A new measure of excessive parental worries about children’s health: development of the Health Anxiety by Proxy Scale (HAPYS)

Objective
Health anxiety by proxy is a newly introduced term to describe parents’ experience of excessive and unpleasant worries about their child’s health. This article describes the development of a new measure, the Health Anxiety by Proxy Scale (HAPYS), for systematic assessment of health anxiety by proxy.

Method
The development of the HAPYS was performed over three phases. (1) Patients clinically assessed to have health anxiety by proxy participated in semi-structured interviews to elaborate their experience of worries regarding their child's health and their related behaviours, and to examine the face validity of items in an existing questionnaire: ‘Illness Worry Scale – parent version’. (2) Based on the findings from Phase 1 the project group and a panel of experts selected and formulated questionnaire items and scoring formats. (3) The HAPYS was pilot-tested twice using cognitive interviewing with healthy parents and parents with health anxiety by proxy followed by further adjustments.

Results
The final version of HAPYS consists of 26 items characteristic of health anxiety by proxy and of an impact section with five items.

Conclusion
Based on the pilot testing the HAPYS showed good face and content validity. It holds the potential to be a valid questionnaire to help clinicians across health care settings assess parents suffering from health anxiety by proxy.