Schulte Fiona, Wurz Amanda, Reynolds Kathleen, Strother Douglas, Dewey Deborah
Division of Hematology Oncology Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada.
Department of Oncology and Paediatrics, University of Calgary, Alberta, Canada.
Pediatr Blood Cancer. 2016 Apr;63(4):677-83. doi: 10.1002/pbc.25868. Epub 2016 Jan 6.
To examine the discrepancy between survivor-parent and sibling-parent reports of health-related quality of life (HRQL) and the level of agreement (i.e., correlation) between child reports (i.e., survivor and sibling) and parent-proxy reports of HRQL.
Fifty-one families participated. Pediatric cancer survivors (49% male; 6-18 years of age) and one sibling (47% male; 9-18 years of age) completed a measure of their HRQL. As well, one parent (14% male; 27-65 years of age) from each family completed a proxy report of their children's (i.e., survivor and sibling) HRQL. Consensus was determined through discrepancy and agreement scores, between parent-proxy and children's (i.e., survivors and siblings) self-reports of total HRQL, and physical, emotional, social, and school functioning subscales.
Repeated-measures analysis of variance (ANOVA) revealed significant group differences for total HRQL (F = 6.79, P ≤ 0.01). Repeated-measure ANOVAs of subscale discrepancy scores revealed significant group differences for physical functioning scores (F = 6.39, P < 0.01). A significant interaction was also found for social functioning when age at diagnosis was considered as a covariate (F = 10.30, P < 0.01). Zero-order and intraclass correlation coefficients revealed different levels of agreement between parent and child reports. Specifically, there was poorer agreement between parent-proxy and sibling's self-reports, particularly on social and emotional subscales.
Discrepancy and agreement are both important indices to consider when examining consensus between parent-proxy and child self-reports. The findings from this study have important implications for future research and suggest that the impact of cancer on siblings should be further investigated.
考察癌症幸存者-父母与同胞-父母在健康相关生活质量（HRQL）报告上的差异，以及儿童报告（即幸存者和同胞）与父母代理报告之间的一致程度（即相关性）。
51个家庭参与研究。儿科癌症幸存者（49%为男性；6 - 18岁）和一名同胞（47%为男性；9 - 18岁）完成了一份HRQL测量量表。此外，每个家庭的一位家长（14%为男性；27 - 65岁）完成了一份关于其子女（即幸存者和同胞）HRQL的代理报告。通过差异得分和一致得分来确定父母代理报告与儿童（即幸存者和同胞）自我报告的总HRQL以及身体、情感、社会和学校功能子量表之间的一致性。
重复测量方差分析（ANOVA）显示，总HRQL存在显著的组间差异（F = 6.79，P≤0.01）。子量表差异得分的重复测量方差分析显示，身体功能得分存在显著的组间差异（F = 6.39，P < 0.01）。当将诊断时的年龄作为协变量考虑时，社会功能方面也发现了显著的交互作用（F = 10.30，P < 0.01）。零阶和组内相关系数显示了父母与儿童报告之间不同程度的一致性。具体而言，父母代理报告与同胞自我报告之间的一致性较差，尤其是在社会和情感子量表上。
在考察父母代理报告与儿童自我报告之间的一致性时，差异和一致性都是需要考虑的重要指标。本研究结果对未来研究具有重要意义，并表明癌症对同胞的影响应进一步研究。
