Quality of Life Research

, Volume 23, Issue 3, pp 927–938 | Cite as

Validity, reliability and discriminative capacity of an electronic quality of life instrument (Pelican) for childhood asthma in the Netherlands

  • S. van Bragt
  • L. van den Bemt
  • B. Thoonen
  • J. Jacobs
  • P. Merkus
  • T. Schermer



To assess psychometric properties of the Pelican instrument, an online Dutch self-administered Quality of Life instrument for childhood asthma for scientific and clinical use.


A cohort study was done in two asthma populations and healthy children. One asthma population had assessment at start, 4 and 8 weeks. The other asthma population and healthy children had one assessment. All children were aged 6–12 years. Children completed the Pelican instrument, Paediatric Asthma Quality of Life Questionnaire, feeling thermometer and Childhood Asthma Control Test. Lung function and fraction exhaled nitric oxide were measured. Parents completed Functional Status II, Asthma Control Questionnaire, Childhood Asthma Control Test questionnaires and symptom diaries. We assessed interpretability, structural validity, internal consistency, reliability, construct and discriminative validity of the Pelican instrument.


Eighty-five asthmatic (mean age 8.5 years) and 49 healthy children (mean age 8.4 years) participated. The Pelican instrument has 5 domains with 21 items after factor analysis. Internal consistency was 0.89 (CI 0.85–0.92), domain reliability showed Cronbach’s α’s from 0.64 to 0.76 and item-to-scale correlations from 0.61 to 0.81. Test–retest reliability was confirmed ICC = 0.88 (CI 0.79–0.93). Construct validity was demonstrated by significant moderate correlations with other relevant asthma outcomes like PAQLQ (r = −0.59, p < 0.01). Discriminative capacity between controlled or uncontrolled asthma (t = 3.20, p < 0.01, Δ = 0.64) and asthma versus healthy subjects (t = 6.31, p < 0.01, Δ = 0.94) was found.


The psychometric properties of the Pelican instrument were acceptable in Dutch paediatric asthma patients between 6 and 12 years old.


Psychometric properties Asthma Children Health-related Quality of Life (HRQL) Reliability Validity 



Asthma Control Questionnaire


American Thoracic Society


Childhood Asthma Questionnaire


Childhood Asthma Control Test


Child Behaviour Checklist for children aged 6–18 years


European Respiratory Society


Fraction exhaled Nitric Oxide


Forced expiratory volume in one second


Functional Status II


Forced vital capacity


General practitioner


How Are You


Health-related quality of life


Inter-class correlation


Paediatric Asthma Quality of Life Instrument


Paediatric Electronic quality of Life Instrument for Childhood Asthma instrument in the Netherlands


Pediatric Quality of Life Inventory



This study was financially supported by the Dutch Lung Foundation (previously Dutch Asthma Foundation). The authors would like to thank all participating children and their parents. We are also grateful to all general practitioners, pharmacists and others who helped recruiting participants and to J. Braspenning, V. Hulsman and P. Madge for the English translation process of the Pelican instrument. Moreover, we would like to thank the ‘Stichting Huisartsenlaboratorium’ (SHL), a regional diagnostic centre, for their help with the data collection. A special thanks goes to Nicol Orbon and Joke Grootens who managed the data collection of this study. Finally, we would like to thank Amadea Gloudemans (AG) and Sabine Wendt (SW), who interviewed the children and helped coding and analysing the interviews with participating children.

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • S. van Bragt
    • 1
  • L. van den Bemt
    • 1
  • B. Thoonen
    • 1
  • J. Jacobs
    • 2
  • P. Merkus
    • 3
  • T. Schermer
    • 1
  1. 1.Department of Primary and Community CareRadboud University Nijmegen Medical Centre (RUNMC)NijmegenThe Netherlands
  2. 2.IQ Health CareRadboud University Nijmegen Medical Centre (RUNMC)NijmegenThe Netherlands
  3. 3.Division of Respiratory Medicine, Department of PaediatricsRadboud University Nijmegen Medical Centre (RUNMC)NijmegenThe Netherlands

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