The PedsQL™ as a measure of parent-rated quality of life in healthy UK toddlers: Psychometric properties and cross-cultural comparisons

The Pediatric Quality of Life Inventory (PedsQL (TM)) is a widely-used generic measure of health-related quality of life (HRQOL) in children aged << 2 years. In the UK, mean scores are known for healthy children aged >= 5 years, but unknown for toddlers. This paper reports the psychometric properties of parent-rated PedsQL (TM) scores in healthy UK toddlers and compares scores with a healthy USA sample. Two-hundred and fifty-six parents of healthy 2-4-year-olds (recruited from UK Children's Centres/nurseries, University staff/volunteers, and a national parent forum) completed the toddler version of the PedsQL (TM). Internal consistency was good (>= 0.70) for all except Nursery Functioning. There were ceiling effects but missing response rates were minimal. Mean scores were: Total score 87.8; Physical Health 92.6; Emotional Functioning 76.0; Social Functioning 89.9; Nursery Functioning 92.3; and Psychosocial Summary 84.6. UK parents rated higher on Physical and Nursery Functioning (p < 0.001), but worse than their US counterparts on Emotional Functioning (p < 0.001) and Psychosocial Summary (p 0.004). In conclusion, the toddler version of the PedsQL (TM) performed well in a UK sample, apart from the Nursery Functioning scale. Further evidence is needed to ascertain its construct and discriminant validity in the UK. Differences between the UK and USA samples highlight the importance of cross-cultural variations.