Abstract
This study examines the association between perceptions of primary caregivers (parent-report) and children (self-report) on their quality of life (QoL) at pre-school age. We also aimed to analyze the health, sociodemographic, and developmental predictors that better explain their QoL. The study comprised 83 healthy children, who attended public kindergarten, with a mean of five years of age, as well as their primary caregivers. The Autoquestionnaire Qualité de Vie Enfant Imagé-AUQEI assessed the self-reported QoL and the Child Health Questionnaire-50 Parent Form-CHQ-PF50 evaluated the parent-reported QoL. Additionally, the Denver II test assessed the child psychomotor development. The multivariate analysis was performed to identify predictive models of QoL reported by parents and children. The significance level was 5%. Fifty children (72%) reported satisfactory QoL according to their self-report (AUQEI). The primary caregivers also reported good QoL in their children (mean scores >70 in all CHQ-PF50 domains). The correlations between the AUQEI and CHQPF50 scores were weak and not significant. There was no significant prediction model of self-reported QoL. However, the worst parent-reported levels of QoL were predicted by female gender, higher frequency of hospitalization, medication use, personal-social development at risk, and school difficulties. The perceptions of the primary caregivers and the children about their QoL at preschool age were not associated. The health, sociodemographic, and developmental indicators were related in a different way with each source of information. None of these indicators explained the self-reported QoL, whereas current health and development indicators predicted the parent-reported QoL.
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ABEP. Associação Brasileira de Empresas de Pesquisa. (2012). Dados com base no Levantamento Sócio Econômico 2011 (Brazilian Association of Research Companies Questionnaire. Data based on the Socio-Economic Survey 2011). Available at: http://www.abep.org/. Accessed 02 Jul 2012.
Akel, B. S., Oksuz, C., Oskay, D., Firat, T., Tarakci, E., & Leblebicioglu, G. (2013). Health-related quality of life in children with obstetrical brachial plexus palsy. Quality of Life Research, 22(9), 2617–2624. https://doi.org/10.1007/s11136-013-0369-x.
Assumpção Jr., F. B., Kuczynski, E., Sprovieri, M. H., & Aranha, E. M. G. (2000). Escala de avaliação de qualidade de vida: (AUQEI - Autoquestionnaire Qualité de Vie Enfant Imagé) validade e confiabilidade de uma escala para qualidade de vida em crianças de 4 a 12 anos. Arquivos de Neuro-Psiquiatria, 58(1), 119–127. https://doi.org/10.1590/S0004-282X2000000100018.
Barreire, S. G., Oliveira, O. A., Kazama, W., Kimura, M., & Santos, V. L. (2003). Quality of life of children with stomas: The children and mothers' point of view. Jornal de Pediatria (Rio de Janeiro), 79(1), 55–62.
Batalha, L. M. C., Fernandes, A. M., Campos, C., Batalha, L. M. C., Fernandes, A. M., & Campos, C. (2015). Qualidade de vida em crianças com câncer: concordância entre crianças e pais. Escola Anna Nery Revista de Enfermagem, 19(2), 292–296. https://doi.org/10.5935/1414-8145.20150039.
Brasil. Ministério da Saúde. (2012). Saúde da criança: crescimento e desenvolvimento. Ministério da Saúde, Brasília, DF. Brasil. (33). Available at: http://bvsms.saude.gov.br/bvs/publicacoes/saude_crianca_crescimento_desenvolvimento.pdf. Accessed 20 Jan 2013.
Bullinger, M., Brutt, A. L., Erhart, M., & Ravens-Sieberer, U. (2008). Psychometric properties of the KINDL-R questionnaire: Results of the BELLA study. European Child & Adolescent Psychiatry, 17(Suppl 1), 125–132. https://doi.org/10.1007/s00787-008-1014-z.
Bunge, E. M., Essink-Bot, M. L., Kobussen, M. P., van Suijlekom-Smit, L. W., Moll, H. A., & Raat, H. (2005). Reliability and validity of health status measurement by the TAPQOL. Archives of Disease in Childhood, 90(4), 351–358. https://doi.org/10.1136/adc.2003.048645.
Colver, A. (2009). Quality of life and participation. Developmental Medicine and Child Neurology, 51(8), 656–659. https://doi.org/10.1111/j.1469-8749.2009.03321.x.
Cremeens, J., Eiser, C., & Blades, M. (2006a). Characteristics of health-related self-report measures for children aged three to eight years: A review of the literature. Quality of Life Research, 15(4), 739–754. https://doi.org/10.1007/s11136-005-4184-x.
