Skip to content
EvidenceHelixEvidenceLib · Scientific Encyclopedia
⌘ K

Scientific library

EvidenceLib encyclopediaAll articles A–Z2,835
Books209
All textbooksMedical textbooksHuman anatomyOrganisms & biodiversityOther sciences
Open-access articles1,406Cancer study catalog458How it is made

My workspace this browser

Saved pages0Notes & annotations0

Recently viewed

Explore by field

Cancer and Oncology182Genetics and Genomics170Neuroscience185Cardiovascular Medicine180Immunology142Pharmacology173Molecular Biology161Infectious Diseases150Rare and Inherited Diseases181Clinical Research173Anatomy and Physiology613Drugs and Chemicals621Psychiatry and Psychology185Public Health and Nutrition178Diagnostics and Medical Technology125Respiratory Medicine113Digestive System and Liver91Metabolism and Endocrine Disease177Bones, Joints, Muscles and Skin213Kidney, Urology and Women's Health173Eye, Ear, Nose and Throat55
Plans & pricingCompare EvidenceHelix workspace plans
Library›Open-access articles›Article

Continue where you left off ()

GO BEYOND THE PAGEReading is just the beginning.

Turn scientific reading into research. Compare studies, examine evidence, and organize your findings in EvidenceHelix Workspace.

Explore Research Workspace →

EvidenceLib · Open-access article · Respiratory Medicine

Identifying candidate items for a health-related quality of life measure in young children with respiratory illness: A scoping review of generic and disease-specific measures

Michaile Gizelle Anthony, Graeme Hoddinott, Dzunisani Patience Baloyi, Anneke Catharina Hesseling, Marieke Margreet van der Zalm

PLOS One 2025 · doi:10.1371/journal.pone.0322493

CC BY 4.0Full textApproximately 21 min read83 references

Table of Contents

AbstractKey pointsIn this articleIntroductionMethodsFindingsDiscussionSupporting informationReferences

Abstract

Background

Health-related quality of life (HRQoL) in young children affected by respiratory illnesses remains understudied, particularly in low- and middle-income countries (LMICs), where the burden of these diseases is disproportionately high. Existing HRQoL measures, including both generic and respiratory disease-specific measures, have been reviewed to identify key components that can guide the development of a novel HRQoL tool for young children (0–5-years) with respiratory illnesses. The study aimed to identify candidate items from existing HRQoL measures to inform the development of a new HRQoL tool for young children (0–5 years-old) with respiratory illnesses in a LMIC setting.

Methods

A scoping review was conducted using PubMed, EBSCOhost, and PsycArticles databases Keywords included variations of the following terms ‘quality of life’, ‘health-related quality of life’, ‘wellbeing’, ‘questionnaire’, ‘instrument’, ‘measure’, ‘children’, ‘toddler’, ‘paediatric’, ‘child*’, ‘develop’ or ‘validation’. The search was limited to English-language articles published between January 2000 and November 2023. Deductive thematic analysis was used to organise the measures and synthesise cross-cutting components.

Results

Out of 1823 articles, data were extracted from 72 articles reporting on 41 measures. Of these, 20 were generic, and 21 were specific to respiratory diseases. The measures’ key dimensions included physical and emotional health, social support, and school functioning. However, few measures, targeted children 0–5-years, and none incorporated child-specific methods for assessing HRQoL. Existing tools varied widely in their domains and definitions, often lacking consistency and not adequately considering the developmental milestones. Furthermore, most tools were developed in high-income settings (HIC), with limited adaption to the socio-economic burden and disease burden contexts in LMICs.

Conclusion

There is an urgent need for a comprehensive HRQoL measure tailored to young children with respiratory illnesses, particularly one designed for use in LMICs. Such a tool should address developmental milestones, cultural sensitivity, and the unique socio-economic challenges faced in these settings.

Key points

  • Out of 1823 articles, data were extracted from 72 articles reporting on 41 measures.
  • Of these, 20 were generic, and 21 were specific to respiratory diseases.
  • The measures’ key dimensions included physical and emotional health, social support, and school functioning.
  • There is an urgent need for a comprehensive HRQoL measure tailored to young children with respiratory illnesses, particularly one designed for use in LMICs.
  • Such a tool should address developmental milestones, cultural sensitivity, and the unique socio-economic challenges faced in these settings.

Sentences taken unchanged from the authors’ abstract, as a reading aid. Not a new analysis and not medical advice.

In this article

  1. Introduction: 9 million children <5-years hospitalised in 2019 [1–5]. Viral infections account for approximately 90% of all paediatric LRTIs [5], but bacterial infections, inflammatory conditions, and structural abnormalities also contribute to significant morbidity.
  2. Methods: A scoping review was conducted, including both published peer-reviewed and grey literature. The review followed the five stages outlined in Arksey and O’Malley’s framework, supplemented by the Joanna Briggs Institute 2015 recommendations [21,22].
  3. Discussion: This review screened 1,823 peer-reviewed articles, ultimately including 72 studies reporting on 41 distinct HRQoL measures, of which 20 were generic and 21 were disease-specific. Notably, only five measures—four generic and one disease-specific (for cystic fibrosis)—were designed for children aged 0–5-years.

Opening sentences of each section, unchanged.

Introduction

Lower respiratory tract infections (LRTIs) are the leading cause of paediatric hospitalisations worldwide, with an estimated 11.9 million children <5-years hospitalised in 2019 [1–5]. Viral infections account for approximately 90% of all paediatric LRTIs [5], but bacterial infections, inflammatory conditions, and structural abnormalities also contribute to significant morbidity. The burden of these illnesses is particularly high in low- and middle-income countries (LMICs), where access to healthcare, early diagnosis, and appropriate management can be challenging [5].

Respiratory illnesses can have long-term impacts on young children, extending beyond the acute phase. Early-life LRTIs are associated with later conditions such as asthma and potentially chronic obstructive pulmonary disorder (COPD). Children who experience recurrent or severe respiratory illnesses may face ongoing respiratory symptoms, developmental delays, and psychosocial challenges, affecting their overall well-being [6–8]. Existing data on the impact of respiratory illnesses and perceived HRQoL are particularly scarce in LMICs, where the burden of these diseases is highest [9–11]. In this study, respiratory illness refers to any condition affecting the airways, lungs, or related structures, causing symptoms like coughing, wheezing, shortness of breath, or respiratory distress. This includes infections, inflammatory conditions, and structural abnormalities.

Despite the profound health and social implications of respiratory illnesses, current tools do not capture their impact on young children’s health-related quality of life (HRQoL) [9–11]. HRQoL is a multidimensional concept that encompasses physical health, emotional well-being, and social interactions, all of which are critical for early childhood development [12].

There is a notable gap in HRQoL measurement for young children with respiratory illnesses, particularly in LMICs, where the burden is highest [9,10]. While some disease-specific HRQoL measures exist—such as those for asthma and cystic fibrosis [13]. HRQoL measures provide valuable tools for clinicians to evaluate treatments, tailor interventions, and improve care. They also inform health policy and resource allocation [12,14]. These tools can be generic, applicable across populations, or disease-specific, focusing on particular symptoms or conditions [15,16]. For children with respiratory illnesses, challenges such as decreased energy, sleep disturbances, and social stigma are often reported [11]. Existing data on the impact of respiratory illnesses and perceived HRQoL are particularly scarce in LMICs, where the burden of these diseases is highest, yet no existing HRQoL measure comprehensively addresses these issues for this age group [9,11].

Although disease-specific HRQoL measures exist, such as CFQ-R for cystic fibrosis, PedsQL Asthma, TACQoL Asthma etc. [17–20], they are often overly specific and not suitable for general use across respiratory illnesses [10]. Moreover, these tools have limitations when applied to high-burden, resource-constrained LMICs, where considerations of developmental milestones, cultural sensitivity, and socio-economic factors are critical [9,10].

