Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences
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Health-related quality of life (HRQoL) may be helpful in identifying children at risk of developing adjustment problems. Few studies have focused on HRQoL among children of ill or substance abusing parents despite their considerable risk status. In the present study, we used the KIDSCREEN-27 to assess self-reported HRQoL in children and adolescents living in families with parental illness, or substance dependence. First, we tested whether the factor structure of the KIDSCREEN-27 was replicated in this population of children. Next, we examined differences in HRQoL according to age, gender, and type of parental illness. Finally, we compared levels of HRQoL in our sample to a normative reference population.
Two hundred and forty-six children and adolescents aged 8–17 years and their ill parents participated. The construct validity of the KIDSCREEN-27 questionnaire was examined by confirmatory factor analysis (CFA). T-tests and ANOVA were used to test differences in HRQoL levels according to age, gender, and parental patient groups, and for comparisons with reference population.
The KIDSCREEN-27 fit the theoretical five-factor model of HRQoL reasonably well. Boys and younger children reported significantly greater well-being on physical well-being, psychological well-being, and peers and social support, compared to girls and older children. Younger children also reported significantly greater well-being at school than did older children. There were no significant differences in HRQoL between groups of children living with different type of parental illness. The children in our sample reported their physical well-being significantly lower than the reference population.
The KIDSCREEN-27 questionnaire appears to work satisfactorily among children of ill or substance abusing parents.
KeywordsFactor structure Construct validity Children at risk Health-related quality of life Parental illness and substance abuse
This study was funded by the Research Council of Norway (ID: 213477).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Regional Committee on Medical and Health Research Ethics, South-East (ID: 2012/1176).
Informed consent was obtained from all individual participants included in the study.
- 1.Barkmann, C., Romer, G., Watson, M., Schulte-Markwort, M. (2007). Parental physical illness as a risk for psychosocial maladjustment in children and adolescents: Epidemiological findings from a national survey in Germany. Psychosomatics: Journal of Consultation Liaison Psychiatry, 48, 476–481.CrossRefGoogle Scholar
- 2.Berg-Nielsen, T. S., & Wichstrom, L. (2012). The mental health of preschoolers in a Norwegian population-based study when their parents have symptoms of borderline, antisocial, and narcissistic personality disorders: At the mercy of unpredictability. Child and Adolescent Psychiatry and Mental Health, 6, 19.CrossRefGoogle Scholar
- 10.Krattenmacher, T., Kuhne, F., Halverscheid, S., Wiegand-Grefe, S., Bergelt, C., Romer, G., et al. (2014). A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life. Journal of Psychosomatic Research, 76, 213–220.CrossRefGoogle Scholar
- 16.The KIDSCREEN Group Europe. (2006). The KIDSCREEN Questionnaires—Quality of life questionnaires for children and adolescents. Handbook. Lengerich: Pabst Science Publishers.Google Scholar
- 19.Mayo, N. E. (2015). Dictionary of Quality of Life and Health Outcomes Measurement. 1st ed. International Society for Quality of Life Research, 3.Google Scholar
- 21.Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., et al. (2007). The KIDSCREEN-27 quality of life measure for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 16, 1347–1356.CrossRefGoogle Scholar
- 24.Sun, R. C. F., & Shek, D. T. L. (2013). Longitudinal influences of positive youth development and life satisfaction on problem behaviour among adolescents in Hong Kong. Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, 114(3), 1171–1197.CrossRefGoogle Scholar
- 26.Palacio-Vieira, J., Villalonga-Olives, E., Valderas, J., Espallargues, M., Herdman, M., Berra, S., et al. (2008). Changes in health-related quality of life (HRQoL) in a population-based sample of children and adolescents after 3 years of follow-up. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 17, 1207–1215.CrossRefGoogle Scholar
- 27.World Health Organization. Health statistics and information systems; WHOQOL: Measuring quality of life. Retrieved from http://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/.
- 29.Detmar, S., Bruil, J., Ravens-Sieberer, U., Gosch, A., & Bisegger, C. (2006). The use of focus groups in the development of the KIDSCREEN HRQL questionnaire. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 15, 1345–1353.CrossRefGoogle Scholar
- 30.Robitail, S., Ravens-Sieberer, U., Simeoni, M.-C., Rajmil, L., Bruil, J., Power, M., et al. (2007). Testing the structural and cross-cultural validity of the KIDSCREEN-27 Quality of Life Questionnaire. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 16, 1335–1345.CrossRefGoogle Scholar
- 34.Meade, T., & Dowswell, E. (2015). Health-related quality of life in a sample of Australian adolescents: Gender and age comparison. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation. https://doi.org/10.1007/s11136-015-1033-4.CrossRefGoogle Scholar
- 35.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: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 18, 1147–1157.CrossRefGoogle Scholar
- 37.Kuhne, F., Krattenmacher, T., Bergelt, C., Ernst, J. C., Flechtner, H. H., Fuhrer, D., et al. (2012). Parental palliative cancer: Psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service. BMC Palliative Care, 11, 21.CrossRefGoogle Scholar
- 46.Stein, A., Ramchandani, P., Murray, L. (2008). Impact of parental psychiatric disorder and physical illness. In M. Rutter, D. Bishop, D. Pine, S. Scott, J. Stevenson, E. Taylor, & A. Thapar (Eds.), Rutter’s child and adolescent psychiatry (5th ed., pp 407–420) xv, 1230 pp. London: Wiley. (Reprinted 2010).Google Scholar
- 48.Europe, T. K. G. (2006). The KIDSCREEN questionnaires: Quality of life questionnaires for children and adolescents. Lengerich: Pabst Science Publishers.Google Scholar
- 49.Ruud, T. B. B., Faugli, A., Amlund Hagen, K., Hellmann, A., Hilsen, M., Kallander, E. K., et al. (2015). Barn som pårørende—-Resultater fra en multisenterstudie. Lørenskog: Akershus universitetssykehus HF.Google Scholar
- 51.Munthén, L. K. (1998–2015). MBO: Mplus User’s Guide. Seventh edition. Los Angeles, CA: Munthén & Munthén.Google Scholar
- 52.Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit Measures. Methods of psychological research online, 8, 23–74.Google Scholar
- 53.Ogden, T., & Hagen, K. A. (2014). Adolescent mental health: Prevention and intervention. New York: Taylor & Francis Group.Google Scholar
- 55.Kayed, N. S., Jozefiak, T., Rimehaug, T., Tjelflaat, T., Brubakk, A. M., & Wickstrom, L. (2015). Resultater fra forskningsprosjektet psykisk helse hos barn og unge i barnevernsinstitusjoner. Trondheim: Norwegian University of Science and Technology.Google Scholar