Abstracts

Rationale: Given the importance of measuring health-related quality of life (HRQL) in children with epilepsy, having a psychometrically sound measure that is feasible to apply across a variety of research settings is essential. The primary aim of this study was to develop a shorter version of the widely used Quality of Life in Childhood Epilepsy Questionnaire (QOLCE) to reduce the time required by respondents to complete. A secondary aim was to assess the stability of results obtained when using a shortened version of the QOLCE to identify risk factors for HRQL 24 months post-diagnosis compared to the original QOLCE.Methods: Data for this study came from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES, N=374), a multi-centre prospective cohort study examining trajectories and epilepsy-related and family determinants of HRQL in children ages four to twelve with newly-diagnosed epilepsy during the first two years after diagnosis. Principle component analysis was used to reduce the number of items in the QOLCE, while exploratory factor analysis with a promax rotation was conducted to assess factor structure and better align the domains of the QOLCE. Confirmatory factor analysis was used to determine goodness of fit for the shortened QOLCE. Multiple regression was used to identify epilepsy-related and family risk factors at diagnosis for HRQL at 24 months. Results: A four-factor, 55-item solution was obtained (18 items removed for low factor loadings and 3 for ambiguous loadings) with the final model representing functioning in four domains of HRQL: Cognitive, Emotional, Social, and Physical. The shortened QOLCE demonstrated excellent goodness of fit: 2=4.26 (df=2, p=0.119), RMSEA=0.056 (90% CI: 0.001-0.131), CFI=0.994, GFI=0.994, SRMSR=0.019, and had excellent internal consistency ( =0.96, subscales >0.80). Risk factors for HRQL remained the same and their magnitudes similar when using the shortened QOLCE compared to the original QOLCE. Controlling for HRQL at diagnosis, predictors for better HRQL 24 months later were as follows: fewer cognitive problems, better family functioning, and fewer family demands.Conclusions: These results suggest that this newly proposed 55-item version of the QOLCE (QOLCE-55) is a reliable measure and that the profile of risk factors identified using the original QOLCE is retained using the shorter version. Given the fewer number of items, QOLCE-55 may be a viable option to reduce respondent burden when assessing HRQL in children with epilepsy.