Skip to main content

Advertisement

SpringerLink
Log in

Psychosocial determinants of quality of life in parents of obese children seeking inpatient treatment

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To examine and identify predictors of parental health-related quality of life (HRQoL) in a sample of obese and very obese children participating in an inpatient program for treating obesity.

Methods

Data are part of a prospective multicenter randomized-controlled intervention trial. Parents (n = 463) of obese and very obese children (7–13 years) completed standardized questionnaires assessing their own and their child’s HRQoL, psychosocial functioning, demographics and parental weight-specific self-efficacy on the child’s admission to an inpatient pediatric weight management program. Weight and height of the children were measured by trained personnel; parental weight was assessed via self-report.

Results

Parents reported lower mental HRQoL compared to healthy adults and even lower than reference values for acute or chronic illness. With respect to physical HRQoL, parents of obese children reported higher scores than both groups. Effect sizes were small to medium. Overweight parents reported a lower physical HRQoL. Mental HRQoL was higher for married parents with a higher educational level and a higher self-efficacy and for those whose children depicted fewer behavioral problems and reported a higher HRQoL. Hierarchical regression analyses revealed that weight-specific self-efficacy explained 3 % of variance in mental HRQoL in addition to the demographic and child psychosocial variables. Parental self-efficacy also partially mediated the association between the child’s HRQoL and parental mental HRQoL.

Conclusion

Childhood obesity is associated with reduced parental HRQoL. Interventions for obesity in children should consider the parents’ psychosocial situation as well. Enhancing parental self-efficacy may be a promising approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hatzmann, J., Heymans, H. S. A., Ferrer-i-Carbonell, A., van Praag, B. M. S., & Grootenhuis, M. A. (2008). Hidden consequences of success in pediatrics: Parental health-related quality of life—results from the Care Project. Pediatrics, 122(5), e1030–e1038.

    Article  PubMed  Google Scholar 

  2. Vermaes, I. P., Janssens, J. M., Bosman, A. M., & Gerris, J. R. (2005). Parents’ psychological adjustment in families of children with spina bifida: A meta-analysis. BioMedCentral Pediatrics, 5, 32.

    Google Scholar 

  3. Brehaut, J. C., Kohen, D. E., Garner, R. E., Miller, A. R., Lach, L. M., Klassen, A. F., et al. (2009). Health among caregivers of children with health problems: Findings from a Canadian population-based study. American Journal of Public Health, 99(7), 1254–1262.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review. International Journal of Obesity, 35, 891–898.

    Article  CAS  PubMed  Google Scholar 

  5. Barlow, S. E. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics, 120(Supplement), 164–192.

    Article  Google Scholar 

  6. Janicke, D. M., Marciel, K. K., Ingerski, L. M., Novoa, W., Lowry, K. W., Sallinen, B. J., et al. (2007). Impact of psychosocial factors on quality of life in overweight youth. Obesity, 15(7), 1799–1807.

    Article  PubMed  Google Scholar 

  7. Cislak, A., Safron, M., Pratt, M., Gaspar, T., & Luszczynska, A. (2012). Family-related predictors of body weight and weight-related behaviours among children and adolescents: A systematic umbrella review. Child Care Health Development, 38(3), 321–331.

    Article  CAS  Google Scholar 

  8. McConley, R. L., Mrug, S., Gilliland, M. J., Lowry, R., Elliott, M. N., Schuster, M. A., et al. (2011). Mediators of maternal depression and family structure on child BMI: Parenting quality and risk factors for child overweight. Obesity, 19(2), 345–352.

    Article  PubMed  Google Scholar 

  9. Warschburger, P., & Kröller, K. (2012). Maternal perception of weight status and health risks associated with obesity in children. Pediatrics, 124(1), e60–e68.

    Article  Google Scholar 

  10. Gundersen, C., Mahatmya, D., Garasky, S., & Lohman, B. J. (2011). Linking psychosocial stressors and childhood obesity. Obesity Reviews, 12(5), e54–e63.

