Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.
Qual Life Res. 2020 Aug;29(8):2171-2181. doi: 10.1007/s11136-020-02472-y. Epub 2020 Mar 13.
Consideration of health-related quality of life (HRQoL) and wellbeing outcomes is important to guide healthcare services for youth with obesity, yet youth perspectives may differ from their parents. This study compared youth and parental HRQoL reports and evaluated levels of concordance across HRQoL domains and as a function of youth age, youth gender and parent informant (mother and father).
376 youths with obesity, recruited from community (N = 223) and hospital settings (N = 153), and their parents (N = 190 mothers; N = 91 fathers), completed the PedsQL. Parental and youth agreement across subgroup dyads (mother; father; child gender; child age) were evaluated using Wilcoxon signed-rank test, intra-correlations coefficients (ICCs) and Bland-Altman plots.
Compared to norms, HRQoL levels (youth self-report and parental proxy reports) were lower in all domains. Both mother and fathers' HRQoL reports were significantly lower than youths, most notably in physical HRQoL. Youth-parent concordance ranged from poor to moderate (ICC = 0.230-0.618), with lowest agreement for Physical HRQOL. Mothers were better proxies with ICCs being significant in all domains. Youth-father ICCs were significant only for Social (ICC = 0.428) and School (ICC = 0.303) domains. Girl-mother agreement was significant across all domains, while girl-father agreement was significant only in the Social domain (ICC = 0.653). Both mothers and fathers were poor raters for boys, and younger youths (aged ≤ 12), with non-significant ICCs in most HRQoL domains.
Parents are poor surrogates for youth HRQoL. Clinicians should be cognizant that parents are not necessarily accurate proxies for youths, and exercise caution when interpreting parent-proxy scores.
考虑与健康相关的生活质量（HRQoL）和幸福感结果对于指导肥胖青少年的医疗保健服务很重要，但青少年的观点可能与他们的父母不同。本研究比较了青少年和父母的 HRQoL 报告，并评估了 HRQoL 各领域的一致性水平，以及青少年年龄、性别和父母信息提供者（母亲和父亲）的功能。
从社区（N=223）和医院环境（N=153）招募了 376 名肥胖青少年及其父母（N=190 位母亲；N=91 位父亲），并完成了 PedsQL。使用 Wilcoxon 符号秩检验、组内相关系数（ICC）和 Bland-Altman 图评估了亚组对偶（母亲；父亲；儿童性别；儿童年龄）中父母和青少年的一致性。
与正常水平相比，所有领域的 HRQoL 水平（青少年自我报告和父母代理报告）均较低。母亲和父亲的 HRQoL 报告均明显低于青少年，尤其是在身体 HRQoL 方面。青少年与父母的一致性程度从差到中等（ICC=0.230-0.618），身体 HRQOL 的一致性最低。母亲是更好的代理，在所有领域的 ICC 均有意义。青少年与父亲的 ICC 仅在社会（ICC=0.428）和学校（ICC=0.303）领域有意义。女孩与母亲的一致性在所有领域都有意义，而女孩与父亲的一致性仅在社会领域（ICC=0.653）有意义。母亲和父亲都是男孩的糟糕评估者，对于年龄较小的青少年（≤12 岁），在大多数 HRQoL 领域的 ICC 均无意义。
父母是青少年 HRQoL 的不良替代品。临床医生应该意识到，父母不一定是青少年的准确代表，在解释父母代理评分时应谨慎。
