Study objectives were to examine measurement invariance of the KIDSCREEN-27 between children with mental disorder and their parents; compare health-related quality of life (HRQL) scores to identify potential domain discrepancies; and, identify mental disorders associated with informant discrepancies. Participants consisted of parents with children who were currently receiving mental health services and screened positive for mental disorder according to the Mini International Neuropsychiatric Interview (n = 92). Measurement invariance was investigated using multiple-group confirmatory factor analysis using maximum likelihood estimation with robust standard errors. Multiple regression was used to identify child mental disorders associated with informant discrepancies, adjusting for relevant child and parent characteristics. Partial invariance was obtained for all domains on the KIDSCREEN-27 with the exception of Physical Well-being for which full invariance was obtained. Parents reported lower KIDSCREEN-27 scores compared to children with significant differences for Psychological Well-being [d = 1.98 (1.62, 2.33)] and Social Support and Peers [d = 0.41 (0.11, 0.70)]. For children with oppositional defiant or conduct disorder who report low HRQL, parents underestimate Psychological Well-being scores (B = 1.29, p < 0.001; B = 1.00, p < 0.01) and for children with major depressive episode, parents underestimate Social Support and Peers scores (B = 0.57, p < 0.05). Findings suggest that the KIDSCREEN-27 is a valid measure of HRQL in children with mental disorder. Externalizing behaviors exhibited by children with oppositional defiant and conduct disorder may prevent parents from recognizing compromises in their psychological well-being. Health professionals should be cognizant that these clinical profiles may predispose informant discrepancies when assessing HRQL in children.
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The authors gratefully acknowledge the children, parents and health professionals and their staff without whose participation this study would not have been possible. We especially Jessica Zelman for coordinating the study and Felice Bontempo, who, through many discussions, provided inspiration for this manuscript. This research was supported by a grant from Hamilton Health Sciences (NIF-14363). Mr. Tompke is supported by funds from the Early Researcher Award from the Ministry of Research, Innovation and Science awarded to Dr. Ferro. Dr. Ferro holds the Canada Research Chair in Youth Mental Health.
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Tompke, B.K., Ferro, M.A. Measurement Invariance and Informant Discrepancies of the KIDSCREEN-27 in Children with Mental Disorder. Applied Research Quality Life 16, 891–910 (2021). https://doi.org/10.1007/s11482-019-09801-5
- Health-related quality of life