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Concurrent Validity of the Self-Report and Proxy-Report Versions of a Health-Related Quality of Life Measure: A Focus Group Study

초등학교 아동과 보호자에게 적용한 삶의 질 평가도구의 동시타당도 연구: 표적집단 파일럿연구

  • Choi, Bongsam (Dept. of Physical Therapy, College of Health and Welfare, Woosong University)
  • 최봉삼 (우송대학교 보건복지대학 물리치료학과)
  • Received : 2023.07.27
  • Accepted : 2023.09.20
  • Published : 2023.09.30

Abstract

Objective : The purpose of this study was to investigate the concurrent validity of the self- and proxy-report versions of the KIDSCREEN-10 quality of life questionnaire. Methods : A total of nine children and nine parents were selected to represent a cohort registered for a school-based wellness program. Two versions of the KIDSCREEN-10 questionnaire (self- and proxy reports) were administered to the children and their parents. The Rasch rating scale model was applied to determine the dimensionality and item difficulty of the two versions of the questionnaire. Moreover, the item-person matching map and Spearman's rho were compared to confirm the concurrent validity of the two versions. Results : All items, except four items (i.e., autonomy, home life, concentration/learning, and peers/social support), fit the Rasch rating scale model of the children's self-report version of the questionnaire. With regard to the parent's proxy-report version, two items misfit the model. While the items of the self- and proxy-report versions showed similar item difficulties, the parents had a tendency to be more severe in their ratings than the children. The correlation between the two versions was relatively low (Spearman's rho = .533, p > .05). The scatterplots between the two versions showed differences in the item difficulties of the physical and psychological well-being and self-perception items. Conclusion : These findings suggest that the three identified items should be taken into consideration when measuring children's health-related quality of life using the KIDSCREEN-10 questionnaire.

목적 : 이 연구의 목적은 학령기아동의 바른 자세유지를 위한 학교기반 웰니스 프로그램 적용 후, 아동의 자기보고식(self-report) 및 보호자의 대리보고식(proxy-report) 삶의 질 평가도구의 동시타당도를 검증하고자 하였다. 연구방법 : 학령기 아동 및 아동의 보호자 각 9명씩 총 18명을 표적집단으로 선정하여 연구대상으로 하였다. 초등학교 아동의 바른자세 유지하기 위한 웰니스 프로그램을 실시한 후 변화된 아동의 삶의 질에 대한 평가를 위해 한글판 KIDSCREEN-10 평가도구(아동용 및 보호자용)를 적용하였다. 라쉬 평정척도 모형을 적용하여, 문항의 적합도 및 난이도, 문항-대상자 도표 비교를 통하여 아동의 자기보고식 평가와 보호자 대리보고식 평가의 동시타당도를 검증하였다. 결과 : 아동의 자기보고식 평가에서는 자율성, 가정생활, 집중/배움, 또래집단/사회적 지지 4개문항, 보호자의 대리보고식 평가에서는 자아 인지적, 기분/정서적인 2개 문항이 적합도 기준을 벗어났다. 아동의 자기보고식 평가는 20점부터 50점 후반대에 분포하였고, 보호자의 대리보고식 평가는 30점 중반부터 50점 후반 영역에 주로 분포하여 비슷한 난이도 분포를 보였다. 아동과 보호자 평가의 상관관계분석결과, 스페어만 상관계수 p=.533(p>.05)으로 중간정도의 관련성을 보였으나 통계학적으로 유의하지 않았다. 아동은 자아인지적 문항을 비교적 쉬운 난이도로 인지하였으나(난이도 13.01), 보호자는 비교적 어려운 난이도 문항으로 인지하였다(난이도 46.21). 아동은 심리적, 신체적인 문항을 보호자보다 어렵게 인지하였고(난이도 각각 50.78, 50.78), 보호자는 아동보다 보다 쉽게 인지하는 반응을 보였다(난이도 각각 38.25, 34.88). 결론 : 향후 아동을 대상으로 하는 삶의 질 연구에서 신체적, 심리적, 자아인지 문항에서 아동과 보호자 평가의 차이점을 고려하여 아동의 삶의 질 평가가 이루어 져야 하겠다.

Keywords

Acknowledgement

이 연구는 2023년도 우송대학교 학술연구 지원자금으로 이루어졌음.

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