Construct Validity and Internal Consistency of the Italian Version of the PedsQLTM 4.0 Generic Core Scale and PedsQLTM 3.0 Cerebral Palsy Module

Ilaria Pedrinelli; Sofia Biagi; Domenico Marco Romeo; Elisa Musto; Valeria Fagiani; Martina Lanza; Erika Guastafierro; Alice Colombo; Andrea Giordano; Cristina Montomoli; Cristiana Rezzani; Tiziana Casalino; Eugenio Mercuri; Daria Riva; Matilde Leonardi; Giovanni Baranello; Emanuela Pagliano

doi:10.3390/children12060749

Construct Validity and Internal Consistency of the Italian Version of the PedsQL^TM 4.0 Generic Core Scale and PedsQL^TM 3.0 Cerebral Palsy Module

Children (Basel). 2025 Jun 9;12(6):749. doi: 10.3390/children12060749.

Authors

Ilaria Pedrinelli¹, Sofia Biagi¹, Domenico Marco Romeo², Elisa Musto², Valeria Fagiani³, Martina Lanza⁴, Erika Guastafierro⁴, Alice Colombo⁴, Andrea Giordano⁴, Cristina Montomoli⁵, Cristiana Rezzani⁵, Tiziana Casalino¹, Eugenio Mercuri², Daria Riva¹, Matilde Leonardi⁴, Giovanni Baranello⁶, Emanuela Pagliano¹

Affiliations

¹ Pediatric Neuroscience Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
² Paediatric Neurology Unit, Catholic University, 00168 Rome, Italy.
³ Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy.
⁴ Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
⁵ Department of Public Health Neuroscience, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy.
⁶ Paediatric Neurology/Neuromuscular Disorders, University College London, Great Ormond Street Institute of Child Health, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 1EH, UK.

Abstract

Background: Health-related quality of life (HRQoL) has emerged as a meaningful outcome measure in clinical trials and healthcare interventions in children with cerebral palsy (CwCP). We assessed the construct validity and internal consistency of the Italian version of the Paediatric QoL inventory (PedsQL^TM) 4.0 Generic Core Scales (GCS) and PedsQL^TM 3.0 Cerebral Palsy Module (CPM).

Methods: A total of 125 CwCP and their parents were enrolled. Participants completed both the GCS and the CPM modules, and the results were compared to those of a sample of 121 healthy peers and their parents. The dimensionality of the two modules was assessed through exploratory factor analysis. Construct validity was assessed by a known-groups method evaluating the differences between CwCP and healthy sample.

Results: Only a few GCS subscales were unidimensional, while all CPM subscales proved to be unidimensional, except for the Speech and Communication subscales of child self-reports. GCS internal consistency was good for all subscales of the parent proxy-reports, as well as for the Physical Activities and Psychosocial Health subscales of child self-reports. CPM internal consistency was good for both parent proxy-reports and-with a few exceptions-child self-reports. As for the PedsQL^TM validity, the GCS proved effective in discriminating between CwCP and healthy participants; the CPM showed a significant association between lower neurofunctional abilities and lower HRQoL. Parent-child concordance shows that child self-report scores were always higher than the those of the proxy-reports for both the GCS and CPM modules.

Conclusions: The present study confirms the internal consistency and construct validity of the Italian version of both PedsQL^TM modules. In CwCP, greater functional disability resulted in lower HRQoL scores, and there was significant discrepancy between the parent and child ratings.

Keywords: Cerebral Palsy; Italian population; PedsQL; children; health-related quality of life.