This review provides an updated overview of HRQoL measures, with a particular emphasis on tools relevant to young children in LMICs. It builds on earlier reviews such as those by Quittner et al., (2008) and Kwon et al., 2023, by identifying critical gaps in HRQoL measurement for specific respiratory illnesses, including pulmonary TB (PTB), which is prevalent in LMICs. These critical gaps include the focus on young children (0–5-years-old), identifying gaps in existing HRQoL measures, addressing the LMIC as well as highlighting the need for a comprehensive approach to the development of HRQoL measure for young children 0–5-years-old in LMICs.

This study aimed to identify candidate items from existing HRQoL measures to inform the development of a new HRQoL tool for young children (0–5 years-old) with respiratory illnesses in a LMIC setting, addressing a significant gap in the current literature.

Methods

A scoping review was conducted, including both published peer-reviewed and grey literature. The review followed the five stages outlined in Arksey and O’Malley’s framework, supplemented by the Joanna Briggs Institute 2015 recommendations [21,22]. Reporting adhered to the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) [23].

Stage 1: Identifying the research question and defining the study scope

The primary aim was to identify all HRQoL measures, including both generic and disease-specific tools, developed for use in children, with a specific focus on measures designed for respiratory illnesses. The review included literature published between January 2000 and November 2023, restricted to English-language manuscripts. The most recent search conducted was on the 30th of November, 2023.

The inclusion criteria encompassed studies reporting on the development, validation, or adaption of HRQoL measures for children. Excluded were conceptual research, studies that applied HRQoL measures without reporting on their development or properties, review articles, and articles focused exclusively on adolescents ≥18-years or adults. The full inclusion and exclusion criteria are outlined in Table 1.

Table 1 Inclusion and exclusion criteria.
Included
• Research articles that described, developed, and/or evaluated HRQoL measurements for children aged 0–18-years-old.• Research articles that described generic, respiratory-disease-specific measures, self-reports, and parent proxy measures.• Research articles that highlighted the domains and items of the HRQoL measure.• Research articles specifically focused on the development and/or validation of respiratory-disease-specific measures.
Excluded
• Research articles that were written in a language other than English.• Research articles published before 2000.• Research articles that reported HRQoL using a tool but did not report any psychometric or tool development data on the tool itself were excluded.• Disease-specific tools unrelated to respiratory illnesses.• Review articles were excluded.• Research articles focusing on cases requiring mechanical intervention or presenting with severe respiratory compromise, which includes children with tracheostomies and those using non-invasive ventilation due to muscle weakness from neuromuscular diseases were excluded.

Stage 2: Identify relevant studies

An initial search of PubMed was conducted to identify relevant articles. This involved analysing the title and abstract text as well as the MeSH terms used to index the articles. Used to describe the articles. Based on these findings, the search terms were refined to focus on quality of life (QoL) and children. The inclusion and exclusion criteria was refined to focus exclusively on respiratory illnesses, excluding research on other diseases and review articles. This targeted approach was intended to provide a cohesive understanding of HRQoL specifically within the context of respiratory conditions, enabling us to underscore the unique challenges and unmet needs in this population. A revised search was undertaken across PubMed, EBSCOhost and PsycArticle. Keywords included a variation of the following terms ‘quality of life’, ‘health-related quality of life’, ‘wellbeing’, ‘questionnaire’, ‘instrument’, ‘measure’, ‘children’, ‘toddler’, ‘paediatric’, ‘child*’, ‘develop’ or ‘validation’. The full search strategy is provided in (S1 Appendix).

A faculty librarian and senior authors (GH & MVDZ) were consulted and assisted in refining the search terms. The iterative search strategy included a broad range of terms such as “health-related quality of life,” “HRQOL,” and “functional status” to ensure comprehensive coverage of relevant dimensions of QoL assessments.

Stage 3: Study selection: the process of identifying and screening records

The results, including titles, and abstracts, were exported and duplicates were removed. The initial screening was performed by the first reviewer (MA), who excluded records unrelated to the development, evaluation, or validation of QoL measures. Two reviewers MA & GH independently screened the remaining results by title. Discrepancies were resolved by a 3rd reviewer MVDZ.

Subsequent abstract screening was conducted by MA & MVDZ, with conflicts resolved by GH. Based on the initial review, the inclusion and exclusions criteria were refined in consultation with senior authors (GH & MVDZ) to focus exclusively on respiratory conditions. Articles unrelated to respiratory conditions, including reviews and studies on other diseases, were excluded to maintain coherence and relevance.

Two reviewers (GH & MA) independently reviewed the full text of eligible articles. Discrepancies were resolved in consultation with MVDZ. This rigorous screening process ensured that only full-text, peer-reviewed articles were included in the scoping review. Additionally, grey literature was limited to full-text, peer-reviewed articles that were not identified through database searches, ensuring a comprehensive synthesis of the existing evidence on QoL in respiratory illnesses among children.

Google search engine and reference list searches

A grey literature search was conducted using the Google web browser. Keywords and inclusion criteria were applied, and results were limited to the first ten pages of search results. A screening process similar to that of the database searches was followed. Reference lists of systematic reviews and included full-text articles were manually screened for additional studies.

Reference lists of systematic reviews and articles that were identified through the database search and Google search were manually screened. Reference lists of the full-text research articles included in our analysis were also screened for additional articles to include in the review. A comprehensive review was conducted by systematically searching scientific literature, supplemented with grey literature sources to capture a broader and more inclusive range of relevant information.

Stage 4: Charting the data

Data extraction was conducted manually using a pre-piloted charting table in MS Excel.

The charting table included data on the study authors and year of publication, generic or disease-specific measures, domains measured, target population (including age), self-report or parent proxy report, response options, and language.

The researchers intentionally did not start with a predefined list of domains, as they wanted to be as comprehensive as possible and allow for the natural emergence of relevant domains during extraction. After gathering the data, we grouped the individual domains based on related attributes—for example, all aspects related to mobility, such as physical functioning, running, and walking, were categorised under the broader physical domain. This approach allowed us to maintain rigour and ensure that our findings captured the full breadth of relevant measures, with the senior authors verifying our groupings to uphold the study’s integrity.

Stage 5: Collating, summarising, and reporting the results

The articles were thematically grouped into generic and disease-specific measures. Within disease-specific measures, articles were further categorised by disease areas including bronchopulmonary dysplasia, cystic fibrosis, asthma, primary ciliary dyskinesia, chronic cough, sinus, upper respiratory tract infection, and rhinitis.

Measures were also grouped based on the applicable age range with tools for children 0–5-years priortised in the presentation. Subsequently, the broad age ranges were highlighted. Articles were summarised based on HRQoL domains reflected, respondent type (e.g., parent proxy, child self-report measures), and country of origin and/or translation. This iterative process was conducted in discussion with senior authors GH and MVDZ, ensured a comprehensive and structured analysis of the data.

Ethics considerations

The study were approved by the Health Research Ethics Committee at Stellenbosch University,

Tygerberg, South Africa (S21/05/084). Furthermore, the study was conducted in accordance with the Declaration of Helsinki.

Findings

Overview of the identified measures of HRQoL

The initial search yielded, 1823 peer-reviewed research articles, of which 495 were duplicates and subsequently removed (See Fig 1). The remaining 1340 unique articles were screened by title, leading to the exclusion of 877 articles. Of the 463 articles screened by abstract, 322 were excluded as they included disease-specific tools unrelated to respiratory illnesses. A total of 141 full-text articles were assessed for eligibility, with 92 excluded for the following reasons a) not being about the development and evaluation of an HRQoL measurement (n = 45), b) review articles (n = 44), and c) duplicates (n = 3).

Fig 1 Process of identification and screening of literature. (Figure not reproduced here; see the original article.)

In total, 72 research articles met the inclusion criteria and were included in the full-text review. These studies described 41 HRQoL measures, including 20 generic and 21 disease-specific tools. Among these, five measures (four generic—IQI, TAPQOL, EQ-TIPS and ITQOL-SF-47 and one disease-specific measure—the Cystic Fibrosis Questionnaire-Revised) were developed specifically for children aged 0–5 years (Tables 2 and 3).

