GCQ - Generic Children’s Quality of Life Measure
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Authors
Jacqueline Collier, PhD and Dorothy MacKinlay, DipClinPsy
Used for
Providing a child-centred measure of children's quality of life.
Suitable for
6 to 14 years.
Description
The Generic Children’s Quality of Life Measure (GCQ) is used to assess perceived quality of life in children between the ages of 6 and 14 years. It has been designed to be used not only with children who have specific health or social difficulties but also with children in the general population. The GCQ is not disease-centred, symptom-oriented or problem-specific. Instead it focuses on areas that are of interest to all children such as family, peer relationships and school.
The GCQ is suitable for a broad range of applications:
- as a starting point for dialogue when a child appears to have quality of life issues but has difficulty expressing or articulating these
- as an exploratory tool when there is concern or uncertainty about how an illness or disability or course of therapy may be affecting a child
- for clinical or research settings as an adjunct to medical therapy.
The fact that it is suitable for use over a considerable development period means that the GCQ can be used to compare children across age groups or for studies of children over long periods of time.
The GCQ is a particularly child-centred measure both in terms of its use of child-friendly words, concepts and layout and in terms of the focus of its measurement. Rather than being based on factors that adults perceive as positive living, it is based on factors that children report as influences on the quality of their lives. This is an important benefit since measures that are based on adult perceptions about what affects life quality rarely make sense to children.
The GCQ has an inviting layout. It is based around a story that describes five children all chatting about different things. No character in the story is indicated as being better than the others and they all have different views. There are two versions of the item booklet: one for boys and one for girls. The only difference is the gender of the five characters (all girls or all boys). In the first section of the questionnaire, the child is asked to respond to each topic of conversation by choosing the character in the story that he/she feels the most like. In the second section, the child is presented with each topic again but this time responds by choosing the character that he/she would most like to be. These two types of response form the basis for the ‘Perceived-Self’ score and the ‘Preferred-Self’ score. Discrepancies between the totals of the two types of score are used to indicate the child’s overall perception of his or her quality of life.
The GCQ can be administered directly to children from 6 to 14 years old and has been used with children below this age range. Based on the Flesch Reading Ease formula (Flesch 1948) the GCQ is graded at 3.1 which is equivalent to the average reading level of a child of eight years. So children below this age will need particularly close supervision with help to understand and respond to the items.
The obtained raw scores are converted to T-scores and/or percentiles (using lookup tables) so that normative comparisons can be made. In addition to the discrepancy score as an indication of overall reported quality of life, the standard scores for the Perceived-Self and Preferred-Self can provide additional information. For example where the discrepancy between them is small but they are both low compared to the norm group there may be issues about low expectations in relation to life quality.
Responses to individual items can also be explored to help refine interpretation of the overall score profile.
Reliability
Internal consistency (Cronbach’s alpha):
| Perceived-Self Scale | 0.74 |
| Preferred-Self scale | 0.84 |
| Quality of Life Scale | 0.78 |
Validity
Content and face validity is supported by the fact that the GCQ items are based on factors children report as affecting their quality of life. The items broadly fit Eiser's (1994) investigation of what children mean by quality of life.
Principal components factor analysis suggested a one factor solution as most appropriate.
Construct validity is based on the hypothesis that a child's quality of life is directly related to satisfaction with life. The correlation between the general life satisfaction item and the overall score for quality of life is 0.50 which supports construct validity on this basis.
Norms
The GCQ norms are based on a sample of 720 children (350 boys and 370 girls) with representation across the age range of 6 to 14 years. The sample was obtained from schools which were selected for four geo-economic categories: rural affluent, rural low affluence communities, urban affluent and urban low affluence communities. Furthermore the individual postcodes of the children were used to identify the enumeration district (Census Office boundaries) for each child. This was then used to obtain the Jarman deprivation score for each child's living area. The sample showed a normal distribution of scores across all three scales. No significant differences were found between groups on the basis of gender or geo-economic category.
Duration
10 to 30 minutes depending on the child's reading ability.
Languages
English
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