Refinement of the Children's International Mucositis Evaluation Scale (ChIMES): child and parent perspectives on understandability, content validity and acceptability

Eur J Oncol Nurs. 2010 Feb;14(1):29-41. doi: 10.1016/j.ejon.2009.10.004. Epub 2009 Dec 1.


Purpose: A new paediatric mucositis assessment instrument, the Children's International Mucositis Evaluation Scale (ChIMES), has required several phases of development. A draft of ChIMES was developed that required further refinement. This paper describes two iterations of refinements of ChIMES using child and parent reporting of understandability, content validity and overall acceptability.

Methods: Parents, children and teenagers were asked to rate their opinion of understandability and overall acceptability of ChIMES on a five-point ordinal scale. Content validity was assessed by whether participants considered the instrument "good", "okay" or "bad". Descriptive analysis of the results was conducted.

Results: One hundred and twenty-two participants evaluated two iterations. On the initial evaluation, ChIMES was considered easy to understand, acceptable and have content validity. However, minor amendments were required and a further iteration of testing was necessary to achieve a satisfactory instrument. A final version of ChIMES was developed.

Conclusion: Modification of each draft of ChIMES was performed until comments were minimal and the scores from participants were consistently high. A final instrument appeared to contain the correct content and was easy to understand by parents, older children and teenagers.

Publication types

  • Comparative Study
  • Evaluation Study
  • Validation Study

MeSH terms

  • Adolescent
  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Attitude to Health
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Mucositis / chemically induced*
  • Mucositis / epidemiology
  • Mucositis / physiopathology
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy*
  • Neoplasms / psychology
  • Pain Measurement / standards*
  • Parent-Child Relations
  • Psychometrics
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Factors