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Cross-cultural development of a child health care questionnaire on satisfaction, utilization, and needs

Journal article
Authors S. Schmidt
U. Thyen
John Chaplin
E. Mueller-Godeffroy
Published in Ambul Pediatr
Volume 7
Issue 5
Pages 374-82
ISSN 1530-1567 (Print)
Publication year 2007
Published at Institute of Clinical Sciences
Pages 374-82
Language en
Keywords Child, *Child Health Services, Cross-Cultural Comparison, *Health Care Surveys, Health Services Accessibility, Humans, Needs Assessment, Patient Satisfaction, *Questionnaires
Subject categories Medical and Health Sciences


OBJECTIVE: The instrument Child Health Care-Satisfaction, Utilization and Needs (CHC-SUN) has been developed cross-culturally to evaluate pediatric health care services for children with special health care needs (CSHCN) from the proxy perspective of parents. METHODS: The children of the participating parents received treatment in pediatric specialty clinics in 7 European countries for asthma, cystic fibrosis, diabetes, epilepsy, cerebral palsy, rheumatoid arthritis, and atopic dermatitis. The instrument was developed through a process including literature review, expert consensus, and item generation through focus groups. The pilot instrument was extensively tested to assess psychometric properties, support item reduction, and evaluate clinical validity. The final field version was tested in a new sample of 795 parents in 7 countries. RESULTS: Pilot testing and item reduction resulted in a practical 40-item instrument with 14 single items related to provision of services (module 1), and 26 items related to 6 scales on satisfaction with care (module 2), and 1 item on general satisfaction with care. Satisfaction with care scales showed very good psychometric properties, both initially and in the field version, with Cronbach's alpha ranging between .80 and .95 in the revised scales. Both modules discriminated well between functional status and diagnosis across countries. CONCLUSIONS: A new instrument is available to measure provision of services and satisfaction with care for children with chronic conditions from the perspective of parents. Cross-cultural analysis reveals that the measure is useful in multinational studies evaluating health services against the background of different health systems.

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