inflammatory bowel disease.
BACKGROUND
Inflammatory bowel disease (IBD) presents a growing medical and epidemiological problem. In respect to patients, health-related quality of life (HRQOL) emerged as informative means to evaluate the impact of disease burden on health. The Short Health Scale (SHS), a disease-specific HRQOL instrument with only 4 questions (symptoms, functioning, worry, and general well-being), was demonstrated as valid, reliable, and responsive in adults. Aim of this study was to assess its psychometric properties in children with IBD.


METHODS
In a multicentric prospective study, HRQOL was assessed in 104 children with IBD by generic (PedsQL) and disease-specific questionnaires (IMPACT-III (HR) and SHS), which were cross-culturally adapted for Croatian. Forty-one patients completed the questionnaires at the second visit 6 to 12 months later. Of them, 27 patients changed from remission to active disease or vice versa and were included in responsiveness to change analysis.


RESULTS
Patients in remission had significantly better scores for symptoms (P = 0.022) and functioning (P = 0.003) than those with active disease. Each of the 4 SHS questions was strongly correlated with the corresponding dimensions of PedsQL and IMPACT-III (HR) questionnaires (rs = 0.50-0.72, P < 0.001). Reliability was confirmed with Cronbach's α = 0.74. Patients who changed from remission to active disease or vice versa showed significant change in following SHS scores: symptoms (P = 0.032), functioning (P = 0.008), and worry (P = 0.021).


CONCLUSIONS
SHS appears to be valid, reliable, and responsive tool to measure HRQOL in children with IBD. Simplicity of use, compactness, and the possibility of immediate interpretation make SHS well suited for both clinical practice and research studies.
*Referral Center for Pediatric Gastroenterology and Nutrition, University Children's Hospital Zagreb, Zagreb Medical School, Zagreb, Croatia; †Department of Environmental and Occupational Health, "Andrija Stampar" School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia; ‡Department for Pediatric Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia; and §Department for Pediatric Gastroenterology, Hepatology and Nutrition, University Hospital Center Zagreb, Zagreb, Croatia.
Slaven
S
Abdovic
Ana Mocic
AM
Pavic
Milan
M
Milosevic
Mladen
M
Persic
Irena
I
Senecic-Cala
Sanja
S
Kolacek
D000293:Adolescent; D002648:Child; D017523:Croatia; D005260:Female; D006304:Health Status; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires