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Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

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Abstract

Purpose

Consideration of health-related quality of life (HRQoL) and wellbeing outcomes is important to guide healthcare services for youth with obesity, yet youth perspectives may differ from their parents. This study compared youth and parental HRQoL reports and evaluated levels of concordance across HRQoL domains and as a function of youth age, youth gender and parent informant (mother and father).

Methods

376 youths with obesity, recruited from community (N = 223) and hospital settings (N = 153), and their parents (N = 190 mothers; N = 91 fathers), completed the PedsQL. Parental and youth agreement across subgroup dyads (mother; father; child gender; child age) were evaluated using Wilcoxon signed-rank test, intra-correlations coefficients (ICCs) and Bland–Altman plots.

Results

Compared to norms, HRQoL levels (youth self-report and parental proxy reports) were lower in all domains. Both mother and fathers’ HRQoL reports were significantly lower than youths, most notably in physical HRQoL. Youth–parent concordance ranged from poor to moderate (ICC = 0.230–0.618), with lowest agreement for Physical HRQOL. Mothers were better proxies with ICCs being significant in all domains. Youth-father ICCs were significant only for Social (ICC = 0.428) and School (ICC = 0.303) domains. Girl–mother agreement was significant across all domains, while girl–father agreement was significant only in the Social domain (ICC = 0.653). Both mothers and fathers were poor raters for boys, and younger youths (aged ≤ 12), with non-significant ICCs in most HRQoL domains.

Conclusions

Parents are poor surrogates for youth HRQoL. Clinicians should be cognizant that parents are not necessarily accurate proxies for youths, and exercise caution when interpreting parent-proxy scores.

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Funding

This study is supported by funding from National Medical Research Council-Clinician Scientist Research Grant (NMRC/CIRG/1407/2014).

Author information

Authors and Affiliations

  1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Delicia Shu Qin Ooi, Kah Yin Loke & Yung Seng Lee

  2. Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore

    Delicia Shu Qin Ooi, Kah Yin Loke, Cindy Wei Li Ho, Yvonne Yijuan Lim, Andrew Anjian Sng & Yung Seng Lee

  3. Youth Preventive Services Division, Health Promotion Board, Singapore, Singapore

    Veronica Tay & Vijaya Karuppiah

  4. Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore

    Lester Yousheng Lai & Konstadina Griva

  5. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore

    Yung Seng Lee

Authors
  1. Delicia Shu Qin Ooi
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Correspondence to Konstadina Griva.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the National Healthcare Group Domain Specific Review Board (2015/00314) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Ooi, D.S.Q., Loke, K.Y., Ho, C.W.L. et al. Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?. Qual Life Res 29, 2171–2181 (2020). https://doi.org/10.1007/s11136-020-02472-y

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