Cremeens, J., Eiser, C., & Blades, M. (2006b). Factors influencing agreement between child self-report and parent proxy-reports on the pediatric quality of life inventory 4.0 (PedsQL) generic core scales. Health and Quality of Life Outcomes, 4, 58. https://doi.org/10.1186/1477-7525-4-58.
Dancey, C. P., & Reidy, J. (2006). Estatística sem matemática para psicologia (3ed.). Porto Alegre: Artmed.
Danckaerts, M., Sonuga-Barke, E. J., Banaschewski, T., Buitelaar, J., Dopfner, M., Hollis, C., et al. (2010). The quality of life of children with attention deficit/hyperactivity disorder: A systematic review. European Child & Adolescent Psychiatry, 19(2), 83–105. https://doi.org/10.1007/s00787-009-0046-3.
Dey, M., Landolt, M. A., & Mohler-Kuo, M. (2013). Assessing parent-child agreement in health-related quality of life among three health status groups. Social Psychiatry and Psychiatric Epidemiology, 48(3), 503–511. https://doi.org/10.1007/s00127-012-0556-z.
Eiser, C., & Morse, R. (2001a). A review of measures of quality of life for children with chronic illness. Archives of Disease in Childhood, 84(3), 205–211.
Eiser, C., & Morse, R. (2001b). Can parents rate their child's health-related quality of life? Results of a systematic review. Quality of Life Research, 10(4), 347–357.
Eiser, C., & Varni, J. W. (2013). Health-related quality of life and symptom reporting: Similarities and differences between children and their parents. European Journal of Pediatrics, 172(10), 1299–1304. https://doi.org/10.1007/s00431-013-2049-9.
Espírito-Santo, H., & Daniel, F. B. (2015). Calcular e apresentar tamanhos do efeito em trabalhos científicos (1): As limitações do p < 0,05 na análise de diferenças de médias de dois grupos. (Artigo de Revisão). Revista Portuguesa de Investigação Comportamental e Social, 1(1), 3–16 http://rpics.ismt.pt/index.php/ISMT/article/view/14.
Fekkes, M., Theunissen, N. C., Brugman, E., Veen, S., Verrips, E. G., Koopman, H. M., et al. (2000). Development and psychometric evaluation of the TAPQOL: A health-related quality of life instrument for 1-5-year-old children. Quality of Life Research, 9(8), 961–972.
Frankenburg, W. K., Dodds, J., Archer, P., Shapiro, H., & Bresnick, B. (1992). The Denver II: A major revision and restandardization of the Denver developmental screening test. Pediatrics, 89(1), 91–97.
Galárraga, R. V., Aguilá, S. L., & Rajmil, L. (2009). Género y salud percibida en la infancia y la adolescencia en España. Gaceta Sanitaria, 23(5), 433–439. https://doi.org/10.1016/j.gaceta.2009.01.014.
Gaspar, T., Matos, M. G. d., Ribeiro, J. L. P., & Leal, I. (2006). Qualidade de vida e bem-estar em crianças e adolescentes. Revista Brasileira de Terapias Cognitivas, 2(2), 47–60.
Giacomoni, C. H., Souza, L. K. d., & Hutz, C. S. (2014). O conceito de felicidade em crianças. Psico-USF, 19(1), 143–153. https://doi.org/10.1590/S1413-82712014000100014.
Gkoltsiou, K., Dimitrakaki, C., Tzavara, C., Papaevangelou, V., Varni, J. W., & Tountas, Y. (2008). Measuring health-related quality of life in Greek children: Psychometric properties of the Greek version of the pediatric quality of life inventory(TM) 4.0 generic Core scales. Quality of Life Research, 17(2), 299–305. https://doi.org/10.1007/s11136-007-9294-1.
Hack, M., Forrest, C. B., Schluchter, M., Taylor, H. G., Drotar, D., Holmbeck, G., et al. (2011). Health status of extremely low-birth-weight children at 8 years of age: Child and parent perspective. Archives of Pediatrics & Adolescent Medicine, 165(10), 922–927. https://doi.org/10.1001/archpediatrics.2011.149.
HealthActCHQ. (2008). The CHQ scoring and interpretation manual. Cambridge: HealthActCHQ.
Houben-van Herten, M., Bai, G., Hafkamp, E., Landgraf, J. M., & Raat, H. (2015). Determinants of health-related quality of life in school-aged children: A general population study in the Netherlands. PLoS One, 10(5), e0125083. https://doi.org/10.1371/journal.pone.0125083.
Jardine, J., Glinianaia, S. V., McConachie, H., Embleton, N. D., & Rankin, J. (2014). Self-reported quality of life of young children with conditions from early infancy: A systematic review. Pediatrics, 134(4), e1129–e1148. https://doi.org/10.1542/peds.2014-0352.
