Klassen A F, Miller A, Fine S
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Child Care Health Dev. 2006 Jul;32(4):397-406. doi: 10.1111/j.1365-2214.2006.00609.x.
There is little information in the research literature of agreement between parent and child in reports of child quality of life (QOL) for a sample of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The aim of our study was to determine whether parent and child concordance is greater for physical domains of QOL than for psychosocial domains; whether parents rate their child's QOL better or poorer than their child's ratings; and whether concordance is related to demographic, socioeconomic or clinical factors.
The study was a questionnaire survey of children aged 10-17 referred to the ADHD clinic and diagnosed with ADHD in the province of British Columbia (Canada) between November 2001 and October 2002 and their parent.
Fifty-eight children diagnosed with ADHD and their parents completed our study questionnaire. The main outcome measure was the Child Health Questionnaire, which permitted comparisons on eight QOL domains and one single item. Intraclass correlation coefficients were moderate for five domains (range from 0.40 to 0.51), and good for three domains (range from 0.60 to 0.75). Children rated their QOL significantly better than their parents in four areas and poorer in one. Standardized Response Means indicated clinically important differences in mean scores for Behaviour and Self-esteem. Compared with population norms, across most domains, children with ADHD reported comparable health. Discrepancies between parent-child ratings were related to the presence of a comorbid oppositional/defiant disorder, a psychosocial stressor and increased ADHD symptoms.
Although self-report is an important means of eliciting QOL data, in children with ADHD, given the discrepancies in this study between parent and child report, measuring both perspectives seems appropriate.
在研究文献中，关于被诊断为注意力缺陷多动障碍（ADHD）的儿童样本的生活质量（QOL）报告中，父母与孩子之间的一致性信息很少。我们研究的目的是确定生活质量的身体领域方面，父母与孩子的一致性是否高于心理社会领域；父母对孩子生活质量的评分是高于还是低于孩子自己的评分；以及一致性是否与人口统计学、社会经济或临床因素有关。
该研究是一项问卷调查，对象是2001年11月至2002年10月间被转介到不列颠哥伦比亚省（加拿大）ADHD诊所并被诊断为ADHD的10至17岁儿童及其父母。
58名被诊断为ADHD的儿童及其父母完成了我们的研究问卷。主要结局指标是儿童健康问卷，该问卷允许对八个生活质量领域和一个单项进行比较。五个领域的组内相关系数为中等（范围从0.40至0.51），三个领域为良好（范围从0.60至0.75）。在四个方面，儿童对自己生活质量的评分显著高于父母，在一个方面则低于父母。标准化反应均值表明，行为和自尊方面的平均得分存在临床上的重要差异。与总体标准相比，在大多数领域，患有ADHD的儿童报告的健康状况相当。亲子评分之间的差异与共病对立违抗障碍、心理社会应激源以及ADHD症状增加有关。
尽管自我报告是获取生活质量数据的重要手段，但在患有ADHD的儿童中，鉴于本研究中父母与孩子报告之间存在差异，同时测量双方的观点似乎是合适的。
