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Health-related quality of life in children and adolescents in Germany: results of the BELLA study

European Child & Adolescent Psychiatry volume 17, pages 148–156 (2008)Cite this article

Abstract

Background

The self-perceived health or health-related quality of life of children and adolescents is increasingly recognised as a relevant outcome in medical practice and public health research. Identifying children and adolescents with particularly low health-related quality of life allows for an early detection of hidden morbidity and health care needs.

Objectives

The present study investigates health-related quality of life in children and adolescents in Germany.

Methods

In the Mental Health Module (BELLA study) of the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 2,863 children and adolescents aged 7–17 years, and 1,700 children and adolescents aged 11–17 years completed the KINDL-R quality of life questionnaire.

Results

The reliability (Cronbach’s α = 0.86) and validity of the measurements using the parent-reported KINDL-R were confirmed. Means and percentiles were calculated for the total sample as well as for strata defined by age, sex, geographical region (east/west), migration status and socioeconomic status. Expected differences in health-related quality of life of children and adolescents from different social backgrounds and with different health statuses were demonstrated by differences in the KINDL-R scores (effect size d up to 1.29).

Conclusion

This study provides representative, normative data (self-report and parent-report) on the test scores of health-related quality of life (KINDL-R) for the population of children and adolescents in Germany in general, as well as in sociodemographic and socioeconomic subpopulations.

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References

  1. Bethell C, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW (2002) Identifying children with special health care needs: development and evaluation of a short screening instrument. Ambul Pediatr 2:38–48

    Article  PubMed  Google Scholar 

  2. Bradley R, Corwyn R (2002) Socioeconomic status and child development. Annu Rev Psychol 53:371–399

    Article  PubMed  Google Scholar 

  3. Bullinger M (2002) Assessing health related quality of life in medicine: an overview over concepts, methods and applications in international research. Restor Neurol Neurosci 20:93–101

    PubMed  Google Scholar 

  4. Bullinger M (2003) Measuring health related quality of life: an international perspective. Adv Exp Med Biol 528:113–122

    Article  PubMed  Google Scholar 

  5. Bullinger M, Brütt AL, Erhart M, Ravens-Sieberer U, BELLA study group (2008) Psychometric properties of the KINDL-R questionnaire: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):125–132

    Google Scholar 

  6. Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56:81–105

    Article  CAS  PubMed  Google Scholar 

  7. Edwards T, Huebner C, Connell F, Patrick D (2002) Adolescents quality of life, Part I: conceptual and measurement model. J Adolesc 25:275–286

    Article  PubMed  Google Scholar 

  8. Erhart M, Hölling H, Bettge S, Ravens-Sieberer U, Schlack R (2007) Der Kinder- und Jugendgesundheitssurvey: Risiken und Ressourcen für die psychische Entwicklung von Kindern und Jugendlichen. [The German health interview and examination survey for children and adolescents (KiGGS): risks and resources for the mental development of children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:800–809

    Article  CAS  PubMed  Google Scholar 

  9. Goodmann R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586

    Article  Google Scholar 

  10. Hays R, Hayashi T (1990) Beyond internal consistency reliability: rationale and users guide for the multitrait analysis program on the microcomputer. Behav Res Methods Instrum Comput 23:167–169

    Google Scholar 

  11. Nunnally JC, Bernstein IR (1994) Psychometric theory. McGraw-Hill, New York

    Google Scholar 

  12. Prevention CfDCa (2000) Measuring healthy days: population assessment of health-related quality of life. Center for Disease Control and Prevention (CDC), Atlanta

    Google Scholar 

  13. Radoschewski M (2000) Gesundheitsbezogene Lebensqualität—Konzepte und Maße. Entwicklungen und Stand im Überblick. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 43:165–189

    Article  Google Scholar 

  14. Rajmil L, Herdman M, De Sanmamed M, Detmar S, Bruil J, Ravens-Sieberer U, Bullinger M, Simeoni M, Auquier P, KIDSCREEN the European Group (2004) Generic health-related quality of life instruments in children and adolescents: a qualitative analysis of content. J Adolesc Health 34:37–45

    Article  PubMed  Google Scholar 

  15. Ravens-Sieberer U (2003) Der KINDL-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen—Revidierte Form. In: Schumacher JKA, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 184–188

