Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences



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.

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This study was funded by the Research Council of Norway (ID: 213477).

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Correspondence to Kristine Amlund Hagen.

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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).

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Hagen, K.A., Hilsen, M., Kallander, E.K. et al. Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences. Qual Life Res 28, 1063–1073 (2019).

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  • Factor structure
  • Construct validity
  • Children at risk
  • Health-related quality of life
  • Parental illness and substance abuse