    Article  CAS  PubMed  Google Scholar 

  11. Decaluwé, V., Braet, C., Moens, E., & Van, V. L. (2006). The association of parental characteristics and psychological problems in obese youngsters. International Journal of Obesity, 30(12), 1766–1774.

    Article  PubMed  Google Scholar 

  12. Epstein, L. H., Klein, K. R., & Wisniewski, L. (1994). Child and parent factors that influence psychological problems in obese children. International Journal of Eating Disorders, 15(2), 151–158.

    Article  CAS  PubMed  Google Scholar 

  13. Pratt, K. J., Lamson, A. L., Swanson, M. S., Lazorick, S., & Collier, D. N. (2012). The importance of assessing for depression with HRQOL in treatment seeking obese youth and their caregivers. Quality of Life Research, 21(8), 1367–1377.

    Article  PubMed  Google Scholar 

  14. Zeller, M. H., Reiter-Purtill, J., Modi, A. C., Gutzwiller, J., Vannatta, K., & Davies, W. H. (2007). Controlled study of critical parent and family factors in the obesigenic environment. Obesity, 15(1), 126–136.

    Article  PubMed  Google Scholar 

  15. Garasky, S., Stewart, S. D., Gundersen, C., Lohman, B. J., & Eisenmann, J. C. (2009). Family stressors and child obesity. Social Science Research, 38(4), 755–766.

    Article  PubMed  Google Scholar 

  16. Guilfoyle, S. M., Zeller, M. H., & Modi, A. C. (2010). Parenting stress impacts obesity-specific health-related quality of life in a pediatric obesity treatment-seeking sample. Journal of Developmental and Behavioral Pediatrics, 31(1), 17–25.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Moens, E., Braet, C., Bosmans, G., & Rosseel, Y. (2009). Unfavourable family characteristics and their associations with childhood obesity: A cross-sectional study. European Eating Disorders Review, 17(4), 315–323.

    Article  PubMed  Google Scholar 

  18. Gibson, L. Y., Byrne, S. M., Davis, E. A., Blair, E., Jacoby, P., & Zubrick, S. R. (2007). The role of family and maternal factors in childhood obesity. Medical Journal of Australia, 186(11), 591–595.

    PubMed  Google Scholar 

  19. Melo, T. R., Jansen, A. K., de Melo Costa Pinto, R., Rizo de Morales, R., Macedo Morales, N., Martins, M., et al. (2011). Quality of life of caregivers of overweight or obese children and adolescents. Revista da Escola de Enfermagen da USP, 45(2), 319–325.

    Article  Google Scholar 

  20. de Zwaan, M., Petersen, I., Kaerber, M., Burgmer, R., Nolting, B., Legenbauer, T., et al. (2009). Obesity and quality of life: A controlled study of normal weight and obese individuals. Psychosomatics, 50, 474–482.

    Article  PubMed  Google Scholar 

  21. Modi, A. C., Guilfoyle, S. M., & Zeller, M. H. (2009). Impaired health-related quality of life in caregivers of youth seeking obesity treatment. Journal of Pediatric Psychology, 34(2), 147–155.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Thompson, R. J., & Gustafson, K. E. (1996). Adaptation to chronic childhood illness. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  23. Bandura, A. (1997). Self-efficacy. The exercise of control. New York: Freeman.

    Google Scholar 

  24. Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25(3), 341–363.

    Article  PubMed  Google Scholar 

  25. Everhart, R. S., Fiese, B. H., & Smyth, J. M. (2008). A cumulative risk model predicting caregiver quality of life in pediatric asthma. Journal of Pediatric Psychology, 33(8), 809–818.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Grus, C. L., Lopez-Hernandez, C., Delamater, A., Applegate, B., Brito, A., Wurm, G., et al. (2001). Parental self-efficacy and morbidity in pediatric asthma. Journal of Asthma, 38, 99–106.