Table 2 Characteristics of the included generic measures of HRQoL.
#NameAge rangeRespondent typeNr domainsNr of itemsDimensions/domainsRecall periodMeasurement scaleCountry developedOr validatedLMIC (yes/no)Reference
1Infant health-related quality of life instrument (IQI)0-3Parent proxy77Sleeping, feeding, breathing, stooling/poo, mood, skin and interactionToday4 point scaleColombia, Hong Kong, United States of America, United Kingdom, China, New ZealandNo[24,25]
2TNO-AZL PRESCHOOL CHILDREN QUALITY OF LIFE (TAPQOL)0-5Parent proxy443Physical functioning, Social functioning, Cognitive functioning, Emotional functioningPast 3 months3 point scaleNetherlandsNo[26]
3DISABKIDS Smiley Questionnaire: The TAKE 6 Assisted Health-Related Quality of Life Measure4-7Assisted self-report & Parent proxy16Not reportedNot reported5 point scaleAustria, France, Germany, Greece, Netherlands, Scotland & SwedenNo[27]
4DISABKIDS-10 Index8-18Self-report and Parent proxy310Mental, Social and Physical impact ofthe heath conditionPast 4 weeks5 point scalePortugal,No[28]
5The DISABKIDS generic quality of life instrument (DCGM-37)4-16Self-report and Parent proxy637Independence, Physical limitation, Social inclusion, Social exclusion, Emotion, and Medication.Not reported5 point scaleAustria, France, Germany, Greece, Netherlands, Scotland & Sweden, JapanNo[29,30]
6EQ-TIPS1-36 MonthsParent proxy66Movement, Play, Pain, Relationships, Communication, EatingToday3 point scaleSouth AfricaYes[16,31–33]
7The Quality of Life Scale for Children (QoL-C)4-9Self-report and Parent proxy55Moving (e.g., walking around), Looking after myself (washing or dressing myself), Doing usual activities (e.g., going to school,playing, hobbies, doing things with family/friends), Having pain (being sore), feeling worried, sad or unhappy.Today3 point scaleEnglandNo[34]
8EQ-5D-Y8-14Self-report and Parent proxy55Mobility (‘walking about’), self-care (‘looking after myself’), usual activities (‘doing usual activities’), pain and discomfort (‘having pain or discomfort’), and anxiety and depression (‘feeling worried, sad or unhappy’).Today3 point scaleGermany, Italy, SA, Spain, Sweden, Netherlands, United KingdomYes[35–37]
9Pediatric Quality of Life Inventory 4.0 Generic Core Scales2-18Self-report and Parent proxy423Physical, Emotional, Social, SchoolPast one month5 point scaleUnited States of America, Greece, Argentina, Iran, United Kingdom, Spain, Palestine, Finland, Malaysia)No[38–45]
10PedsQL 4.0 SF152-18Self-report and Parent proxy515Physical functioning, Psychosocial health, Emotional functioning, Social functioning, School functioningPast one month5 point scaleUnited States of AmericaNo[46,47]
11The Very Short Well-being Questionnaire for Children (VSWQ-C)6 and olderSelf-report44Home life, School life, Friends, and HealthPast week5 point scaleEnglandNo
12KINDL-R3-18-Self-report and Parent proxy624Physical well- being, Emotional well-being, Self-esteem, Family, Friends, and Everyday functioning (school or nursery school/kindergarten).Past week5 point scaleGermany & SerbiaNo[48,49]
13Kiddy-KINDL3-6Self-report and Parent proxy612Physical well-being, Psychological well-being, Self-esteem, Family, Friends and Everyday Functioning.Past week3 point scaleGermanyNo[50]
14ITQOL-SF472 months- 5-years-oldParent proxy647Physical function, Growth and development, Bodily pain, Temperament and moods, Behavior, and General health perceptions.Today4 point scaleNetherlands[51,52]
15KIDSCREEN -108-18Self-report and Parent proxyunidimensional global HRQoL index10HealthLast week5 point scaleAustria, Czech Republic, France, Germany, Greece, Hungary, Ireland, Poland, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom, JapanNo[53,54]
16KIDSCREEN- 278-18Self-report and Parent proxy527Physical well-being, psychological well-being, autonomy & parents, Peers & social support and School environmentLast week5 point scaleJapanNo[54]
17KIDSCREEN – 528-18Self-report and Parent proxy1052Physical well-being, Psychological well- being: life satisfaction and positive emotions, Moods and emotions, Social support and peers relation, Parents relation and home life, Self-perception: body image and self-esteem, Autonomy, Cognitive and school functioning, Bullying and social rejection, and Perceived financial opportunities.Last week5 point scaleAustria, France, Germany, Spain, Switzerland, Netherlands, United Kingdom, Norway, GreeceNo[55–57]
18FirstNations-CQOL0-12Parent-proxy321Patient experiences, Quality of life and Patient supportNot reportedNot reportedAustraliaNo[58]
19Multidimensional child well-being scale (MCWBS)9-15Self-report430Physical well-being, psychological well-being, social well-being and educational well-beingNot reported5 point scaleChinaNo[59]
20Kids-CAT7-17Self-report5377Physical well-being, psychological well-being, family well-being, social well-being and school well-being>4 weeksNot reportedGermanyNo[60]
Table 3 Characteristics of included disease-specific HRQoL measures.
#Measure nameDisease TypeAge rangeRespondent typeNr domainsNr of itemsDimensions/DomainsRecall periodMeasurement scaleCountry developed/validatedLMIC (Yes/no)Reference
1Child Chronic Cough quality of life measure (CC-QOL)Cough7-17Self-report3161) Physical domains, 2) Social domain & 3) Psychological domainThe past week7 point Likert scaleBrisbaneNo[61]
2Parent-proxy Children’s Acute Cough-specific QoL Questionnaire (PAC-QoL)Chronic cough0-18Parent proxy316Physical, Social, and Emotional domains24 Hours7 point Likert scaleBrisbane, MelbourneNo[62]
3Paediatric chronic cough (PC-QOL)Chronic cough0-14Parent proxy327Psychological, Physical and SocialNot reported7 point Likert scaleBrisbaneNo[63]
4The Children’s Health Survey for Asthma (CHSA-C)Asthma7-16Self-report and Parent Proxy325Physical Health, Child Activities, and Emotional Health2 weeks5 point scaleUnited States of AmericaNo[64]
5The Integrated Therapeutics Group Pediatric Asthma Short FormAsthma5-12Parent proxy317Daytime symptoms, Night-time symptoms & Functional limitationsPast 4 weeks5 point scaleNot reportedUnknown[65]
6The Childhood Asthma Questionnaires (CAQ-B)Asthma7-11Self-report and Parent Proxy423Not reportedNot reportedNot reportedNot reportedUnknown[66]
7“A pictorial version of the PediatricAsthma Quality of Life Questionnaire (PAQLQ)”Asthma5-7Parent proxy213Caregivers daily activities, Fear and worryPast week7 point Likert scaleUnited States of AmericaNo[67]
8PedsQL 3.0 Asthma ModuleAsthma2-16Self-report and Parent Proxy428Asthma Symptoms, Treatment Problems, Worry, and Communicationpast 1 month5 point scaleUnited States of AmericaNo[19,68]
9The Exeter health related quality of life measure (EXQOL)Asthma6-12Computer based Self report and parent proxyNot reported12not reportedNot reported2 point scaleNot reportedUnknown[69]
10DISABKIDS Asthma Module (DISABKIDS-AsM)Asthma8-18Self-report and parent proxy2 d11Impact and WorryNot reported5 point scaleSão PauloYes[70]
11Asthma-related quality of life (ARQOL)Asthma6-13Self-report535Restriction of social life, Physical disturbances, Limitation in physical activity, Daily inconveniences in managing the disease, and Emotional distress,Not reportedNot reportedTaiwanNo[71]
12How are you? (HAY)Asthma8-12Self-report and Parent Proxy4 Generic & 4 Asthma specific32Generic domains: Physical activities, Cognitive activities, Social activities, and Physical complaints Asthma specific domains: Asthma symptoms, Emotions related to asthma, Self-concept, and Self-managementprevious week4 point scaleHollandNo[72]
13TACQOL-AsthmaAsthma8-16Self-report and Parent Proxy568Complaints (spontaneous asthma symptoms), Situations (that provoke symptoms), Treatment (visits to the doctors), Medication (use of) and Emotions (negative emotions).Last month3 point scale (Child) 5 point scale (caregiver)NetherlandsNo[20]
14Cystic Fibrosis Questionnaire- Revised (CFQ-R)Cystic Fibrosis4-60 MonthsSelf-report and parent proxy526Respiratory Symptoms, Treatment Burden, Vitality,. Health Perceptions and Physical Functioning were administered to parents of children ≥36 months due to limited relevance for younger children (e.g., “difficulty climbing stairs”).Past week4 point scaleUnited States of America, Canada, GermanyNo[17,18]
15Cystic Fibrosis Questionnaire (CFQ)–Child versionCystic Fibrosis6-13self and parent proxy333Physical Symptoms, Emotional Functioning, and Social FunctioningNot reported4 point scaleUnited States of America and Puerto RicoNo[73]
16The Paediatric Allergic Rhinitis Quality of Life Questionnaire (Ped-AR-QoL)Rhinitis6-14Self-report and Parent Proxy520Symptoms, Symptom duration, Emotion, Activities and SleepLast 2 weeks4 point scaleGreeceNo[74]
17Health related quality of life instrument for Primary Ciliary Dyskinesia (QOL-PCD)Primary ciliary dyskinesia6-17Self-report and Parent Proxy5Child self-: 37 and Parent proxy version:41Child self-report: Physical Functioning, Emotional Functioning, Social Functioning, Treatment Burden, Upper Respiratory Symptoms, Lower Respiratory Symptoms and Ears & Hearing Symptoms. Parent proxy: Physical Functioning, Emotional Functioning, Social Functioning, Treatment Burden, Upper Respiratory Symptoms, Lower Respiratory Symptoms and Ears & Hearing Symptoms. Health Perception and Eating & WeightPast week4 point scaleUnited States of America, United Kingdom, Ireland & CanadaNo[75]
18“Wisconsin Upper RespiratorySymptom Survey for Kids (WURSS‐K)”Upper respiratory Illness10 and olderSelf-report315Global illness severity, Severity-symptom and ImpactToday5 point Likert scalePolishNo[76]
19Bronchopulmonary dysplasia quality of life measure (BPD-QoL)Bronchopulmonary dysplasia4-8Parent proxy5331) Pulmonary complaints, 2) school functioning, 3) Growth and nutrition 4) Exercise and locomotion & 5) Emotional functioning and health care concerns.Not reported7 point Likert scaleNetherlandsNo[77]
20Sinus and Nasal Quality of Life Survey (SN-5)Sinus2-12Parent proxy55Symptoms of infection, Nasal obstruction, Allergy, Emotionaldistress and Activity limitation4 weeks7 point Likert scaleUnited States of America[78]
21Child acute cough-specific measures (PAC-QOL6)Cough0-18Self-report and Parent Proxy36Physical, social and emotionalNot reportedNot reportedNot reported[79]

