Development, Reliability, and Validity of the Children's Questions about Death Scale

Abstract

Most measures of parent-child communication about death are specific only to families of chronically ill children. In contrast, The Children's Questions About Death Scale (CQADS) was constructed to assess how effectively mothers respond to questions about death that their healthy children are likely to ask them. The CQADS originated from a pool of 237 questions that mothers ( N = 116) reported they had been asked by their children regarding death. Final item selection was determined by categorizing the questions using four categories (essence, intentionality, loss of relationship, and self-oriented) and selecting a representative set of four items in each category that demonstrated adequate response variability and inter-rater agreement. The scoring criteria for the CQADS were established on the basis of expert opinion in the literature. Operationally defined scoring criteria were developed so that mothers' written responses to each of the questions on the CQADS could be rated for effectiveness on a scale from 1 ( not at all effective) to 5 ( very effective). Total scores could range from 16 to 80, with higher scores indicating greater effectiveness in responding to children's questions about death. The CQADS has excellent test-retest reliability ( r = .95, p < .05), and inter-rater reliability greater than .80.