第24屆 海報式論文醫療類【中文版兒童日常生活參與度評量表於腦性麻痺兒童之信效度初步研究 Cross-cultural Adaptation and Preliminary Clinimetric Properties of the Child Engagement in Daily Life Measure V2 in Traditional

陳姵亘¹、劉文瑜^1,3、徐琳雅²、黃暄雅³、賴靜暄¹

Pei-Hsuan Chen¹, Wen-Yu Liu^1,3, Lin-Ya Hsu², Syuan-Ya Haung³, Ching-Hsuan Lai¹

¹長庚大學物理治療學系、
²美國華盛頓大學(西雅圖)復健醫學系、
³林口長庚紀念醫院復健科
¹Department of Physical Therapy, Chang Gung University, Taoyuan, Taiwan,
²Department of Physical Medicine and Rehabilitation (Linkou Branch), Chang Gung Memorial Hospital, Taoyuan, Taiwan,
³Department of Rehabilitation Medicine, University of Washington Seattle, USA

Background and Purpose: The Child Engagement in Daily Life Measure -Version 2 (CEDL-V2) is a parent-proxy questionnaire comprising 29 items, designed by Chiarello et al., to assess children with cerebral palsy (CP) aged 1.5 to 12 years. The questionnaire encompasses two main domains: (1) Participation in Family and Recreational Activities (Family Rec) with 11 items, and (2) Performance of Self-care Activities (Self-care) with 18 items. The CEDL-V2 was concise and readily accessible, and there are documented indications of its reliability and validity. Chiarello et al. conducted a test-retest analysis involving 55 parents of children with CP in the Family Rec domain and 31 parents of children with CP in the Self-care domain. The test-retest reliability for the Family Rec domain demonstrated a range from fair to excellent, with an ICC value of 0.78 for the frequency dimension and 0.68 for the enjoyment dimension, respectively. In the Self-care domain, test-retest reliability was excellent, indicated by an ICC value of 0.97. The Child Health Conditions Questionnaire (CHCQ), developed by Barlett et al., comprises 16 items focused on assessing the quantity and influence of health conditions experienced by children with CP in their daily lives. According to the report by Barlett et al., the test-retest reliability was established for both the number (ICC = 0.80) and the average impact of health conditions (ICC = 0.85). In North America, the CHCQ and CEDL-V2 were primarily chosen for clinical assessments, aiding parents and therapists in quickly comprehending the conditions prevalent among children with CP. However, the two measures haven’t been adapted into Traditional Chinese language. The aim of the study was to cross-culturally adapt both the CEDL-V2 and the CHCQ into Traditional Chinese, followed by an investigation into the reliability and validity of the resulting Traditional Chinese version of these assessment tools.

Methods: The process of cross-cultural adaptation for the CEDL-V2 and CHCQ involved a modified procedure as outlined by Beaton et al. (2000). This adaptation was carried out with the input and expertise of three specialists. Children with CP aged 6 to 12 years old and their caregivers in Taiwan were invited to participate in this study. Up until August 2023, caregivers of 16 children with varying levels of gross motor function as classified by the GMFCS (I=5; II=3; III=5; IV=1; V=2) successfully completed the measurements. The children involved in the study had an average age of 8.88 years (with a SD of 1.65 years). Among them, 50% were boy. The caregivers, predominantly mothers (68.75%), had an average age of 42.56 years (with a SD of 8.05 years). Construct validity was assessed using Pearson correlation coefficients to examine the relationships among the CEDL-V2 and CHCQ scores and different characteristics of the participants. To evaluate reliability, internal consistency was calculated using Cronbach's alpha coefficient.

Results: For the Traditional Chinese versions, the average content validity scores for relevance, clarity, and simplicity were 0.99, 0.97, and 0.98 for the CEDL-V2, and 1, 0.97, and 1 for the CHCQ, respectively. The Traditional Chinese version of the CEDL-V2 and CHCQ demonstrated excellent internal consistency, with Cronbach's alpha coefficients of 0.98 and 0.94, respectively. The correlation between the Traditional Chinese version of the frequency dimension in the Family Rec domain, and the Selfcare domain of CEDL-V2 and CHCQ was strong (r = -0.57, p

Conclusions: The current study is ongoing. The preliminary clinimetric properties of the Traditional Chinese CEDL-V2 and CHCQ include feasibility, supported by evidence of content validity. Upon completion of the Traditional Chinese adaptations of the CHCQ and CEDL-V2, parents and service providers will have concrete tools to accurately monitor the developmental progress of children with CP, grounded in empirical evidence. This achievement will greatly simplify results interpretation within clinical environments.

Keywords: cerebral palsy, Child Engagement; Cross-cultural Adaptation