Age range.

Of the 20 generic HRQoL measures, four were applied to children aged 2–18-years, five were designed for children aged 8–18-years, Seven were applicable to children 3–16-year, four were specifically developed for children aged 0–5-year (IQI, TAPQOL, EQ-TIPS and ITQOL-SF-47).

Of the 21 disease-specific HRQoL measures, five measures were applicable to a broad age range of children aged 0–18-years. Fifteen were designed for children ≥4-years (see Table 3). Only one measure, the Cystic Fibrosis (CFQ Child version), was specifically tailored for children 0–5-years.

HRQoL domains and items.

A total of 101 domains were identified across the 20 generic HRQoL measures, with the number of domains per measure from 1 to 10 (See Fig 2). The most frequently assessed domains across all ages included: 1) physical well-being (n = 14), 2) emotional well-being (n = 10), 3) psychological well-being (n = 8), and 4) social support/functioning (n = 13).

Fig 2 Domains and Dimensions: Generic Measures. (Figure not reproduced here; see the original article.)

The number of items per measure ranged from 4 to 377, with considerable variability across domains. For children aged 0–5-years, commonly assessed domains included physical, emotional, cognitive, and social functioning. Less commonly measured domains in this age group included communication and sleep.

A total of 79 domains were identified across the 21 disease-specific measures, with the number of domains per measure ranging from four to nine. One measure, namely the Exeter health-related quality of life measure (EXQOL) did not report on specific domains. Commonly assessed domains across all ages included:1) symptoms (n = 12), 2) physical domain (n = 10), 3) emotional domain (n = 11), and 4) social domain (n = 8). The number of items per measure ranged from 5 to 68. For children aged 0–5 years, key domains included respiratory symptoms, treatment burden, vitality, health perceptions, and physical functioning (See Fig 3).

Fig 3 Domains and Dimensions: Disease-specific Measures. (Figure not reproduced here; see the original article.)

Respondents to the HRQoL measures.

Among the 41HRQoL measures identified: 11 (5 generic; 6 disease-specific) were designed exclusively for parent proxy respondents (See Table 2 and Table 3). Nine (2 generic; 7 disease-specific) were exclusively for the use of child self-report HRQoL. The remaining 24 (12 generic; 12 disease-specific) were designed for both child self-report as well as parent proxy respondents. All five measures applicable to 0–5-years were designed for parent proxy respondents.

Country of origin.

Of the 41 HRQoL measures: 24 (12 generic; 12 disease-specific) were developed in HICs (see Table 2 and Table 3). Two (1 generic; 1 disease-specific) measures were developed in LMICs including (South Africa and Sao Paulo). The EQ-TIPS (generic) was developed in South Africa. The DISABKIDS-AsM (disease-specific) was developed in Sao Paulo for children with asthma aged 8–18-years. Ten (7 generic; 3 disease-specific) measures were developed and validated in multiple country. Four disease-specific measures did not report the country of origin. The development of the EQ-5D-Y took place in multiple countries, including SA, however, was not validated in a LMIC. Notably, none of the disease-specific measures for children aged 0–5 years were developed in LMICs.

Discussion

This review screened 1,823 peer-reviewed articles, ultimately including 72 studies reporting on 41 distinct HRQoL measures, of which 20 were generic and 21 were disease-specific. Notably, only five measures—four generic and one disease-specific (for cystic fibrosis)—were designed for children aged 0–5-years. The identified HRQoL measures displayed substantial variability, encompassing 101 domains across generic measures and 79 across disease-specific measures. While the most commonly assessed domains included physical and emotional well-being, the majority of measures were developed in HICs, with only two originating from LMICs. This underscores a significant gap in contextually relevant HRQoL tools for children with respiratory illnesses, including PTB, in LMIC settings.

A key finding of this review is the limited availability of both generic and respiratory disease-specific HRQoL measures for young children aged 0–5-years. Furthermore, the development and validation of existing measures in LMICs remain scarce, despite the different socioeconomic contexts and high burden of respiratory diseases in these regions. While measures varied in their included domains and items, physical, emotional, cognitive, and social functioning were the most relevant domains for young children. However, many measures lacked developmental adaptations or clear guidance for assessing these domains in this age group.

Although valuable insights can be drawn from the available measures, several limitations must be addressed: 1) Existing tools exhibit inconsistent definitions, criteria, and inclusion of domains and items, limiting comparability across studies and 2;) Most HRQoL measures were developed in HICs and are not readily adaptable to LMICs without accounting for distinct cultural, linguistic, and socioeconomic factors. While HRQoL measures developed in HICs may not fully account for the unique challenges faced in LMICs, further research is necessary to assess the influence of cultural, linguistic, and socioeconomic factors on their applicability.

Research has demonstrated that HRQoL tools like the PedsQL or EQ-5D-Y can be successfully adapted for LMICs through rigorous cultural validation and iterative testing, such as cognitive interviews and pilot studies. These adaptations underscore the importance of contextualised approaches in HRQoL measurement. However, the lack of a disease-specific HRQoL measure tailored to young children with respiratory illnesses in LMICs—especially TB—remains a critical gap [10,80,81].

