Skip to main content
Top
Published in: European Child & Adolescent Psychiatry 1/2008

01-12-2008 | ORIGINAL CONTRIBUTION

Health-related quality of life in children and adolescents in Germany: results of the BELLA study

Authors: Prof. Dr. Ulrike Ravens-Sieberer, MPH, Dr. Michael Erhart, Dipl.-Psych. Nora Wille, MPH, Prof. Dr. Monika Bullinger, the BELLA study group

Published in: European Child & Adolescent Psychiatry | Special Issue 1/2008

Login to get access

Abstract

Background

The self-perceived health or health-related quality of life of children and adolescents is increasingly recognised as a relevant outcome in medical practice and public health research. Identifying children and adolescents with particularly low health-related quality of life allows for an early detection of hidden morbidity and health care needs.

Objectives

The present study investigates health-related quality of life in children and adolescents in Germany.

Methods

In the Mental Health Module (BELLA study) of the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 2,863 children and adolescents aged 7–17 years, and 1,700 children and adolescents aged 11–17 years completed the KINDL-R quality of life questionnaire.

Results

The reliability (Cronbach’s α = 0.86) and validity of the measurements using the parent-reported KINDL-R were confirmed. Means and percentiles were calculated for the total sample as well as for strata defined by age, sex, geographical region (east/west), migration status and socioeconomic status. Expected differences in health-related quality of life of children and adolescents from different social backgrounds and with different health statuses were demonstrated by differences in the KINDL-R scores (effect size d up to 1.29).

