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Measuring health-related quality of life in children with chronic medical conditions: reliability and validity of the Arabic version of PedsQL 4.0 Generic Core Scales

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Measuring health-related quality of life in large pediatric populations has several distinct benefits. It can aid in identifying the subgroups of children who are at risk of health problems, in determining the burden of a particular disease or disability, and in informing efforts aimed at prevention and intervention. The objectives of this study were to validate the Arabic version of the PedsQL 4.0 Generic Core Scales in Egyptian children with chronic conditions and to assess the impact of chronic illness on their quality of life.

Patients and methods

The analyses were based on 718 pediatric patients who were recruited from the outpatient clinics of Assiut University Children Hospital utilizing the Arabic version of PedsQL 4.0 Generic Core Scales. They were divided into eight groups: 71 children with acute lymphoblastic leukemia, 125 children with bronchial asthma, 40 children with type I diabetes mellitus, 149 children with epilepsy, 63 children with rheumatic heart disease, 110 children with chronic kidney disease, 104 children with β-thalassemia, and 56 children with tuberculosis. An additional convenience sample of 121 healthy children and adolescents was gathered to assess comprehensibility and to test discriminant validity.


Arabic version of the PedsQL 4.0 was feasible, easy to administer, completed without, or with minimal, help by most children and parents, and required a brief administration time. Cronbach’s α internal consistency values for the total and subscale scores exceeded 0.70. Test–retest reliability was high (reliability coefficient exceeded 0.9). Physical, emotional, social, school, psychosocial, and total scores of healthy children were on average significantly higher than scores of children with chronic conditions. PedsQL 4.0 total scores also varied significantly across health conditions as measured by analysis of variance test. Patients with epilepsy and diabetes mellitus reported the highest scores, while patients with thalassemia and rheumatic heart disease reported the lowest scores.


The Arabic version of the PedsQL 4.0 Generic Core Scales proved to be understandable and feasible to use. It showed good reliability for healthy and children with chronic medical conditions and their parents. It also shows good construct and discriminant validity properties in this setting, making this instrument suitable for research and clinical use in the Egyptian setting. The results also demonstrate the effects of pediatric chronic conditions on patient health-related quality of life across disease clusters.
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Keywords: Egypt; PedsQL 4.0; children; chronic conditions; health related quality of life; validity

Document Type: Research Article

Affiliations: Department of Neurology and Psychiatry, Assiut University Hospitals, Asyut, Egypt

Publication date: January 1, 2018

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