A study of concordance between adolescent self-report and parent-proxy report of health-related quality of life in school-going adolescents

Abstract

Objectives: The purpose of the study was to determine the degree of concordance between the self-report and the parent's proxy report of health-related quality of life (HRQoL) in school-going adolescents using the World Health Organization Quality of Life (WHOQOL)-BREF instrument in India. Methods: Twenty schools were purposively selected out of the 1900 schools in Lucknow, India. About 5% adolescents (between 10-19 years) per school were randomly selected by lottery system. Subjects, whose parents consented for child's participation, completed the WHOQOL-BREF self-report and their parents filled the WHOQOL-BREF proxy-report for adolescent's HRQoL. Degree of concordance and association were assessed using Cohen's κ and Spearman's correlation, respectively. Results: Five hundred fifteen adolescents (mean age=14 years with a standard deviation of ±2 years; 48.2% females) were included. κ Statistic values ranged from fair to moderate for all facets and dimensions of HRQoL between adolescent and parent report (κ =0.31-0.58, P<.01). There were moderate to very strong correlations between adolescent self and parent proxy report (r=0.62-0.81, P<.01) which declined with age of adolescent. The mother's scores correlated best in psychological dimension (r=0.81-0.88, P<.01) while that of father correlated best in environment dimension (r=0.81-0.79, P<.01), irrespective of child's gender. Conclusion: Our study illustrated that fair to moderate agreement existed between parent proxy and subject's self-report for adolescent's HRQoL. That may be an indicator for suitability of parent's proxy report in certain dimensions, if a child is unavailable or unable to respond. However, further research may provide new insights into the determinants of concordance between subject self and parent proxy report of adolescent HRQoL.