    Google Scholar 

  16. Ravens-Sieberer U, Bettge S, Erhart M (2003) Lebensqualität von Kindern und Jugendlichen—Ergebnisse aus der Pilotphase des Kinder—und Jugendgesundheitssurveys. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 46:340–345

    Article  Google Scholar 

  17. Ravens-Sieberer U, Bullinger M (1998) Assessing health related quality of life in chronically ill children with the german KINDL: first psychomertric and content analytical results. Qual Life Res 7:399–407

    Article  CAS  PubMed  Google Scholar 

  18. Ravens-Sieberer U, Erhart M, Wille N, Wetzel R, Nickel J, Bullinger M (2006) Generic health-related quality of life assessment in children and adolescents: methodological considerations. Pharmacoeconomics 24:1199–1220

    Article  PubMed  Google Scholar 

  19. Ravens Sieberer U, Gosch A, Abel T, Auquier P, Bellach B, Bruil J, Dür W, Power M, Rajmil L, KIDSCREEN the European Group (2001) Quality of life in children and adolescents—a European public health perspective. Soz Praventivmed 46:297–302

    Article  Google Scholar 

  20. Ravens-Sieberer U, Kurth B-M, KiGGS study group, BELLA study group (2008) The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 17(Suppl1): 10–21

    Google Scholar 

  21. Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen H-U, Rothenberger A, Herpertz-Dahlmann B, Resch F, Hölling H, Bullinger M, Barkmann C, Schulte-Markwort M, Döpfner M as the BELLA study group (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl1):22–23

  22. Schumacher J, Klaiberg A, Brähler E (2003) Diagnostik von Lebensqualität und Wohlbefinden–Eine Einführung. In: Schumacher J, Klaiberg A, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 9–24

    Google Scholar 

  23. von Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U (2006) Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health 60:130–135

    Article  Google Scholar 

  24. Wallander JL, Thompson RJ (1995) Psychosocial adjustment of children with chronic physical conditions. In: Roberts MC (ed) Handbook of pediatric psychology. Guilford Press, New York, pp 124–141

    Google Scholar 

  25. Ware J (2003) Conceptualization and measurement of health-related quality of life: comments on an evolving field. Arch Phys Med Rehabil 84:S43–S51

    Article  PubMed  Google Scholar 

  26. Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundesgesundheitssurvey. Gesundheitswesen 61:S178–S183

    PubMed  Google Scholar 

  27. Wille N, Bettge S, Ravens-Sieberer U, BELLA study group (2008) Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):133–147

    Google Scholar 

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Conflict of interest

All authors declare no conflict of interest.

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Authors and Affiliations

  1. Center for Obstetrics and Paediatrics, Dept. of Psychosomatics in Children and Adolescents, University Clinic Hamburg-Eppendorf, Martinistaße 52, W29, 20246, Hamburg, Germany

    Ulrike Ravens-Sieberer MPH,  Michael Erhart &  Nora Wille MPH

  2. Center for Psychosocial Medicine, Institute and Polyclinic for Medical Psychology, University Clinic Hamburg-Eppendorf, Hamburg, Germany

    Monika Bullinger

Authors
  1. Ulrike Ravens-Sieberer MPH
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  2. Michael Erhart
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  3. Nora Wille MPH
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  4. Monika Bullinger
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the BELLA study group

Corresponding author

Correspondence to Ulrike Ravens-Sieberer MPH.

Additional information

Members of the BELLA study group: Ulrike Ravens-Sieberer (Principal Investigator), Claus Barkmann, Susanne Bettge, Monika Bullinger, Manfred Döpfner, Michael Erhart, Beate Herpertz-Dahlmann, Heike Hölling, Franz Resch, Aribert Rothenberger, Michael Schulte-Markwort, Nora Wille, Hans-Ulrich Wittchen.

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Ravens-Sieberer, U., Erhart, M., Wille, N. et al. Health-related quality of life in children and adolescents in Germany: results of the BELLA study. Eur Child Adolesc Psychiatry 17 (Suppl 1), 148–156 (2008). https://doi.org/10.1007/s00787-008-1016-x

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  • DOI: https://doi.org/10.1007/s00787-008-1016-x

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