While previous reviews have focused on HRQoL tools for conditions like asthma, cystic fibrosis, vocal cord dysfunction, and sleep-related disorders [82]. This review serves as an update to this previous work, as it includes additional HRQoL measures related to respiratory conditions. There are now several well-documented and validated generic HRQoL measures for use in children and proxies, such as EQ-5D-Y [35–37], EQ-TIPS [16,32,33], and PedsQL [38,83]. Initially, only a few disease-specific measures developed, but these have now become more common and are available in several paediatric conditions such as asthma [19,20,64–71] and cystic fibrosis [17,18,73]. There has been growing interest in the assessment of HRQoL among children affected by respiratory illnesses including TB, in LMIC due to the potential long-term impact of disease on children’s lives. However, there remains a lack of a disease-specific HRQoL measure for the youngest children with respiratory illnesses in an LMIC.

This review highlights substantial inconsistencies in the domains and items included in HRQoL measures, particularly those for young children [12,15]. The developmental stages of early childhood necessitate tools that not only assess functioning but also consider developmental milestones. Proxy reporting, commonly used for young children, poses challenges due to caregivers’ limited ability to interpret non-observable aspects of HRQoL and the potential influence of their emotional proximity to the child [10]. Alternative methods, such as creative play, body mapping, and role-playing, may provide more nuanced insights into HRQoL for children aged 3–5-years.

This review has several strengths and limitations. A comprehensive search strategy captured all available data on HRQoL measures for children, providing a valuable resource for researchers. However, restricting the search to English-language articles published from 2000 onward may have excluded foundational studies or non-English research, particularly from LMICs. Additionally, limiting the review to English-language articles may have resulted in the omission of relevant research conducted in other languages, particularly from LMICs where diverse cultural and contextual factors significantly impact children’s HRQoL. As a result, this may affect the comprehensiveness of our findings and limit the generalisability of the conclusions drawn from the available literature. Additionally, the exclusion of HRQoL websites and conference proceedings may have omitted emerging tools or insights not yet published in peer-reviewed literature. Consequently, some recent developments in HRQoL measures for paediatric respiratory conditions may not be fully captured in our analysis.

There is an urgent need to develop and validate a disease-specific HRQoL measure tailored to children with respiratory illnesses in LMICs, with particular emphasis on the youngest age group. In the interim, existing HRQoL tools should be used cautiously, ensuring they are appropriately adapted to the socio-cultural context. Addressing these gaps will advance the understanding and assessment of HRQoL for children in LMICs, ultimately improving outcomes for those affected by respiratory illnesses, including TB.

Supporting information

Acknowledgements

We would like to thank the study staff and the support staff at Stellenbosch University, Desmond Tutu TB Centre for their dedication and assistance throughout the study.