Jozefiak, T., Larsson, B., Wichstrom, L., Mattejat, F., & Ravens-Sieberer, U. (2008). Quality of life as reported by school children and their parents: A cross-sectional survey. Health and Quality of Life Outcomes, 6, 34. https://doi.org/10.1186/1477-7525-6-34.
Klassen, A. F., Miller, A., & Fine, S. (2006). Agreement between parent and child report of quality of life in children with attention-deficit/hyperactivity disorder. Child: Care, Health and Development, 32(4), 397–406. https://doi.org/10.1111/j.1365-2214.2006.00609.x.
Klatchoian, D. A., Len, C. A., Terreri, M. T., Silva, M., Itamoto, C., Ciconelli, R. M., et al. (2008). Quality of life of children and adolescents from Sao Paulo: Reliability and validity of the Brazilian version of the pediatric quality of life inventory version 4.0 generic Core scales. Jornal Pediatria (Rio de Janeiro), 84(4), 308–315. https://doi.org/10.2223/JPED.1788.
Lack, C. W., Storch, E. A., Keeley, M. L., Geffken, G. R., Ricketts, E. D., Murphy, T. K., et al. (2009). Quality of life in children and adolescents with obsessive-compulsive disorder: Base rates, parent-child agreement, and clinical correlates. Social Psychiatry and Psychiatric Epidemiology, 44(11), 935–942. https://doi.org/10.1007/s00127-009-0013-9.
Machado, C. S., Ruperto, N., Silva, C. H., Ferriani, V. P., Roscoe, I., Campos, L. M., et al. (2001). The Brazilian version of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ). Clinical and Experimental Rheumatology, 19(4 Suppl 23), S25–S29.
Manificat, S., Dazord, A., Cochat, P., & Nicolas, J. (1997). Évaluation de la qualité de vie en pédiatrie : comment recueillir le point de vue de l'enfant. Archives de Pédiatrie, 4(12), 1238–1246. https://doi.org/10.1016/S0929-693X(97)82616-4.
Michel, G., Bisegger, C., Fuhr, D. C., & Abel, T. (2009). Age and gender differences in health-related quality of life of children and adolescents in Europe: A multilevel analysis. Quality of Life Research, 18(9), 1147–1157. https://doi.org/10.1007/s11136-009-9538-3.
Nascimento, M. M., Melo, T. R., Pinto, R. M., Morales, N. M., Mendonca, T. M., Paro, H. B., et al. (2016). Parents' perception of health-related quality of life in children and adolescents with excess weight. Jornal Pediatria (Rio de Janeiro), 92(1), 65–72. https://doi.org/10.1016/j.jped.2015.04.006.
NCHS. National Center for Health Statistics. (2000). CDC Growth Charts - United States - Homepage. Available at: http://www.cdc.gov/growthcharts/ (NCHS). Accessed 10 Jan 2011.
Raat, H., Bonsel, G. J., Essink-Bot, M. L., Landgraf, J. M., & Gemke, R. J. (2002). Reliability and validity of comprehensive health status measures in children: The child health questionnaire in relation to the health utilities index. Journal of Clinical Epidemiology, 55(1), 67–76.
Raat, H., Botterweck, A. M., Landgraf, J. M., Hoogeveen, W. C., & Essink-Bot, M. L. (2005). Reliability and validity of the short form of the child health questionnaire for parents (CHQ-PF28) in large random school based and general population samples. Journal of Epidemiology and Community Health, 59(1), 75–82. https://doi.org/10.1136/jech.2003.012914.
Raat, H., Landgraf, J. M., Oostenbrink, R., Moll, H. A., & Essink-Bot, M. L. (2007). Reliability and validity of the infant and toddler quality of life questionnaire (ITQOL) in a general population and respiratory disease sample. Quality of Life Research, 16(3), 445–460. https://doi.org/10.1007/s11136-006-9134-8.
Rajmil, L., Robles, N., Rodriguez-Arjona, D., Azuara, M., Codina, F., Raat, H., et al. (2014). Comparison of the web-based and paper [corrected] questionnaires of the Spanish and Catalan versionsof the KIDSCREEN-52. PLoS One, 9(12), e114527. https://doi.org/10.1371/journal.pone.0114527.
Ravens-Sieberer, U., Erhart, M., Wille, N., & Bullinger, M. (2008). Health-related quality of life in children and adolescents in Germany: Results of the BELLA study. European Child & Adolescent Psychiatry, 17(Suppl 1), 148–156. https://doi.org/10.1007/s00787-008-1016-x.
