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01-08-2020 | Obesity

Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

Authors: Delicia Shu Qin Ooi, Kah Yin Loke, Cindy Wei Li Ho, Yvonne Yijuan Lim, Veronica Tay, Vijaya Karuppiah, Andrew Anjian Sng, Lester Yousheng Lai, Yung Seng Lee, Konstadina Griva

Published in: Quality of Life Research | Issue 8/2020

Abstract

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.

Afshin, A., Forouzanfar, M. H., Reitsma, M. B., Sur, P., Estep, K., Lee, A., et al. (2017). Health effects of overweight and obesity in 195 countries over 25 years. The New England Journal of Medicine,377(1), 13–27. https://doi.org/10.1056/NEJMoa1614362.CrossRefPubMed

Ogden, C. L., Carroll, M. D., Fryar, C. D., & Flegal, K. M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. https://doi.org/10.1017/S1368980017000088.CrossRefPubMed

National Health Service. (2018). Statistics on obesity, physical activity and diet. National Statistics. Retrieved March 27, 2019, from https://files.digital.nhs.uk/publication/0/0/obes-phys-acti-diet-eng-2018-rep.pdf.

Ha, K. H., & Kim, D. J. (2016). Epidemiology of childhood obesity in Korea. Endocrinology and Metabolism,31(4), 510–518.CrossRef

Chu, N. F. (2001). Prevalence and trends of obesity among school children in Taiwan—The Taipei Children Heart Study. International Journal of Obesity. https://doi.org/10.1038/sj.ijo.0801486.CrossRefPubMed

Must, A., & Strauss, R. S. (1999). Risks and consequences of childhood and adolescent obesity. International Journal of Obesity. https://doi.org/10.1038/sj.ijo.0800852.CrossRefPubMed

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health. https://doi.org/10.2105/AJPH.2009.159491.CrossRefPubMedPubMedCentral

Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of the American Medical Association. https://doi.org/10.1001/jama.289.14.1813.CrossRefPubMed

Upton, P., Lawford, J., & Eiser, C. (2008). Parent-child agreement across child health-related quality of life instruments: A review of the literature. Quality of Life Research. https://doi.org/10.1007/s11136-008-9350-5.CrossRefPubMed

10.

Mash, E. J., & Hunsley, J. (2005). Evidence-based assessment of child and adolescent disorders: Issues and challenges. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1207/s15374424jccp3403_1.CrossRefPubMed

11.

Hughes, A. R., Farewell, K., Harris, D., & Reilly, J. J. (2007). Quality of life in a clinical sample of obese children. International Journal of Obesity. https://doi.org/10.1038/sj.ijo.0803410.CrossRefPubMed

12.

Zeller, M. H., & Modi, A. C. (2006). Predictors of health-related quality of life in obese youth. Obesity. https://doi.org/10.1038/oby.2006.15.CrossRefPubMed

13.

Pinhas-Hamiel, O., Singer, S., Pilpel, N., Fradkin, A., Modan, D., & Reichman, B. (2006). Health-related quality of life among children and adolescents: Associations with obesity. International Journal of Obesity. https://doi.org/10.1038/sj.ijo.0803107.CrossRefPubMed

14.

Jalali-Farahani, S., Shojaei, F. A., Parvin, P., & Amiri, P. (2018). Comparison of health-related quality of life (HRQoL) among healthy, obese and chronically ill Iranian children. BMC Public Health,18(1), 1337. https://doi.org/10.1186/s12889-018-6239-2.CrossRefPubMedPubMedCentral

15.

Bianchini, J. A. A., Da Silva, D. F., Nardo, C. C. S., Carolino, I. D. R., Hernandes, F., & Nardo Junior, N. (2013). Parent-proxy perception of overweight adolescents’ health-related quality of life is different according to adolescent gender and age and parent gender. European Journal of Pediatrics. https://doi.org/10.1007/s00431-013-2050-3.CrossRefPubMed

16.

Lin, C. Y., Su, C. T., Wang, J. D., & Ma, H. I. (2013). Self-rated and parent-rated quality of life (QoL) for community-based obese and overweight children. Acta Paediatrica, International Journal of Paediatrics.. https://doi.org/10.1111/apa.12108.CrossRef

17.

Jaeschke, R., Singer, J., & Guyatt, G. H. (1989). Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials. https://doi.org/10.1016/0197-2456(89)90005-6.CrossRefPubMed

18.

Eiser, C., & Morse, R. (2001). Can parents rate their child’s health-related quality of life? Results of a systematic. Quality of Life Research. https://doi.org/10.1023/A:1012253723272.CrossRefPubMed

19.

Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQLTM* 4 0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambulatory Pediatrics. https://doi.org/10.1367/1539-4409(2003)003%3c0329:tpaapp%3e2.0.co;2.CrossRefPubMed

20.

Østbye, T., Malhotra, R., Wong, H. B., Tan, S. B., & Saw, S. M. (2010). The effect of body mass on health-related quality of life among Singaporean adolescents: Results from the SCORM study. Quality of Life Research. https://doi.org/10.1007/s11136-009-9578-8.CrossRefPubMed

21.

Rosner, B. (2010). Fundamentals of Biostatistics. American Journal of Public Health and the Nations Health. https://doi.org/10.2105/AJPH.59.7.1266-a.CrossRef

22.

Martin Bland, J., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet. https://doi.org/10.1016/S0140-6736(86)90837-8.CrossRef

23.

Ranganathan, P., Pramesh, C., & Aggarwal, R. (2017). Common pitfalls in statistical analysis: Measures of agreement. Perspectives in Clinical Research. https://doi.org/10.4103/picr.picr_123_17.CrossRefPubMedPubMedCentral

24.

Sneeuw, K. C. A., Sprangers, M. A. G., & Aaronson, N. K. (2002). The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease. Journal of Clinical Epidemiology. https://doi.org/10.1016/S0895-4356(02)00479-1.CrossRefPubMed

25.

Fredrickson, B. L., Noll, S. M., Roberts, T. A., Quinn, D. M., & Twenge, J. M. (1998). That swimsuit becomes you: Sex differences in self-objedification, restrained eating, and math performance. Journal of Personality and Social Psychology. https://doi.org/10.1037/0022-3514.75.1.269.CrossRefPubMed

26.

Groot, W. (2000). Adaptation and scale of reference bias in self-assessments of quality of life. Journal of Health Economics. https://doi.org/10.1016/S0167-6296(99)00037-5.CrossRefPubMed

27.

Elliott Brown, K. A., & Barbarin, O. A. (1996). Gender differences in parenting a child with cancer. Social Work in Health Care,22(4), 53–71. https://doi.org/10.1300/J010v22n04_04.CrossRef

28.

Ho, H.-Z., Chen, W.-W., Tran, C. N., & Ko, C.-T. (2012). Parental involvement in taiwanese families: Father-mother differences. Childhood Education. https://doi.org/10.1080/00094056.2010.10523173.CrossRef

29.

Thornton, A., Orbuch, T. L., & Axinn, W. G. (1995). Parent-child relationships during the transition to adulthood. Journal of Family Issues. https://doi.org/10.1177/019251395016005003.CrossRef

30.

Endendijk, J. J., Groeneveld, M. G., Bakermans-Kranenburg, M. J., & Mesman, J. (2016). Gender-Differentiated parenting revisited: Meta-analysis reveals very few differences in parental control of boys and girls. PLoS ONE. https://doi.org/10.1371/journal.pone.0159193.CrossRefPubMedPubMedCentral

31.

Amin, A., Kågesten, A., Adebayo, E., & Chandra-Mouli, V. (2018). Addressing gender socialization and masculinity norms among adolescent boys: Policy and programmatic implications. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2017.06.022.CrossRefPubMed

32.

Keijsers, L., Branje, S. J. T., Frijns, T., Finkenauer, C., & Meeus, W. (2010). Gender differences in keeping secrets from parents in adolescence. Developmental Psychology. https://doi.org/10.1037/a0018115.CrossRefPubMed

33.

Jozefiak, T., Larsson, B., Wichstrøm, L., Mattejat, F., & Ravens-Sieberer, U. (2008). Quality of Life as reported by school children and their parents: A cross-sectional survey. Health and Quality of Life Outcomes. https://doi.org/10.1186/1477-7525-6-34.CrossRefPubMedPubMedCentral

34.

Seid, M., Varni, J. W., & Jacobs, J. R. (2000). Pediatric health-related quality-of-life measurement technology: intersections between science, managed care, and clinical care. Journal of Clinical Psychology in Medical Settings,7(1), 17–27. https://doi.org/10.1023/A:1009541218764.CrossRef

Title: Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?
Authors: Delicia Shu Qin Ooi
Kah Yin Loke
Cindy Wei Li Ho
Yvonne Yijuan Lim
Veronica Tay
Vijaya Karuppiah
Andrew Anjian Sng
Lester Yousheng Lai
Yung Seng Lee
Konstadina Griva
Publication date: 01-08-2020
Publisher: Springer International Publishing
Keywords: Obesity
Obesity
Published in: Quality of Life Research / Issue 8/2020
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-020-02472-y

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Springer Medicine

Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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