Abstract
BackgroundThe aim of this study is to quantify the level of agreement between self-reporting and proxy-assessment of children's health-related quality of life using KINDL-R in a large population based study in Germany and to identify factors which are associated with agreement.MethodsThe German Health Interview and Examination Survey for Children and Adolescents included the KINDL-R questionnaire on health-related quality of life. 6388 children and adolescents filled in the questionnaire while their parents answered the proxy version. Means and standard deviation for the self- and proxy ratings, and also the Pearson und Intra-Class correlation coefficients for the absolute agreement were calculated. The relationship between other variables and parent-child agreement were determined by means of logistic regression.ResultsIn the 'Physical', 'Self-esteem' and 'School' dimension and for the 'Total' score, the parents significantly overestimated the quality of life of their child. In contrast, the quality of life of the children in the dimensions 'Psychological well-being' and 'Family' were considerably underestimated by the parents. The proportion of parent-child ratings in agreement (difference < 0.5 standard deviations) ranges from 34.9% for the 'Self-esteem' scale to 51.9% in the 'Psychological' scale. The most important factor explaining parents rating was the level of the child's self-assessment followed by the parent's assessment of the subjective health, or reported emotional abnormalities.ConclusionsOur study shows that parental reports cannot adequately replace self-assessment for 11-17 year olds. In view of the different underlying perspectives, the parental assessments should where possible only be regarded as providing supplementary information.
Highlights
The aim of this study is to quantify the level of agreement between self-reporting and proxyassessment of children’s health-related quality of life using KINDL-R in a large population based study in Germany and to identify factors which are associated with agreement
‘Friends’ is the only dimension for which the parental assessment switches with age between too low and too high
The parents gave the 11-13 year-olds a lower quality of life whereas for the 14-17 year-olds they reported a higher quality of life
Summary
The aim of this study is to quantify the level of agreement between self-reporting and proxyassessment of children’s health-related quality of life using KINDL-R in a large population based study in Germany and to identify factors which are associated with agreement. In recent years, increasing importance has been attached to health-related quality of life (HRQoL) in child and adolescent medicine. Solans et al [2] identified 30 generic and 64 diseasespecific instruments to register the quality of life of children and adolescents. Some generic as well as some disease-specific instruments draw only on the selfreporting of the children and adolescents. A number of instruments (43% of generic instruments and 30% of disease-specific ones) have versions both for parental (proxy) assessment and self-assessment. Some methods are based solely on information provided by parents
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