Quality of life measure for children with Epilepsy: A psychometric evaluation of the Italian version

OBJECTIVE: To report on the Italian validation of the Child Epilepsy Quality of Life Questionnaire (CHEQOL-25), including both the child self-report and parent-proxy versions. METHODS: The validation procedure was conducted at a single Italian centre between July 2024 and July 2025, involving 252 children with epilepsy and their parents. A forward-backward translation process was carried out in line with established best-practice guidelines. Data collection included family interviews and medical chart reviews. Psychometric evaluation covered reliability and validity. RESULTS: All items exceeded the accepted thresholds (≥ 0.78) for both content validity and comprehensibility. The factor structure closely replicated the original five-factor model, with certain items showing stronger loadings than the original study within the Interpersonal/Social and Intrapersonal/Emotional domains in both related versions. The Secrecy factor showed greater variability (h² = 0.06-.83), possibly reflecting differences in parental interpretation or their sensitivity to the epilepsy concealment. Children who engaged in playful activities scored higher across most subscales, particularly in the Interpersonal/Social and the Quest for Normality domains of the self-report version. Importantly, children not receiving school support reported higher scores across several subscales, suggesting fewer perceived psychosocial challenges. Agreement between child self-reports and parent proxy-reports ranged from moderate to strong (ICC = 0.53-.71). CONCLUSIONS: The Italian version of the CHEQOL-25 measure demonstrates strong psychometric properties (consistent with the original version) and reinforces the value of assessing quality of life in children with epilepsy across diverse cultural contexts.