    Article  CAS  PubMed  Google Scholar 

  27. Streisand, R., Swift, E., Wickmark, T., Chen, R., & Holmes, C. S. (2005). Pediatric parenting stress among parents of children with type 1 diabetes: The role of self-efficacy, responsibility, and fear. Journal of Pediatric Psychology, 30(6), 513–521.

    Article  PubMed  Google Scholar 

  28. Noojin, A. B., & Wallander, J. L. (1997). Perceived problem-solving ability, stress, and coping in mothers of children with physical disabilities: Potential cognitive influences on adjustment. International Journal of Behavioral Medicine, 4(4), 415–432.

    Article  CAS  PubMed  Google Scholar 

  29. Silver, E. J., Bauman, L. J., & Ireys, H. T. (1995). Relationships of self-esteem and efficacy to psychological distress in mothers of children with chronic physical illnesses. Health Psychology, 14, 333–340.

    Article  CAS  PubMed  Google Scholar 

  30. Reinehr, T., & Wabitsch, M. (2003). Strukturierte Erfassung der Therapieangebote für adipöse Kinder und Jugendliche—ein Projekt der Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA). Monatsschrift Kinderheilkunde, 151, 757–761.

    Article  Google Scholar 

  31. Kromeyer-Hauschild, K., Wabitsch, M., Kunze, D., Geller, F., Geiß, H. C., Hesse, V., et al. (2001). Perzentile für den Body-Mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde, 149, 807–818.

    Article  Google Scholar 

  32. Bullinger, M., & Kirchberger, I. (1998). SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen: Hogrefe.

    Google Scholar 

  33. Gandek, B., Ware, J., Aaronson, N., Apolone, G., Bjorner, J., Brazier, J., et al. (1998). Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: Results from the IQOLA Project. Journal of Clinical Epidemiology, 51(11), 1171–1178.

    Article  CAS  PubMed  Google Scholar 

  34. Ravens-Sieberer, U. (2003). Der KINDL-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen—Revidierte Form. In J. Schumacher, A. Klaiberg, & E. Brähler (Eds.), Diagnostische Verfahren zu Lebensqualität und Wohlbefinden (pp. 184–188). Göttingen: Hogrefe.

    Google Scholar 

  35. Woerner, W., Becker, A., Friedrich, C., Klasen, H., Goodman, R., & Rothenberger, A. (2002). Normierung und Evaluation der deutschen Elternversion des Strengths and Difficulties Questionnaire (SDQ): Ergebnisse einer repräsentativen Felderhebung. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 30, 105–112.

    Article  CAS  PubMed  Google Scholar 

  36. Rothenberger, A., & Woerner, W. (2004). Strengths and Difficulties Questionnaire (SDQ). Evaluations and applications. European Child and Adolescent Psychiatry, 13(Suppl 2), II1–II2.

    PubMed  Google Scholar 

  37. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research—Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  CAS  PubMed  Google Scholar 

  38. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.

    Article  Google Scholar 

  39. Helfferich, C., Hendel-Kramer, A., & Klindworth, H. (2003). Gesundheit alleinerziehender Mütter und Väter. Gesundheitsberichterstattung des Bundes. Heft 14. Berlin: Robert-Koch-Institut.

  40. Mattejat, F., König, U., Barchewitz, C., Felbel, D., Herpertz-Dahlmann, B., Hoehne, D., et al. (2003). Zur Lebensqualität von psychisch kranken Kindern und ihren Eltern. Ergebnisse der ersten multizentrischen Studie mit der Elternversion des Inventars zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK). Kindheit und Entwicklung, 14(1), 39–47.

    Article  Google Scholar 

  41. Meltzer, H., Ford, T., Goodman, R., & Vostanis, P. (2011). The burden of caring for children with emotional or conduct disorders. International Journal of Family Medicine, 1, 1–8.

