Abstract
Background
Health-related quality of life (HRQL) is a concept being increasingly used in paediatric health care. Since health professionals have to rely on both child and adult reports of the child’s condition, more information as to which factors moderate the correspondence between these reports would be useful.
Aim and methods
This study attempted to identify the cross-informant variance (CIV) in child, parent and teacher reports about the child’s HRQL in a large sample of elementary school children. We used the Austrian-German version of the generic core Pediatric Quality of Life Inventory™ (PedsQL™) for children and parents as well as a short HRQL rating scale derived from PedsQL™ for teachers. We identified the CIV with the use of intraclass correlation and paired score differences in 620 triple assessments, compared them to results of other PedsQL™ studies and tried to identify the factors having an impact on CIV and on the self-reported HRQL of children whose proxy ratings demonstrated a large CIV.
Results
On the whole, our results indicated low to medium agreement between children and parents, similar to results of other PedsQL™ studies in schoolchildren. The only variable that was found explaining child-parent variance was the child’s gender, with girls deviating more from their parents than boys. Child-teacher and parent-teacher CIV seemed to be primarily an effect of the child’s school performance and the teacher-parent relationship. Children whose proxy ratings differed by more than ± 15 scores showed significantly lower self-reported HRQL in some areas as compared to children whose proxy ratings showed less CIV.
Conclusion
Our results underline that it is more difficult to get concordant HRQL ratings of schoolchildren as compared to children with chronic disease.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101:213–232
Bastiaansen D, Kot HM, Bongers IL, Varni JW, Verhulst FC (2004) Measuring quality of life in children referred for psychiatric problems: psychometric properties of the PedsQL™ 4.0 generic core scales. Qual Life Res 13:489–495
Bullinger M, Schmidt S, Petersen C, Ravens-Sieberer U (2006) Quality of life—evaluation criteria for children with chronic conditions in medical care. J Public Health 14:343–355
Cremeens J, Eiser C, Blades M (2006) Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory 4.0 (PedsQL™) generic core scales. Health Qual Life Outcomes 4:58
De Civita M, Regier D, Alamgir AH, Anis AH, Fitzgerald MJ, Marra CA (2005) Evaluating health-related quality-of-life studies in paediatric populations: some conceptual, methodological and developmental considerations and recent applications. Pharmacoeconomics 23:659–685
Eiser C, Morse R (2001a) The measurement of quality of life in children: past and future perspectives. J Dev Behav Pediatr 22:248–256
Eiser C, Morse R (2001b) Can parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 10:347–357
Felder-Puig R, Frey E, Proksch K, Varni JW, Gadner H, Topf R (2004) Validation of the German version of the Pediatric Quality of Life Inventory (PedsQL™) in childhood cancer patients off treatment and children with epilepsy. Qual Life Res 13:223–234
Felder-Puig R, di Gallo A, Waldenmair M, Norden P, Winter A, Gadner H, Topf R (2006) Health-related quality of life of pediatric patients receiving allogeneic stem cell or bone marrow transplantation: results of a longitudinal, multi-center study. Bone Marrow Transplant 38:119–126
Pickard AS, Knight SJ (2005) Proxy evaluation of health-related quality of life. Med Care 43:493–499
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
Ravens-Sieberer U, Ellert U, Erhart M (2007) Gesundheitsbezogene Lebensqualität von Kindern und Jugendlichen in Deutschland (Health-related quality of life of children and adolescents in Germany). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:810–818
Reinfjell T, Diseth TH, Veenstra M, Vikan A (2006) Measuring health-related quality of life in young adolescents: reliability and validity in the Norwegian version of the Pediatric Quality of Life Inventory 4.0 (PedsQL™) generic core scales. Health Qual Life Outcomes 4:61
Sawyer MG, Whitham JN, Roberton DM, Taplin JE, Varni JW, Baghurst PA (2004) The relationship between health-related quality of life, pain and coping strategies in juvenile idiopathic arthritis. Rheumatology 43:325–330
Schwimmer JB, Burwinkle TM, Varni JW (2003) Health-related quality of life of severely obese children and adolescents. JAMA 289:1813–1819
Upton P, Eiser C, Cheung I, Hutchings HA, Jenney M, Maddocks A, Russell IT, Williams JG (2005) Measurement properties of the UK-English version of the Pediatric Quality of Life Inventory 4.0 (PedsQL™) generic core scales. Health Qual Life Outcomes 3:22
Uzark K, Jones K, Burwinkle TM, Varni JW (2003) The Pediatric Quality of Life Inventory™ in children with heart disease. Prog Pediatr Cardiol 18:141–148
Varni JW, Seid M, Kurtin PS (1999a) Pediatric health-related quality of life measurement technology: a guide for health care decision makers. JCOM 6:33–40
Varni JW, Seid M, Rode CA (1999b) The PedsQL™: measurement model for the Pediatric Quality of Life Inventory. Med Care 37:126–139
Varni JW, Seid M, Kurtin PS (2001) The PedsQL™ 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 39:800–812
Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P (2002) The PedsQL™ in pediatric cancer: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module. Cancer 94:2090–2106
Varni JW, Burwinkle TM, Seid M, Skarr D (2003a) The PedsQL™ 4.0 as a pediatric population health measure: reasibility, reliability, and validity. Ambul Pediatr 3:329–341
Varni JW, Burwinkle TM, Jacobs JR, Gottschalk M, Kaufman F, Jones KL (2003b) The PedsQL™ in type 1 and type 2 diabetes: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales and type 1 Diabetes Module. Diabetes Care 26:631–637
Varni JW, Burwinkle TM, Rapoff MA, Kamps JL, Olson N (2004) The PedsQL™ in pediatric asthma: reliability and validity of the Pediatric Quality of Life Inventory generic core scales and asthma module. J Behav Med 27:297–318
Varni JW, Burwinkle TM, Lane MM (2005) Health-related quality of life measurement in pediatric clinical practice: an appraisal and precept for future research and application. Health Qual Life Outcomes 3:34
Varni JW, Burwinkle TM, Seid M (2006) The PedsQL™ 4.0 as a school population health measure: feasibility, reliability, and validity. Qual Life Res 15:203–215
Williams J, Wake M, Hesketh K, Maher E, Waters E (2005) Health-related quality of life in overweight and obese children. JAMA 293:70–76
Acknowledgements
We would like to thank all participating children, parents and teachers who so willingly contributed to this study. We are also grateful to Ms. Hildegard Cirit and Dr. Roland Lavaulx-Vrécourt for organisational support, and Professor James W. Varni for continuous scientific advice and encouragement.
Funding
This study was supported by the “Fonds Gesundes Oesterreich”, grant no. 1121.
Conflict of interest statement
The authors confirm that there are no relevant associations that might pose a conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Felder-Puig, R., Topf, R., Gadner, H. et al. Measuring health-related quality of life in children from different perspectives using the Pediatric Quality of Life Inventory™ (PedsQL™) and teachers’ ratings. J Public Health 16, 317–325 (2008). https://doi.org/10.1007/s10389-008-0181-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-008-0181-1