Conclusion

This study provides representative, normative data (self-report and parent-report) on the test scores of health-related quality of life (KINDL-R) for the population of children and adolescents in Germany in general, as well as in sociodemographic and socioeconomic subpopulations.
Literature
1.
go back to reference Bethell C, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW (2002) Identifying children with special health care needs: development and evaluation of a short screening instrument. Ambul Pediatr 2:38–48CrossRefPubMed Bethell C, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW (2002) Identifying children with special health care needs: development and evaluation of a short screening instrument. Ambul Pediatr 2:38–48CrossRefPubMed
2.
go back to reference Bradley R, Corwyn R (2002) Socioeconomic status and child development. Annu Rev Psychol 53:371–399CrossRefPubMed Bradley R, Corwyn R (2002) Socioeconomic status and child development. Annu Rev Psychol 53:371–399CrossRefPubMed
3.
go back to reference Bullinger M (2002) Assessing health related quality of life in medicine: an overview over concepts, methods and applications in international research. Restor Neurol Neurosci 20:93–101PubMed Bullinger M (2002) Assessing health related quality of life in medicine: an overview over concepts, methods and applications in international research. Restor Neurol Neurosci 20:93–101PubMed
4.
go back to reference Bullinger M (2003) Measuring health related quality of life: an international perspective. Adv Exp Med Biol 528:113–122CrossRefPubMed Bullinger M (2003) Measuring health related quality of life: an international perspective. Adv Exp Med Biol 528:113–122CrossRefPubMed
5.
go back to reference Bullinger M, Brütt AL, Erhart M, Ravens-Sieberer U, BELLA study group (2008) Psychometric properties of the KINDL-R questionnaire: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):125–132 Bullinger M, Brütt AL, Erhart M, Ravens-Sieberer U, BELLA study group (2008) Psychometric properties of the KINDL-R questionnaire: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):125–132
6.
go back to reference Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56:81–105CrossRefPubMed Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56:81–105CrossRefPubMed
7.
go back to reference Edwards T, Huebner C, Connell F, Patrick D (2002) Adolescents quality of life, Part I: conceptual and measurement model. J Adolesc 25:275–286CrossRefPubMed Edwards T, Huebner C, Connell F, Patrick D (2002) Adolescents quality of life, Part I: conceptual and measurement model. J Adolesc 25:275–286CrossRefPubMed
8.
go back to reference Erhart M, Hölling H, Bettge S, Ravens-Sieberer U, Schlack R (2007) Der Kinder- und Jugendgesundheitssurvey: Risiken und Ressourcen für die psychische Entwicklung von Kindern und Jugendlichen. [The German health interview and examination survey for children and adolescents (KiGGS): risks and resources for the mental development of children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:800–809CrossRefPubMed Erhart M, Hölling H, Bettge S, Ravens-Sieberer U, Schlack R (2007) Der Kinder- und Jugendgesundheitssurvey: Risiken und Ressourcen für die psychische Entwicklung von Kindern und Jugendlichen. [The German health interview and examination survey for children and adolescents (KiGGS): risks and resources for the mental development of children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:800–809CrossRefPubMed
9.
go back to reference Goodmann R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRef Goodmann R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586CrossRef
10.
go back to reference Hays R, Hayashi T (1990) Beyond internal consistency reliability: rationale and users guide for the multitrait analysis program on the microcomputer. Behav Res Methods Instrum Comput 23:167–169 Hays R, Hayashi T (1990) Beyond internal consistency reliability: rationale and users guide for the multitrait analysis program on the microcomputer. Behav Res Methods Instrum Comput 23:167–169
11.
go back to reference Nunnally JC, Bernstein IR (1994) Psychometric theory. McGraw-Hill, New York Nunnally JC, Bernstein IR (1994) Psychometric theory. McGraw-Hill, New York
12.
go back to reference Prevention CfDCa (2000) Measuring healthy days: population assessment of health-related quality of life. Center for Disease Control and Prevention (CDC), Atlanta Prevention CfDCa (2000) Measuring healthy days: population assessment of health-related quality of life. Center for Disease Control and Prevention (CDC), Atlanta
13.
go back to reference Radoschewski M (2000) Gesundheitsbezogene Lebensqualität—Konzepte und Maße. Entwicklungen und Stand im Überblick. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 43:165–189CrossRef Radoschewski M (2000) Gesundheitsbezogene Lebensqualität—Konzepte und Maße. Entwicklungen und Stand im Überblick. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 43:165–189CrossRef
14.
go back to reference Rajmil L, Herdman M, De Sanmamed M, Detmar S, Bruil J, Ravens-Sieberer U, Bullinger M, Simeoni M, Auquier P, KIDSCREEN the European Group (2004) Generic health-related quality of life instruments in children and adolescents: a qualitative analysis of content. J Adolesc Health 34:37–45CrossRefPubMed Rajmil L, Herdman M, De Sanmamed M, Detmar S, Bruil J, Ravens-Sieberer U, Bullinger M, Simeoni M, Auquier P, KIDSCREEN the European Group (2004) Generic health-related quality of life instruments in children and adolescents: a qualitative analysis of content. J Adolesc Health 34:37–45CrossRefPubMed