    Article  Google Scholar 

  42. Guillamón, N., Nieto, R., Pousada, M., Redolar, D., Muñoz, E., Hernández, E., et al. (2013). Quality of life and mental health among parents of children with cerebral palsy: The influence of self-efficacy and coping strategies. Journal of Clinical Nursing, 22(11–12), 1579–1590.

    Article  PubMed  Google Scholar 

  43. Warschburger, P. (2000). Chronisch kranke Kinder und Jugendliche. Psychosoziale Belastungen und Bewältigungsanforderungen. Göttingen: Hogrefe.

    Google Scholar 

  44. Warschburger, P. (2005). The unhappy obese child. International Journal of Obesity, 29(Suppl 2), 127–129.

    Article  Google Scholar 

  45. Brettschneider, A. K., Ellert, U., & Schaffrath Rosario, A. (2012). Comparison of BMI derived from parent-reported height and weight with measured values: Results from the German KiGGS study. International Journal of Environmental Research and Public Health, 9(2), 632–647.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Fuchs, T., Eschenbeck, H., Krug, S., Schlaud, M., & Kohlmann, C. W. (2012). Perception makes the difference: The association of actual and perceived weight status with self-reported and parent-reported personal resources and well-being in adolescents. Applied Psychology: Health and Well-Being, 4(3), 321–340.

    Google Scholar 

  47. Braet, C., Mervielde, I., & Vandereycken, W. (1997). Psychological aspects of childhood obesity: A controlled study in a clinical and nonclinical sample. Journal of Pediatric Psychology, 22(1), 59–71.

    Article  CAS  PubMed  Google Scholar 

  48. Fitzgibbon, M. L., Stolley, M. R., & Kirschenbaum, D. S. (1993). Obese people who seek treatment have different characteristics than those who do not seek treatment. Health Psychology, 12(5), 342–345.

    Article  CAS  PubMed  Google Scholar 

  49. Warschburger, P., Buchholz, H. T., & Petermann, F. (2004). Psychological adjustment in parents of young children with atopic dermatitis: Which factors predict parental quality of life? The British Journal of Dermatology, 150(2), 304–311.

    Article  CAS  PubMed  Google Scholar 

  50. Niemeier, B. S., Hektner, J. M., & Enger, K. B. (2012). Parent participation in weight-related health interventions for children and adolescents: A systematic review and meta-analysis. Preventive Medicine, 55(1), 3–13.

    Article  PubMed  Google Scholar 

  51. Warschburger, P., Fromme, C., Petermann, F., Wojtalla, N., & Oepen, J. (2001). Conceptualisation and evaluation of a cognitive-behavioural training programme for children and adolescents with obesity. International Journal of Obesity, 25, 1–3.

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by a DFG (German Research Foundation) Grant (WA 1143/3-1; 4-1: 4-2). Special thanks to Dr. Kröller for statistical discussions and Patricia Kulla for critical proofreading. We greatly appreciate the support of our cooperation clinics: Kinder-Reha-Klinik ‘Am Nicolausholz’ Bad Kösen, Charlottenhall Vorsorge und Rehabilitationsklinik für Kinder und Jugendliche Bad Salzungen, Fachklinik Prinzregent Luitpold Scheidegg, Edelsteinklinik Bruchweiler, Spessart-Klinik Bad Orb, Viktoriastift Bad Kreuznach, Kinder- und Jugendklinik Gesundheitspark Bad Gottleuba, Auguste-Viktoria-Klinik Bad Lippspringe, AHG Klinik für Kinder und Jugendliche Beelitz-Heilstätten.

Author information

Authors and Affiliations

  1. Counseling Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany

    Petra Warschburger & Daniela Kühne

Authors
  1. Petra Warschburger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Kühne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petra Warschburger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Warschburger, P., Kühne, D. Psychosocial determinants of quality of life in parents of obese children seeking inpatient treatment. Qual Life Res 23, 1985–1995 (2014). https://doi.org/10.1007/s11136-014-0659-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-014-0659-y

Keywords

Search

Navigation