Agreement was not found in adolescents' quality of life rated by parents and adolescents

作者：Huang I Chan^*; Shenkman Elizabeth A; Leite Walter; Knapp Caprice A; Thompson Lindsay A; Revicki Dennis A

来源：Journal of Clinical Epidemiology, 2009, 62(3): 337-346.

DOI：10.1016/j.jclinepi.2008.06.012

• Adolescent
• Confirmatory factor analysis
• Health-related quality of life
• Health status
• Proxy
• Measurement invariance

Objective: Limited evidence examines agreement between the ratings of adolescents' health-related quality of life (HRQOL) by parents and adolescents especially accounting for measurement properties. This study aimed to test whether agreement exists between the dyads using a methodology of measurement invariance.
Study Design and Setting: We conducted a telephone survey to collect data from parents and their adolescents enrolled in Florida's Children's Medical Services (376 pairs) using the PedsQL 4.0. We used multi-group confirmatory factor analysis to test measurement invariance, including configural (equivalent HRQOL construct), metric (equivalent item-domain associations), scalar (equivalent starting value of ratings), and residual (equivalent nonsysternatic measurement errors of ratings) invariance. We also investigated correlates of discrepancies in the dyadic ratings.
Results: There were equivalent HRQOL constructs and item-domain associations between the dyads. However, some items show different starting values and nonsysternatic errors in the dyadic ratings. After adjusting for noninvariant items, adolescents reported significant higher HRQOL scores than parents in all domains (P < 0.05). Parents' rating of adolescents' health significantly contributed to discrepancies in the dyadic ratings (P < 0.05).
Conclusions: Adolescents rated HRQOL higher than their parents. This discrepancy was associated with severe health conditions. Without assuring measurement invariance, comparisons of the dyadic HRQOL ratings can be misleading.

• 出版日期2009-3