Validity and reliability of the DISABKIDS asthma module in children and adolescents, the effect of video education on quality of life in ASTHMA management

Aim and hypothesis: The aims of the study are to adapt the "DISABKIDS asthma module", which measures the quality of life in children with asthma, into Turkish, to plan an intervention study to prevent the factors affecting the quality of life and to evaluate the effect of video education on children's quality of life. Methods: The first stage of the study is methodological and the second stage is a quasi-experimental intervention study. It was conducted by interviewing children aged 8-16 years old, diagnosed with asthma in the last year, without any additional chronic disease and their parents (n = 110), who applied to Aydın Adnan Menderes University Application and Research Hospital Pediatric Allergy and Immunology Outpatient Clinic between August 2019-January 2021. The DISABKIDS Asthma module consists of two sub-dimensions: impact (six questions) and anxiety (five questions). It is designed as two separate forms for children and parents. The child form was used in the analyzes. Structural validity (EFA and cFA), simultaneous validity, union and decomposition validity in validity analysis; In reliability analysis, internal consistency (Cronbach's alpha value), equivalent forms analysis (PAQLQ) and split-half analysis were performed. In addition to these analyzes, Rasch analysis was applied. During the intervention phase, the participants (n = 52) were evaluated by pre-test and post-test. SPSS 21, AMOS 21, Winsteps package programs were used in the analyzes. The work started with all necessary permissions. Type-1 error was accepted 0.05%. Results: 56.4% of the children are male (n = 62), the median age is 10 (25-75p, 9-13). 78.2% of the parents are female (n = 86), the median age is 38 (25-75p, 34.0-42.7), 50.9% is equal to their income and expense, 70.8% have two children. In two dimensions of the scale, floor and ceiling effects are <10%. KMO for AFA is 0.76, Barlett sphericity test is p <0.001; A two-factor structure with eigenvalue> 1 and cumulative variance of 62.8% was determined. Unlike the original scale of the scale, two items were transferred to the worry dimension (Impact 4, Worry 7 questions). CFA fit indicators are not within acceptable limits (Χ2 / df = 4.33, RMSEA = 0.17; GFI = 0.81; CFI = 0.79; SRMR = 0.09). Two items were removed from the effect dimension in line with the model correction suggestions (Impact dimension three, worry dimension six questions). The first of the extracted items is in effect size and cross-loaded to a question of concern; Although the second one is of anxiety, it places a burden on the effect dimension. As a result of the corrections, the compliance indicators (Χ2 = 2.05, RMSEA = 0.09; GFI = 0.90; CFI = 0.93; SRMR = 0.06) are within acceptable limits. Factors determined by CFA meet the combination and separation validity criteria (CR> 0.70, AVE> 0.5 and AVE> MSV, AVE> ASV). The Cronbach alpha value after CFA is 0.84 in the impact dimension, 0.85 in the worry dimension, and 0.86 in total. There is a strong, positive and significant correlation between the DISABKIDS asthma module and the PAQLQ scores simultaneously applied (r = 0.545, p <0.001). Spearman-Brown value was 0.82, Guttman Split-half value was 0.80. Child form INFIT / OUTFIT values are within ideal limits in terms of impact and anxiety, on the basis of individual items and on average (0.5-1.5). After the training video, there was an increase in points in all dimensions of the scale and in the symptom form. Conclusion: The psychometric properties of the DISABKIDS asthma module Turkish version are good and acceptable. The shortness of the scale is an advantage; it is more applicable in outpatient clinic conditions than existing asthma scales. The scale is promising to evaluate and monitor asthma from the child's own and the parent's perspective separately and to improve the quality of life. Video education increased children's quality of life scores by reducing their anxiety. Keywords: Asthma, DISABKIDS, Reliability and Validity, Quality of Life, Education, Health