Psychometric validation of the French version of the PedsQL™4.0 generic health-related quality of life questionnaire for 2-4-year-old children

The Pediatric Quality of Life Inventory version 4.0 (PedsQL (TM) 4.0) is an internationally recognized, generic, health-related quality of life (HRQoL) questionnaire, but its proxy 2-4-year-old version has not been validated in France. This study proposes a psychometric validation of this tool for French children aged 2 to 4 years and 11 months. A total of 220 parents of typically developing children participated. Acceptability was explored. Internal consistency was tested using Cronbach's alpha. Factor structure was tested using an exploratory structural equation modeling (ESEM). Risk of bias was assessed regarding gender and age effect on HRQoL using Student's t test. Except for school functioning, compliance was good (< 2.9%). No floor effects were observed, but ceiling effects were found for all scores. The total score had good internal consistency (Cronbach's alpha = .82). The Cronbach's alpha of each subscale was between .53 and .71. Factor analysis rejected the original 4-factor structure and revealed an alternative 2-factor structure. The total score and emotional scale score did not appear to be sensitive to gender or child age. Conclusions: The PedsQL (TM) 4.0 generic HRQoL questionnaire presents good psychometric properties, regarding acceptability and reliability. For use among French children aged 2 to 4 years and 11 months, we recommend retaining the total score and the emotional scale score.