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      Child-rated versus parent-rated quality of life of community-based obese children across gender and grade

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          Abstract

          Background

          Quality of life (QoL), which can be examined using self-reports or parental reports, might help healthcare providers understand obese children’s subjective well-being in several domains of life. Community-based obese children report their QoL lower than their parents do. However, the differences between child- and parent-reported QoL have neither been tested across gender and grade nor analyzed by item. This study probed the relationship between obesity and QoL item scores in children, and compared child-reported with parent-reported QoL stratified by gender and grade.

          Methods

          One hundred eighty-seven dyads of 8- to 12-year-old children (60 obese, 127 normal-weight) and their parents were recruited. QoL was assessed using both child- and parent-reported Pediatric Quality of Life Inventory 4.0 (PedsQL) questionnaires.

          Results

          Regression analyses showed specific difficulties with physical and emotional QoL in third- and fourth-grade obese boys (β = 0.278-0.620), and specific problems with social functioning in fifth- and sixth-grade obese girls (β = 0.337-0.411). Moreover, parents seemed unaware of the specific difficulties that their children faced (β = 0.274-0.435).

          Conclusions

          Obese children seemed to have their difficulties from third to fifth grade, respectively, and their parents seemed unaware of them. Thus, parents need to be more aware of specific difficulties related to childhood obesity.

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          Most cited references35

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          Health-related quality of life of severely obese children and adolescents.

          Jeffrey B. Schwimmer, Tasha Burwinkle, James Varni (2003)
          One in 7 US children and adolescents is obese, yet little is known about their health-related quality of life (QOL). To examine the health-related QOL of obese children and adolescents compared with children and adolescents who are healthy or those diagnosed as having cancer. Cross-sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years (mean [SD], 12.1 [3] years), who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002. Children and adolescents had a mean (SD) body mass index (BMI) of 34.7 (9.3) and BMI z score of 2.6 (0.5). Child self-report and parent proxy report using a pediatric QOL inventory generic core scale (range, 0-100). The inventory was administered by an interviewer for children aged 5 through 7 years. Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer. Compared with healthy children and adolescents, obese children and adolescents reported significantly (P<.001) lower health-related QOL in all domains (mean [SD] total score, 67 [16.3] for obese children and adolescents; 83 [14.8] for healthy children and adolescents). Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents (odds ratio [OR], 5.5; 95% confidence interval [CI], 3.4-8.7) and were similar to children and adolescents diagnosed as having cancer (OR, 1.3; 95% CI, 0.8-2.3). Children and adolescents with obstructive sleep apnea reported a significantly lower health-related QOL total score (mean [SD], 53.8 [13.3]) than obese children and adolescents without obstructive sleep apnea (mean [SD], 67.9 [16.2]). For parent proxy report, the child or adolescent's BMI z score was significantly inversely correlated with total score (r = -0.246; P =.01), physical functioning (r = -0.263; P<.01), social functioning (r = -0.347; P<.001), and psychosocial functioning (r = -0.209; P =.03). Severely obese children and adolescents have lower health-related QOL than children and adolescents who are healthy and similar QOL as those diagnosed as having cancer. Physicians, parents, and teachers need to be informed of the risk for impaired health-related QOL among obese children and adolescents to target interventions that could enhance health outcomes.
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            The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity.

            James Varni, Tasha Burwinkle, Michael Seid … (2003)
            The application of health-related quality of life (HRQOL) as a pediatric population health measure may facilitate risk assessment and resource allocation, the tracking of community health, the identification of health disparities, and the determination of health outcomes from interventions and policy decisions. To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a measure of pediatric population health for children and adolescents. Mail survey in February and March 2001 to 20 031 families with children ages 2-16 years throughout the State of California encompassing all new enrollees in the State's Children's Health Insurance Program (SCHIP) for those months and targeted language groups. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 10 241 families through a statewide mail survey to evaluate the HRQOL of new enrollees in SCHIP. The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha =.89 child;.92 parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was also related to indicators of health care access, days missed from school, days sick in bed or too ill to play, and days needing care. The results demonstrate the feasibility, reliability, and validity of the PedsQL 4.0 as a pediatric population health outcome. Measuring pediatric HRQOL may be a way to evaluate the health outcomes of SCHIP.
            Article 0 comments Cited 304 times – based on 0 reviews     Review now
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              Parent-child agreement across child health-related quality of life instruments: a review of the literature.

              Penney Upton, Joanne Lawford, Christine Eiser (2008)
              To systematically review the literature published since 1999 on paediatric health-related quality of life (HRQL) in relation to parent-child agreement. Literature searches used to identify studies which evaluated parent-child agreement for child HRQL measures. Nineteen studies were identified, including four HRQL instruments. The Pediatric Quality of Life Inventory (PedsQL) was most commonly used. Differences in parent-child agreement were noted between domains for different measures. The impact of child and parent characteristics were not consistently considered; however parents of children in a nonclinical sample tended to report higher child HRQL scores than children themselves, while parents of children with health conditions tended to underestimate child HRQL. Despite increasing numbers of studies considering children's HRQL, information about variables contributing to parent-child agreement levels remains limited. Authors need to consistently provide evidence for reliability and validity of measures, and design studies to systematically investigate variables that impact on levels of parent-child agreement.
              Article 0 comments Cited 192 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Chia-Ting Su
                Jung-Der Wang
                Chung-Ying Lin
                Journal
                Journal ID (nlm-ta): Health Qual Life Outcomes
                Journal ID (iso-abbrev): Health Qual Life Outcomes
                Title: Health and Quality of Life Outcomes
                Publisher: BioMed Central
                ISSN (Electronic): 1477-7525
                Publication date Collection: 2013
                Publication date (Electronic): 10 December 2013
                Volume: 11
                Page: 206
                Affiliations
                [1 ]Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
                [2 ]Institute of Public Health, College of Medicine, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan
                [3 ]Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
                [4 ]Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
                Article
                Publisher ID: 1477-7525-11-206
                DOI: 10.1186/1477-7525-11-206
                PMC ID: 4029491
                PubMed ID: 24325683
                SO-VID: 5bb18728-75c0-4969-8f66-82c2b900c1c7
                Copyright © Copyright © 2013 Su et al.; licensee BioMed Central Ltd.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 23 June 2013
                Date accepted : 3 December 2013
                Categories
                Subject: Research

                ScienceOpen disciplines: Health & Social care
                Keywords: obese,pediatric,quality of life,self-report,proxy report
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: obese, pediatric, quality of life, self-report, proxy report

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