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.

中文翻译：

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肥胖青年的自我和父母代言的健康相关生活质量（HRQoL）：父母是好的替代品吗？

目的

考虑健康相关的生活质量（HRQoL）和幸福感对于指导肥胖青年提供医疗服务很重要，但是青年的观点可能与父母不同。这项研究比较了青年和父母的HRQoL报告，并评估了HRQoL各个领域之间的一致性水平，并根据青年年龄，青年性别和父母知情者（母亲和父亲）进行了评估。

方法

从社区（N  = 223）和医院环境（N  = 153）招募的376名肥胖青年及其父母（N  = 190个母亲；N  = 91个父亲）完成了PedsQL。使用Wilcoxon符号秩检验，内相关系数（ICC）和Bland-Altman图对亚组二元组（母亲，父亲，儿童性别，儿童年龄）的父母和青年协议进行了评估。

结果

与规范相比，HRQoL水平（青年自我报告和父母代理报告）在所有领域均较低。父母的HRQoL报告均显着低于青年，尤其是身体HRQoL。青年与父母的和谐程度从差到中等（ICC = 0.230–0.618），对身体HRQOL的一致性最低。母亲是更好的代理，ICC在所有领域都很重要。青年父亲ICC仅在社交（ICC = 0.428）和学校（ICC = 0.303）领域有意义。女孩与母亲之间的协议在所有领域都很重要，而女孩与父亲之间的协议仅在社会领域才有意义（ICC = 0.653）。父亲和母亲对男孩和年轻的年轻人（≤12岁）的评分都不高，在大多数HRQoL领域中ICC均不显着。

结论

父母对于青年HRQoL来说是可怜的代理人。临床医生应意识到父母不一定是青年的准确代表，并在解释父母代表得分时要谨慎。