References

  1. SitthikarnkhaP, UppalaR, NiamsanitS, SutraS, ThepsuthammaratK, TechasatianL, et al. Epidemiology of acute lower respiratory tract infection hospitalizations in Thai children: A 5-year national data analysis. Influenza Other Respir Viruses. 2022;16(1):142–50. doi: 10.1111/irv.12911 34523811 PMC8692802 doi:10.1111/irv.12911 PubMed
  2. KerenR, LuanX, LocalioR, HallM, McLeodL, DaiD, et al. Prioritization of comparative effectiveness research topics in hospital pediatrics. Arch Pediatr Adolesc Med. 2012;166(12):1155–64. doi: 10.1001/archpediatrics.2012.1266 23027409 doi:10.1001/archpediatrics.2012.1266 PubMed
  3. KorsunN, AngelovaS, TrifonovaI, GeorgievaI, VolevaS, TzotchevaI, et al. Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria. Braz J Microbiol. 2019;50(1):117–25. doi: 10.1007/s42770-018-0033-2 30637646 PMC6863252 doi:10.1007/s42770-018-0033-2 PubMed
  4. GulA, KhanS, ArshadM, AnjumSI, AttaullahS, AliI, et al. Peripheral blood T cells response in human parainfluenza virus-associated lower respiratory tract infection in children. Saudi J Biol Sci. 2020;27(10):2847–52. doi: 10.1016/j.sjbs.2020.07.005 32994745 PMC7499292 doi:10.1016/j.sjbs.2020.07.005 PubMed
  5. KhanMA. Epidemiological studies on lower respiratory tract infection in children in the District Bannu, Khyber Pakhtunkhwa, Pakistan. Egypt J Bronchol. 2022;16(1). doi: 10.1186/s43168-022-00119-9 doi:10.1186/s43168-022-00119-9
  6. NightingaleR, CarlinF, MeghjiJ, McMullenK, EvansD, van der ZalmMM, et al. Post-TB health and wellbeing. Int J Tuberc Lung Dis. 2023; 27(4):248–83.37035971 10.5588/ijtld.22.0514PMC10094053 doi:10.5588/ijtld.22.0514 PubMed
  7. StocksJ, HislopA, SonnappaS. Early lung development: lifelong effect on respiratory health and disease. Lancet Respir Med. 2013;1(9):728–42. doi: 10.1016/S2213-2600(13)70118-8 24429276 doi:10.1016/S2213-2600(13)70118-8 PubMed
  8. NkereuwemE, AgblaS, SallahdeenA, OwolabiO, SillahAK, GenekahM, et al. Reduced lung function and health-related quality of life after treatment for pulmonary tuberculosis in Gambian children: a cross-sectional comparative study. Thorax. 2023;78(3):281–7. doi: 10.1136/thorax-2022-219085 36109164 PMC9985734 doi:10.1136/thorax-2022-219085 PubMed
  9. AnthonyMG, JohnsonLS, van NiekerkM, MfwazeA, BavumaB, HesselingAC, et al. Health-related quality of life in children with presumptive TB. IJTLD Open. 2024;1(11):495–500. doi: 10.5588/ijtldopen.24.0355 39544879 PMC11558787 doi:10.5588/ijtldopen.24.0355 PubMed
  10. Anthony M, Hoddinott G, Van Niekerk M, Hesseling AC, van der ZM. An item bank to measure health-related quality of life among youngest children (0-5-years-old) affected by respiratory illnesses – expert stakeholders and end-user perspectives from the Western Cape, South Africa. 2024 0:Submitted10.1186/s12955-024-02308-0PMC1152365239472952 doi:10.1186/s12955-024-02308-0 PubMed
  11. WaheedY, KhanMA, FatimaR, YaqoobA, MirzaA, QadeerE, et al. Infection control in hospitals managing drug-resistant tuberculosis in Pakistan: how are we doing?. Public Health Action. 2017;7(1):26–31. doi: 10.5588/pha.16.012528775940 PMC5526491 doi:10.5588/pha.16.0125 PubMed
  12. GermainN, AballéaS, ToumiM. Measuring the health-related quality of life in young children: how far have we come?. J Mark Access Health Policy. 2019;7(1):1618661. doi: 10.1080/20016689.2019.1618661 31156762 PMC6534256 doi:10.1080/20016689.2019.1618661 PubMed
  13. GermainN, AballéaS, ToumiM. Measuring health-related quality of life in young children: how far have we come? J Mark Access Heal Policy [Internet]. 2019;7(1). Available from: doi: 10.1080/20016689.2019.1618661PMC653425631156762 doi:10.1080/20016689.2019.1618661 PubMed
  14. YinS, NjaiR, BarkerL, SiegelPZ, LiaoY. Summarizing health-related quality of life (HRQOL): development and testing of a one-factor model. Popul Health Metr. 2016;14:22. doi: 10.1186/s12963-016-0091-3 27408606 PMC4940947 doi:10.1186/s12963-016-0091-3 PubMed
  15. SolansM, PaneS, EstradaM-D, Serra-SuttonV, BerraS, HerdmanM, et al. Health-related quality of life measurement in children and adolescents: a systematic review of generic and disease-specific instruments. Value Health. 2008;11(4):742–64. doi: 10.1111/j.1524-4733.2007.00293.x 18179668 doi:10.1111/j.1524-4733.2007.00293.x PubMed
  16. VerstraeteJ, RammaL, JelsmaJ. Validity and reliability testing of the Toddler and Infant (TANDI) Health Related Quality of Life instrument for very young children. J Patient Rep Outcomes. 2020;4(1):94. doi: 10.1186/s41687-020-00251-4 33165662 PMC7652950 doi:10.1186/s41687-020-00251-4 PubMed
  17. AlpernAN, BrumbackLC, RatjenF, RosenfeldM, DavisSD, QuittnerAL. Initial evaluation of the Parent Cystic Fibrosis Questionnaire--Revised (CFQ-R) in infants and young children. J Cyst Fibros. 2015;14(3):403–11. doi: 10.1016/j.jcf.2014.11.002 25443473 doi:10.1016/j.jcf.2014.11.002 PubMed
  18. SchmidtA, WenningerK, NiemannN, WahnU, StaabD. Health-related quality of life in children with cystic fibrosis: Validation of the German CFQ-R. Health Qual Life Outcomes. 2009;7:1–10.19954541 10.1186/1477-7525-7-97PMC2794264 doi:10.1186/1477-7525-7-97 PubMed
  19. GreenleyRN, JosieKL, DrotarD. Self-reported quality of life among inner-city youth with asthma: an empirical examination of the PedsQL 3.0 Asthma Module. Ann Allergy Asthma Immunol. 2008;100(2):106–11. doi: 10.1016/S1081-1206(10)60418-8 18320911 doi:10.1016/S1081-1206(10)60418-8 PubMed
  20. FlapperBCT, KoopmanHM, tenNC, van der SchansCP. Psychometric properties of the TACQOL-asthma, a disease-specific measure of health related quality-of-life for children with asthma and their parents. Chron Respir Dis. 2006;3(2):65–72. doi: 10.1191/1479972306cd102oa 16729764 doi:10.1191/1479972306cd102oa PubMed
  21. ArkseyH, O’MalleyL. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol Theory Pract. 2005; 8(1):19–32.
  22. PetersMDJ, GodfreyCM, KhalilH, McInerneyP, ParkerD, SoaresCB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6. doi: 10.1097/XEB.0000000000000050 26134548 doi:10.1097/XEB.0000000000000050 PubMed
  23. TriccoAC, LillieE, ZarinW, O’BrienKK, ColquhounH, LevacD, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73.30178033 10.7326/M18-0850 doi:10.7326/M18-0850 PubMed
  24. KlassenAF, LandgrafJM, LeeSK, BarerM, RainaP, ChanHWP, et al. Health related quality of life in 3 and 4 year old children and their parents: Preliminary findings about a new questionnaire. Health Qual Life Outcomes. 2003;1:1–11.14690543 10.1186/1477-7525-1-81PMC331419 doi:10.1186/1477-7525-1-81 PubMed
  25. JabrayilovR, van AsseltADI, VermeulenKM, VolgerS, DetzelP, DainelliL, et al. A descriptive system for the Infant health-related Quality of life Instrument (IQI): Measuring health with a mobile app. PLoS One. 2018;13(8):e0203276. doi: 10.1371/journal.pone.0203276 30169510 PMC6118381 doi:10.1371/journal.pone.0203276 PubMed
  26. BungeEM, Essink-BotM-L, KobussenMPHM, van Suijlekom-SmitLWA, MollHA, RaatH. Reliability and validity of health status measurement by the TAPQOL. Arch Dis Child. 2005;90(4):351–8. doi: 10.1136/adc.2003.048645 15781921 PMC1720358 doi:10.1136/adc.2003.048645 PubMed
  27. ChaplinJE, KoopmanHM, SchmidtS, DISABKIDS Group. DISABKIDS smiley questionnaire: the TAKE 6 assisted health-related quality of life measure for 4 to 7-year-olds. Clin Psychol Psychother. 2008;15(3):173–80. doi: 10.1002/cpp.570 19115438 doi:10.1002/cpp.570 PubMed
  28. CaronaC, SilvaN, MoreiraH, CanavarroMC, BullingerM. Does the small fit them all? The utility of Disabkids-10 Index for the assessment of pediatric health-related quality of life across age-groups, genders, and informants. J Child Health Care. 2015;19(4):466–77. doi: 10.1177/1367493514522867 24599030 doi:10.1177/1367493514522867 PubMed
  29. PetersenC, SchmidtS, PowerM, BullingerM, DISABKIDS Group. Development and pilot-testing of a health-related quality of life chronic generic module for children and adolescents with chronic health conditions: a European perspective. Qual Life Res. 2005;14(4):1065–77. doi: 10.1007/s11136-004-2575-z 16041902 doi:10.1007/s11136-004-2575-z PubMed
