Saturday, June 22, 2024

Assessment of Children’s Quality of Life and Well-being in Eastern China

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Children’s health and well-being are paramount indicators of a society’s overall health. An insightful study was conducted in Shandong Province, eastern China, focusing on the health-related quality of life (HRQoL) and subjective well-being (SWB) of children aged 9-12 years. This research delves into the concordance between children’s self-reports and their parents’ proxy assessments, offering valuable insights into the alignment and discrepancies in perceptions between the two groups.

The study surveyed 810 children and their parents, achieving a high response rate of 98.6% for children and 79.4% for parents. Children completed questionnaires including the Child Health Utility 9D (CHU9D), Pediatric Quality of Life Inventory (PedsQLâ„¢) 4.0 Short Form 15 Generic Core Scales, and the Student’s Life Satisfaction Scale (SLSS). These instruments measured various facets of HRQoL and SWB, alongside socio-demographic data and self-reported health status.

Data Collection and Analysis

Spearman’s correlation coefficients were employed to gauge and compare the agreement of HRQoL and SWB instruments. Exploratory factor analysis (EFA) identified unique latent factors associated with these instruments. Additionally, the weighted kappa coefficient and Bland-Altman plots were used to assess the concordance between child self-reports and parent proxy-assessments.

The results revealed that children’s self-reported mean scores were CHU9D = 0.87, PedsQLâ„¢ = 83.47, and SLSS = 30.90. Parents reported mean scores of PedsQLâ„¢ = 68.61 and SLSS = 31.23. A moderate correlation was noted between child self-reported PedsQLâ„¢ and CHU9D (r = 0.52), while a weak correlation existed between CHU9D and SLSS (r = 0.27).

Key Findings and Implications

EFA results identified three factors, with seven SLSS items forming a standalone factor, and the nine CHU9D dimensions sharing two common factors with PedsQLâ„¢. It was observed that there was a low level of concordance across all comparisons and domains between parents and children (weighted kappa

The findings underscore that CHU9D and PedsQLâ„¢ instruments show higher agreement in measuring HRQoL in children, whereas CHU9D/PedsQLâ„¢ and SLSS instruments have low agreement. This suggests that SWB measurements can provide additional insights that might be overlooked when using HRQoL instruments alone.

Concrete Insights for Application

• CHU9D and PedsQL™ are reliable for assessing HRQoL in children, indicating higher agreement compared to other instruments.
• SWB instruments like SLSS can uncover unique aspects of children’s well-being that HRQoL tools might miss.
• Low concordance between parent and child assessments suggests the need for direct child participation in well-being studies.
• Mother-child concordance tends to be higher than father-child concordance, highlighting the potential influence of parental roles on assessment accuracy.

Overall, the study reveals significant insights into the alignment between children’s self-reported well-being and their parents’ assessments, emphasizing the importance of utilizing a combination of HRQoL and SWB instruments for a comprehensive evaluation.

Original Article: Health Qual Life Outcomes. 2024 May 31;22(1):41. doi: 10.1186/s12955-024-02258-7.

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