15.
go back to reference Ravens-Sieberer U (2003) Der KINDL-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen—Revidierte Form. In: Schumacher JKA, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 184–188 Ravens-Sieberer U (2003) Der KINDL-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen—Revidierte Form. In: Schumacher JKA, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 184–188
16.
go back to reference Ravens-Sieberer U, Bettge S, Erhart M (2003) Lebensqualität von Kindern und Jugendlichen—Ergebnisse aus der Pilotphase des Kinder—und Jugendgesundheitssurveys. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 46:340–345CrossRef Ravens-Sieberer U, Bettge S, Erhart M (2003) Lebensqualität von Kindern und Jugendlichen—Ergebnisse aus der Pilotphase des Kinder—und Jugendgesundheitssurveys. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 46:340–345CrossRef
17.
go back to reference Ravens-Sieberer U, Bullinger M (1998) Assessing health related quality of life in chronically ill children with the german KINDL: first psychomertric and content analytical results. Qual Life Res 7:399–407CrossRefPubMed Ravens-Sieberer U, Bullinger M (1998) Assessing health related quality of life in chronically ill children with the german KINDL: first psychomertric and content analytical results. Qual Life Res 7:399–407CrossRefPubMed
18.
go back to reference 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 24:1199–1220CrossRefPubMed 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 24:1199–1220CrossRefPubMed
19.
go back to reference Ravens Sieberer U, Gosch A, Abel T, Auquier P, Bellach B, Bruil J, Dür W, Power M, Rajmil L, KIDSCREEN the European Group (2001) Quality of life in children and adolescents—a European public health perspective. Soz Praventivmed 46:297–302CrossRef Ravens Sieberer U, Gosch A, Abel T, Auquier P, Bellach B, Bruil J, Dür W, Power M, Rajmil L, KIDSCREEN the European Group (2001) Quality of life in children and adolescents—a European public health perspective. Soz Praventivmed 46:297–302CrossRef
20.
go back to reference Ravens-Sieberer U, Kurth B-M, KiGGS study group, BELLA study group (2008) The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 17(Suppl1): 10–21 Ravens-Sieberer U, Kurth B-M, KiGGS study group, BELLA study group (2008) The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 17(Suppl1): 10–21
21.
go back to reference Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen H-U, Rothenberger A, Herpertz-Dahlmann B, Resch F, Hölling H, Bullinger M, Barkmann C, Schulte-Markwort M, Döpfner M as the BELLA study group (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl1):22–23 Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen H-U, Rothenberger A, Herpertz-Dahlmann B, Resch F, Hölling H, Bullinger M, Barkmann C, Schulte-Markwort M, Döpfner M as the BELLA study group (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl1):22–23
22.
go back to reference Schumacher J, Klaiberg A, Brähler E (2003) Diagnostik von Lebensqualität und Wohlbefinden–Eine Einführung. In: Schumacher J, Klaiberg A, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 9–24 Schumacher J, Klaiberg A, Brähler E (2003) Diagnostik von Lebensqualität und Wohlbefinden–Eine Einführung. In: Schumacher J, Klaiberg A, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen, pp 9–24
23.
go back to reference von Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U (2006) Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health 60:130–135CrossRef von Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U (2006) Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health 60:130–135CrossRef
24.
go back to reference Wallander JL, Thompson RJ (1995) Psychosocial adjustment of children with chronic physical conditions. In: Roberts MC (ed) Handbook of pediatric psychology. Guilford Press, New York, pp 124–141 Wallander JL, Thompson RJ (1995) Psychosocial adjustment of children with chronic physical conditions. In: Roberts MC (ed) Handbook of pediatric psychology. Guilford Press, New York, pp 124–141
25.
go back to reference Ware J (2003) Conceptualization and measurement of health-related quality of life: comments on an evolving field. Arch Phys Med Rehabil 84:S43–S51CrossRefPubMed Ware J (2003) Conceptualization and measurement of health-related quality of life: comments on an evolving field. Arch Phys Med Rehabil 84:S43–S51CrossRefPubMed
26.
go back to reference Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundesgesundheitssurvey. Gesundheitswesen 61:S178–S183PubMed Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundesgesundheitssurvey. Gesundheitswesen 61:S178–S183PubMed
27.
go back to reference Wille N, Bettge S, Ravens-Sieberer U, BELLA study group (2008) Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):133–147 Wille N, Bettge S, Ravens-Sieberer U, BELLA study group (2008) Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):133–147
Metadata
Title
Health-related quality of life in children and adolescents in Germany: results of the BELLA study
Authors
Prof. Dr. Ulrike Ravens-Sieberer, MPH
Dr. Michael Erhart
Dipl.-Psych. Nora Wille, MPH
Prof. Dr. Monika Bullinger
the BELLA study group
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
European Child & Adolescent Psychiatry / Issue Special Issue 1/2008
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-008-1016-x

Other articles of this Special Issue 1/2008

European Child & Adolescent Psychiatry 1/2008 Go to the issue