  30. SasakiH, KakeeN, MorisakiN, MoriR, Ravens-SiebererU, BullingerM. Assessing health-related quality of life in Japanese children with a chronic condition: validation of the DISABKIDS chronic generic module. Health Qual Life Outcomes. 2018;16(1):85. doi: 10.1186/s12955-018-0911-1 29720193 PMC5932858 doi:10.1186/s12955-018-0911-1 PubMed
  31. VerstraeteJ, RammaL, JelsmaJ. Item generation for a proxy health related quality of life measure in very young children. Health Qual Life Outcomes. 2020;18(1):11. doi: 10.1186/s12955-020-1271-1 31937311 PMC6961344 doi:10.1186/s12955-020-1271-1 PubMed
  32. VerstraeteJ, LloydAJ, JelsmaJ. Performance of the Toddler and Infant (TANDI) Health-Related Quality of Life Instrument in 3-4-Year-Old Children. Children (Basel). 2021;8(10):920. doi: 10.3390/children8100920 34682184 PMC8534352 doi:10.3390/children8100920 PubMed
  33. VerstraeteJ, LloydA, ScottD, JelsmaJ. How does the EQ-5D-Y Proxy version 1 perform in 3, 4 and 5-year-old children? Health Qual Life Outcomes. 2020;18(1):1–10.32448278 10.1186/s12955-020-01410-3PMC7247261 doi:10.1186/s12955-020-01410-3 PubMed
  34. L. ThompsonH, RevilleM-C, PriceA, ReynoldsL, RodgersL, FordT. The Quality of Life Scale for Children (QoL-C). J Child Serv. 2014;9(1):4–17. doi: 10.1108/jcs-05-2013-0019 doi:10.1108/jcs-05-2013-0019
  35. Ravens-SiebererU, WilleN, BadiaX, BonselG, BurströmK, CavriniG, et al. Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 2010;19(6):887–97. doi: 10.1007/s11136-010-9649-x 20401552 PMC2892614 doi:10.1007/s11136-010-9649-x PubMed
  36. WilleN, BadiaX, BonselG, BurströmK, CavriniG, DevlinN, et al. Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Qual Life Res. 2010;19(6):875–86. doi: 10.1007/s11136-010-9648-y 20405245 PMC2892611 doi:10.1007/s11136-010-9648-y PubMed
  37. ScottD, FergusonGD, JelsmaJ. The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study. Health Qual Life Outcomes. 2017;15(1):12. doi: 10.1186/s12955-017-0590-3 28103872 PMC5248508 doi:10.1186/s12955-017-0590-3 PubMed
  38. VarniJW, LimbersCA, BurwinkleTM. Parent proxy-report of their children’s health-related quality of life: an analysis of 13,878 parents’ reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2. doi: 10.1186/1477-7525-5-2 17201923 PMC1769359 doi:10.1186/1477-7525-5-2 PubMed
  39. GkoltsiouK, DimitrakakiC, TzavaraC, PapaevangelouV, VarniJW, TountasY. Measuring health-related quality of life in Greek children: Psychometric properties of the Greek version of the Pediatric Quality of Life Inventory TM 4.0 Generic Core Scales. Qual Life Res. 2008;17(2):299–305.18080786 10.1007/s11136-007-9294-1 doi:10.1007/s11136-007-9294-1 PubMed
  40. RoizenM, RodríguezS, BauerG, MedinG, BevilacquaS, VarniJW, et al. Initial validation of the Argentinean Spanish version of the PedsQL 4.0 Generic Core Scales in children and adolescents with chronic diseases: acceptability and comprehensibility in low-income settings. Health Qual Life Outcomes. 2008;6:59. doi: 10.1186/1477-7525-6-59 18687134 PMC2533649 doi:10.1186/1477-7525-6-59 PubMed
  41. HaoY, TianQ, LuY, ChaiY, RaoS. Psychometric properties of the Chinese version of the Pediatric Quality of Life Inventory 4.0 generic core scales. Qual Life Res. 2010;19(8):1229–33. doi: 10.1007/s11136-010-9672-y 20473781 doi:10.1007/s11136-010-9672-y PubMed
  42. UptonP, EiserC, CheungI, HutchingsHA, JenneyM, MaddocksA, et al. Measurement properties of the UK-English version of the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes. 2005;3:22. doi: 10.1186/1477-7525-3-22 15804349 PMC1079918 doi:10.1186/1477-7525-3-22 PubMed
  43. ArabiatD, ElliottB, DraperP, Al JaberyM. Cross-cultural validation of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) generic core scale into Arabic language. Scand J Caring Sci. 2011;25(4):828–33. doi: 10.1111/j.1471-6712.2011.00889.x 21564151 doi:10.1111/j.1471-6712.2011.00889.x PubMed
  44. LaaksonenC, AromaaM, HeinonenOJ, SuominenS, SalanteräS. Paediatric health-related quality of life instrument for primary school children: cross-cultural validation. J Adv Nurs. 2007;59(5):542–50. doi: 10.1111/j.1365-2648.2007.04347.x 17681083 doi:10.1111/j.1365-2648.2007.04347.x PubMed
  45. AinuddinHA, LohSY, ChinnaK, LowWY, RoslaniAC. Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents. J Child Health Care. 2015;19(2):229–38. doi: 10.1177/1367493513504834 24154841 doi:10.1177/1367493513504834 PubMed
  46. ChanKS, Mangione-SmithR, BurwinkleTM, RosenM, VarniJW. The PedsQL: reliability and validity of the short-form generic core scales and Asthma Module. Med Care. 2005;43(3):256–65. doi: 10.1097/00005650-200503000-00008 15725982 doi:10.1097/00005650-200503000-00008 PubMed
  47. SmeesR, RinaldiLJ, SimnerJ. Well-being measures for younger children. Psychol Assess. 2020;32(2):154–69. doi: 10.1037/pas0000768 31599610 doi:10.1037/pas0000768 PubMed
  48. BullingerM, BrüttAL, ErhartM, Ravens-SiebererU, BELLA StudyGroup. Psychometric properties of the KINDL-R questionnaire: results of the BELLA study. Eur Child Adolesc Psychiatry. 2008;17 Suppl 1:125–32. doi: 10.1007/s00787-008-1014-z 19132312 doi:10.1007/s00787-008-1014-z PubMed
  49. StevanovicD. Serbian KINDL questionnaire for quality of life assessments in healthy children and adolescents: reproducibility and construct validity. Health Qual Life Outcomes. 2009;7:79. doi: 10.1186/1477-7525-7-79 19715576 PMC2739511 doi:10.1186/1477-7525-7-79 PubMed
  50. Villalonga-OlivesE, Kiese-HimmelC, WitteC, AlmansaJ, DusilovaI, HackerK, et al. Self-reported health-related quality of life in kindergarten children: psychometric properties of the Kiddy-KINDL. Public Health. 2015;129(7):889–95. doi: 10.1016/j.puhe.2015.04.020 26051961 doi:10.1016/j.puhe.2015.04.020 PubMed
  51. LandgrafJM, VogelI, OostenbrinkR, van BaarME, RaatH. Parent-reported health outcomes in infants/toddlers: measurement properties and clinical validity of the ITQOL-SF47. Qual Life Res. 2013;22(3):635–46. doi: 10.1007/s11136-012-0177-8 22528242 doi:10.1007/s11136-012-0177-8 PubMed
  52. RaatH, LandgrafJM, OostenbrinkR, MollHA, Essink-BotM-L. Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample. Qual Life Res. 2007;16(3):445–60. doi: 10.1007/s11136-006-9134-8 17111231 PMC2792359 doi:10.1007/s11136-006-9134-8 PubMed
  53. Ravens-SiebererU, ErhartM, RajmilL, HerdmanM, AuquierP, BruilJ, et al. Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Qual Life Res. 2010;19(10):1487–500. doi: 10.1007/s11136-010-9706-5 20668950 PMC2977059 doi:10.1007/s11136-010-9706-5 PubMed
  54. NezuS, IwasakaH, SaekiK, ObayashiK, IshizukaR, GomaH, et al. Reliability and validity of Japanese versions of KIDSCREEN-27 and KIDSCREEN-10 questionnaires. Environ Health Prev Med. 2016;21(3):154–63.26883049 10.1007/s12199-016-0510-xPMC4823216 doi:10.1007/s12199-016-0510-x PubMed
  55. RobitailS, SimeoniM-C, ErhartM, Ravens-SiebererU, BruilJ, AuquierP, et al. Validation of the European proxy KIDSCREEN-52 pilot test health-related quality of life questionnaire: first results. J Adolesc Health. 2006;39(4):596.e1–10. doi: 10.1016/j.jadohealth.2006.01.009 16982396 doi:10.1016/j.jadohealth.2006.01.009 PubMed
  56. HaraldstadK, ChristophersenKA, EideH, NativgGK, HelsethS. Health related quality of life in children and adolescents: Reliability and validity of the Norwegian version of KIDSCREEN-52 questionnaire, a cross sectional study Int J Nurs Stud. 2011;48(5):573–81.21067750 10.1016/j.ijnurstu.2010.10.001 doi:10.1016/j.ijnurstu.2010.10.001 PubMed
  57. TzavaraC, TzonouA, ZervasI, Ravens-SiebererU, DimitrakakiC, TountasY. Reliability and validity of the KIDSCREEN-52 health-related quality of life questionnaire in a Greek adolescent population. Ann Gen Psychiatry. 2012;11:3. doi: 10.1186/1744-859X-11-3 22329924 PMC3298788 doi:10.1186/1744-859X-11-3 PubMed
  58. ButtenK, JonesL, NewcombePA, ChangAB, SheffieldJK, O’GradyK-AF, et al. Development and validation of a parent-proxy health-related quality of life survey for Australian First Nations children. BMJ Open. 2021;11(8):e046007. doi: 10.1136/bmjopen-2020-046007 34400446 PMC8370500 doi:10.1136/bmjopen-2020-046007 PubMed
