Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis
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To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN).
The KIDSCREEN-52 questionnaire was filled in by 21,590 children and adolescents aged 8–18 from 12 countries. We used multilevel regression analyses to model the hierarchical structure of the data. In addition, effect sizes were computed to test for gender differences within each age group.
Children generally showed better HRQOL than adolescents (P < 0.001). While boys and girls had similar HRQOL at young age, girls’ HRQOL declined more than boys’ (P < 0.001) with increasing age, depending on the HRQOL scale. There was significant variation between countries both at the youngest age and for age trajectories.
For the first time, gender and age differences in children’s and adolescents’ HRQOL across Europe were assessed using a comprehensive and standardised instrument. Gender and age differences exist for most HRQOL scales. Differences in HRQOL across Europe point to the importance of national contexts for youth’s well-being.
KeywordsQuality of life Child Adolescent Sex characteristics Europe
Health-related quality of life
United Nations International Children’s Emergency Fund
World Health Organisation
The authors are grateful to the children, adolescents, and families in the participating European countries and to the members of the KIDSCREEN group. Members of the KIDSCREEN group are Austria: Wolfgang Duer, Kristina Fuerth; Czech Republic: Ladislav Czerny; France: Pascal Auquier, Marie-Claude Simeoni, Stephane Robitail; Germany: Ulrike Ravens-Sieberer (international coordinator-in-chief), Michael Erhart, Jennifer Nickel, Bärbel-Maria Kurth, Angela Gosch, Ursula von Rüden; Greece: Yannis Tountas, Christina Dimitrakakis; Hungary: Agnes Czimbalmos, Anna Aszman; Ireland: Jean Kilroe, Celia Keenaghan; The Netherlands: Jeanet Bruil, Symone Detmar, Eric Verrips; Poland: Joanna Mazur, Ewa Mierzejeswka; Spain: Luis Rajmil, Silvina Berra, Cristian Tebé, Michael Herdman, Jordi Alonso; Sweden: Curt Hagquist; Switzerland: Thomas Abel, Corinna Bisegger, Bernhard Cloetta, Claudia Farley; and United Kingdom: Mick Power, Clare Atherton, Katy Phillips.
Conflict of interests
No conflict of interest. We also declare that we have full control of all primary data, and we agree to allow the journal to review their data if requested.
The KIDSCREEN project was financed by a grant from the European Commission (QLG-CT-2000-00751) within the EC 5th Framework-Programme “Quality of Life and Management of Living Resources”. In Switzerland, the project was funded by the Swiss Federal Office for Education and Science. Gisela Michel was funded by a fellowship of the Swiss National Science Foundation (PA001–117433/1).
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