Robles, N., Rajmil, L., Rodriguez-Arjona, D., Azuara, M., Codina, F., Raat, H., et al. (2015). Development of the web-based Spanish and Catalan versions of the Euroqol 5D-Y (EQ-5D-Y) and comparison of results with the paper version. Health and Quality of Life Outcomes, 13, 72. https://doi.org/10.1186/s12955-015-0271-z.
Rotsika, V., Coccossis, M., Vlassopoulos, M., Papaeleftheriou, E., Sakellariou, K., Anagnostopoulos, D. C., et al. (2011). Does the subjective quality of life of children with specific learning disabilities (SpLD) agree with their parents' proxy reports? Quality of Life Research, 20(8), 1271–1278. https://doi.org/10.1007/s11136-011-9857-z.
Saigal, S. (2013). Quality of life of former premature infants during adolescence and beyond. Early Human Development, 89(4), 209–213. https://doi.org/10.1016/j.earlhumdev.2013.01.012.
Sattoe, J. N., van Staa, A., & Moll, H. A. (2012). The proxy problem anatomized: Child-parent disagreement in health related quality of life reports of chronically ill adolescents. Health and Quality of Life Outcomes, 10, 10. https://doi.org/10.1186/1477-7525-10-10.
Schlindwein-Zanini, R., Portuguez, M. W., Costa, D. I., Marroni, S., & Costa, J. C. (2007). Refractory epilepsy: Rebound of quality of life of child and his caretaker. Journal of Epilepsy and Clinical Neurophysiology, 13(4), 159–162. https://doi.org/10.1590/S1676-26492007000400003.
Stevanovic, D. (2013). Impact of emotional and behavioral symptoms on quality of life in chil. Quality of Life Research, 22(2), 333–337. https://doi.org/10.1007/s11136-012-0158-y.
Svedberg, P., Eriksson, M., & Boman, E. (2013). Associations between scores of psychosomatic health symptoms and health-related quality of life in children and adolescents. (OriginalPaper). Health and Quality of Life Outcomes, 11(1), 1. https://doi.org/10.1186/1477-7525-11-176.
Theunissen, N. C., Vogels, T. G., Koopman, H. M., Verrips, G. H., Zwinderman, K. A., Verloove-Vanhorick, S. P., et al. (1998). The proxy problem: Child report versus parent report in health-related quality of life research. Quality of Life Research, 7(5), 387–397.
Upton, P., Eiser, C., Cheung, I., Hutchings, H. A., Jenney, M., Maddocks, A., et al. (2005). Measurement properties of the UK-English version of the pediatric quality of life inventory 4.0 (PedsQL) generic core scales. Health and Quality of Life Outcomes, 3, 22. https://doi.org/10.1186/1477-7525-3-22.
Upton, P., Lawford, J., & Eiser, C. (2008). Parent-child agreement across child health-related quality of life instruments: A review of the literature. Quality of Life Research, 17(6), 895–913. https://doi.org/10.1007/s11136-008-9350-5.
Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). How young can children reliably and validly self-report their health-related quality of life?: An analysis of 8,591 children across age subgroups with the PedsQL 4.0 generic Core scales. Health and Quality of Life Outcomes, 5, 1. https://doi.org/10.1186/1477-7525-5-1.
Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL 4.0: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care, 39(8), 800–812.
Vetter, T. R., Bridgewater, C. L., & McGwin Jr., G. (2012). An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: Who should the clinician believe? Health and Quality of Life Outcomes, 10, 85. https://doi.org/10.1186/1477-7525-10-85.
Vieira, M. E. B., & Linhares, M. B. M. (2016). Quality of life of individuals born preterm: A systematic review of assessment approaches. Quality of Life Research. https://doi.org/10.1007/s11136-016-1259-9.
Waters, E., Davis, E., Ronen, G. M., Rosenbaum, P., Livingston, M., & Saigal, S. (2009). Quality of life instruments for children and adolescents with neurodisabilities: How to choose the appropriate instrument. Developmental Medicine and Child Neurology, 51(8), 660–669. https://doi.org/10.1111/j.1469-8749.2009.03324.x.
Acknowledgments
The authors are grateful to the National Council for Scientific and Technological Development (CNPq) for financial support awarded to the authors (Grant Number 142168/2014-9 for Vieira MEB and Grant for productive researcher for Linhares MBM).
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This study was funded by National Council for Scientific and Technological Development (CNPq). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study protocol was approved by the Ethics Committee. Informed and free consent was obtained from all parents.
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Vieira, M.E.B., Formiga, C.K.M.R. & Linhares, M.B.M. Quality of Life Reported by Pre-School Children and their Primary Caregivers. Child Ind Res 11, 1967–1982 (2018). https://doi.org/10.1007/s12187-017-9518-z
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DOI: https://doi.org/10.1007/s12187-017-9518-z