  59. Jiang S, Ngai SS yum Assessing multiple domains of child well-being: Preliminary development and validation of the multidimensional child well-being scale (MCWBS) Curr Psychol 41(8):5458–69 2022
  60. DevineJ, OttoC, RoseM, BarthelD, FischerF, MühlanH, et al. A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT. Qual Life Res. 2015;24(4):871–84. doi: 10.1007/s11136-014-0812-7 25307509 doi:10.1007/s11136-014-0812-7 PubMed
  61. NewcombePA, SheffieldJK, PetskyHL, MarchantJM, WillisC, ChangAB. A child chronic cough-specific quality of life measure: development and validation. Thorax. 2016;71(8):695–700. doi: 10.1136/thoraxjnl-2015-207473 26842959 doi:10.1136/thoraxjnl-2015-207473 PubMed
  62. Anderson-JamesS, NewcombePA, MarchantJM, O’GradyK-AF, AcworthJP, StoneDG, et al. An acute cough-specific quality-of-life questionnaire for children: Development and validation. J Allergy Clin Immunol. 2015;135(5):1179-85.e1-4. doi: 10.1016/j.jaci.2014.08.036 25441641 doi:10.1016/j.jaci.2014.08.036 PubMed
  63. NewcombePA, SheffieldJK, JuniperEF, PetskyHL, WillisC, ChangAB. Validation of a parent-proxy quality of life questionnaire for paediatric chronic cough (PC-QOL). Thorax. 2010;65(9):819–23. doi: 10.1136/thx.2009.133868 20805179 doi:10.1136/thx.2009.133868 PubMed
  64. RadeckiL, OlsonLM, FrintnerMP, WeissKB. Reliability and Validity of the Children’s Health Survey for Asthma–Child Version. Pediatr Asthma, Allergy Immunol. 2008;21(2):89–98. doi: 10.1089/pai.2008.0001 doi:10.1089/pai.2008.0001
  65. BuksteinDA, McGrathMM, BuchnerDA, LandgrafJ, GossTF. Evaluation of a short form for measuring health-related quality of life among pediatric asthma patients. J Allergy Clin Immunol. 2000;105(2 Pt 1):245–51. doi: 10.1016/s0091-6749(00)90072-1 10669843 doi:10.1016/s0091-6749(00)90072-1 PubMed
  66. ChongL-Y, ChayO-M, Shu-ChuenL. Is the childhood asthma questionnaire a good measure of health-related quality of life of asthmatic children in Asia?: validation among paediatric patients with asthma in Singapore. Pharmacoeconomics. 2006;24(6):609–21. doi: 10.2165/00019053-200624060-00007 16761907 doi:10.2165/00019053-200624060-00007 PubMed
  67. EverhartRS, FieseBH. Development and initial validation of a pictorial quality of life measure for young children with asthma. J Pediatr Psychol. 2009;34(9):966–76. doi: 10.1093/jpepsy/jsn145 19168502 PMC2782248 doi:10.1093/jpepsy/jsn145 PubMed
  68. VarniJW, BurwinkleTM, RapoffMA, KampsJL, OlsonN. The PedsQL in pediatric asthma: reliability and validity of the Pediatric Quality of Life Inventory generic core scales and asthma module. J Behav Med. 2004;27(3):297–318. doi: 10.1023/b:jobm.0000028500.53608.2c 15259457 doi:10.1023/b:jobm.0000028500.53608.2c PubMed
  69. EiserC, VanceYH, SeamarkD. The development of a theoretically driven generic measure of quality of life for children aged 6-12 years: a preliminary report. Child Care Health Dev. 2000;26(6):445–56. doi: 10.1046/j.1365-2214.2000.00177.x 11091261 doi:10.1046/j.1365-2214.2000.00177.x PubMed
  70. SilvaN, CaronaC, CrespoC, BullingerM, CanavarroMC. The Portuguese DISABKIDS Asthma Module: a global index of asthma-specific quality of life for children and adolescents. J Asthma. 2014;51(6):645–51. doi: 10.3109/02770903.2014.885042 24447285 doi:10.3109/02770903.2014.885042 PubMed
  71. ChiangL-C, TzengL-F, FuL-S, HuangJ-L. Testing a questionnaire to measure asthma-related quality of life among children. J Nurs Scholarsh. 2006;38(4):383–6. doi: 10.1111/j.1547-5069.2006.00131.x 17181088 doi:10.1111/j.1547-5069.2006.00131.x PubMed
  72. le CoqEM, BoekeAJ, BezemerPD, CollandVT, van EijkJT. Which source should we use to measure quality of life in children with asthma: the children themselves or their parents?. Qual Life Res. 2000;9(6):625–36. doi: 10.1023/a:1008977200176 11236853 doi:10.1023/a:1008977200176 PubMed
  73. ModiAC, QuittnerAL. Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. J Pediatr Psychol. 2003;28(8):535–45. doi: 10.1093/jpepsy/jsg044 14602844 doi:10.1093/jpepsy/jsg044 PubMed
  74. MavroudiA, ChrysochoouE-A, BoyleRJ, PapastergiopulosA, KarantaglisN, KaragiannidouA, et al. Validation study of the pediatric allergic rhinitis quality of life questionnaire. Asian Pac J Allergy Immunol. 2016;34(2):159–65. doi: 10.12932/AP0651.34.2.2016 27007838 doi:10.12932/AP0651.34.2.2016 PubMed
  75. BehanL, LeighMW, DellSD, QuittnerAL, HoggC, LucasJS. Validation of pediatric health-related quality of life instruments for primary ciliary dyskinesia (QOL-PCD). Pediatr Pulmonol.2019;54(12):2011–20.31475479 10.1002/ppul.24507PMC6851410 doi:10.1002/ppul.24507 PubMed
  76. Ostrzyżek-PrzeździeckaK, PanczykM, RatajczakA, BronikowskiM, FeleszkoW. Validation and clinical evaluation of a Polish translation of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K). Health Qual Life Outcomes. 2021;19(1):153. doi: 10.1186/s12955-021-01791-z 34030710 PMC8142287 doi:10.1186/s12955-021-01791-z PubMed
  77. Meijer-SchaapL, DuboisAEJ, KollenBJ, Tijmens-van derHulst J, Flokstra-deBlok BMJ, VrijlandtEJLE. Development and construct validation of a parent-proxy quality of life instrument in children with bronchopulmonary dysplasia aged 4–8 years old. Qual Life Res [Internet]. 2019;28(2):523–33. Available from: 10.1007/s11136-018-2029-730350255 PMC6373528 doi:10.1007/s11136-018-2029-7 PubMed
  78. KayDJ, RosenfeldRM. Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg. 2003;128(1):17–26. doi: 10.1067/mhn.2003.41 12574754 doi:10.1067/mhn.2003.41 PubMed
  79. Anderson-JamesS, NewcombePA, MarchantJM, TurnerCT, ChangAB. Children’s acute cough-specific quality of life: revalidation and development of a short form. Lung. 2021;199(5):527–34. doi: 10.1007/s00408-021-00482-2 34623514 doi:10.1007/s00408-021-00482-2 PubMed
  80. VerstraeteJ, ScottD. Comparison of the EQ-5D-Y-5L, EQ-5D-Y-3L and PedsQL in children and adolescents. J Patient Rep Outcomes. 2022;6(1):67. doi: 10.1186/s41687-022-00480-9 35708825 PMC9203648 doi:10.1186/s41687-022-00480-9 PubMed
  81. NgwiraLG, MaheswaranH, PetrouS, NiessenLW, SmithSC. Cross-cultural adaptation and psychometric validation of the Chichewa (Malawi) PedsQLTM 4.0 Generic Core Scales child self-report and PedsQLTM 4.0 GCS teen self-report. J Patient-Reported Outcomes. 2024; 8(1).10.1186/s41687-024-00761-5PMC1138756039254899 doi:10.1186/s41687-024-00761-5 PubMed
  82. QuittnerAL, ModiA, CruzI. Systematic review of health-related quality of life measures for children with respiratory conditions. Paediatr Respir Rev. 2008;9(3):220–32. doi: 10.1016/j.prrv.2008.05.003 18694714 doi:10.1016/j.prrv.2008.05.003 PubMed
  83. VarniJW, BurwinkleTM, SeidM. The PedsQL 4.0 as a school population health measure: feasibility, reliability, and validity. Qual Life Res. 2006;15(2):203–15. doi: 10.1007/s11136-005-1388-z 16468077 doi:10.1007/s11136-005-1388-z PubMed

Attribution. Michaile Gizelle Anthony, Graeme Hoddinott, Dzunisani Patience Baloyi, Anneke Catharina Hesseling, Marieke Margreet van der Zalm. Identifying candidate items for a health-related quality of life measure in young children with respiratory illness: A scoping review of generic and disease-specific measures. PLOS One (2025);20(5). doi:10.1371/journal.pone.0322493 © 2025 Anthony et al Licensed under CC BY 4.0. Reproduced from the open-access article via Europe PMC (PubMed 40323923). Text, tables and references reproduced from the open-access article; figures and images are not reproduced and no wording was changed.

About this article

Journal
PLOS One
Year
2025
Licence
CC BY 4.0
Source
Europe PMC
PubMed
40323923
Field
Respiratory Medicine

EvidenceLib is a research-education resource, not medical advice. It does not diagnose, prescribe or recommend starting, stopping or changing any treatment. Talk to a qualified clinician about your own situation. Methods, sources and licences · Rights and removal requests · Legal · Support