Abstract
Objectives: This study examined parental knowledge of their children's oral-health-related quality of life (OHRQoL)(Objective 1), and the effects of different analytical techniques to manage ‘Don't know’(DK) responses on the validity and reliability of the questionnaire (Objective 2) and the level of agreement between parental and child reports (Objective 3). Methods: The parental (PPQ) and child (CPQ11–14) components of the Child Oral Health Quality of Life Questionnaire were used. Objectives 1 and 2 were addressed in the study that involved 221 parents and Objective 3 in the study that involved 63 pairs of parents and children. Four methods for treating DK responses in the PPQ were tested: listwise deletion, item mean imputation, imputation of the value zero and adjustment of scores to account for items with DK responses. Results: Respectively, 26 and 11% of the parents gave ≥3 and 6≥ DK responses to 33 items comprising the PPQ. DK responses were associated with child's age and clinical condition, and parental gender. The methods of managing DK responses did not have differing effects on the measurement properties of the PPQ and the level of agreement between parents and children. Conclusion: Some parents have limited knowledge concerning their children's OHRQoL. However, given that parental and child reports are measuring different realities, information provided by parents is useful even if it is incomplete.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Landgraf JM, Abetz L, Ware JE Jr. Child Health Questionnaire (CHQ): A User Manual. Boston, MA: The Health Institute, New England Medical Center, 1996.
le Coq EM, Colland VT, Boeke AJ, Boeke P, Bezemer DP. Van Eijk JT. Reproducibility, construct validity, and responsiveness of the 'How Are You?' (HAY), a self-report quality of life questionnaire for children with asthma. J Asthma 2000; 37(1): 43–58.
Varni JW, Seid M, Kurtin PS. PedsQL_ 4.0: reliability and validity of the Pediatric Quality of Life Inventory_ Version 4.0 Generic Core Scales in healthy and patient populations. Med Care 2001; 39(8): 800–812.
Theunissen NCM, Vogels TGC, Koopman HM, et al. The proxy problem: Child report versus parent report in healthrelated quality of life research. Qual Life Research 1998; 7: 387–397.
Vogels T, Verripis GHW, Verloove-Vanhorick SR, et al. Measuring health-related quality of life in children: The development of the TACQOL parent form. Qual Life Res 1998; 7: 457–465.
Verrips GHW, Vogels AGC, den Ouden AL, Paneth N, Verloove-Vanhorick SP. Measuring health-related quality of life in adolescents: Agreement between raters and between methods of administration. Child: Care Health Develop 2000; 26: 457–469.
Sawyer M, Antoniou G, Toogood I, Rice M. A comparison of parent and adolescent reports describing the health-related quality of life of adolescents treated for cancer. Int J Cancer 1999; 12(Suppl): S39–S45.
Parsons SK, Barlow SE, Levy SL, Supran SE, Kaplan SH. Health-related quality of life in pediatric bone marrow transplant survivors: According to whom? Int J Cancer 1999; 12(Suppl): S46–S51.
Jokovic A, Locker D, Stephens M, Kenny D, Tompson B. Validity and reliability of a questionnaire to measure child oral health-related quality of life. J Dent Res 2002; 81(7): 459–463.
Jokovic A, Locker D, Stephens M, Kenny D, Tompson B. Measuring parental perceptions of child oral health-related quality of life. J Public Health Dentistry Spring 2003; 63(2): 67–72.
Streiner D, Norman G. Health Measurement Scales. A Practical Guide to Development and Use. New York: Oxford University Press, 1996.
DeVellis RF. Scale Development. Theory and Application. Newbury Park: Applied Social Research Methods Series, Vol. 26, Sage Publications, 1991.
Guyatt G, Bombardier C, Tugwell P. Measuring diseasespecific quality of life in clinical trials. J Can Med Assoc 1986; 134: 889–895.
Juniper EF, Guyatt GH, Jaeschke R. How to develop and validate a new health-related quality of life instrument. In: Spilker B (ed.), Quality of Life and Pharmacoeconomics in Clinical Trials, Philadelphia: Lippincott-Raven Publishers, 1996. 15. Jokovic A, Locker D, Stephens M, Guyatt G. Agreement between mothers and children in rating child oral healthrelated quality of life. Community Dent Oral Epidemiol, 2003; 31: 335-343.
Ware JE (Jr), Show KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Gui86903de. Boston, MA: The Health Institute, New England Medical Center, 1993.
Bartko JJ. The intraclass correlation coefficient as a measure of reliability. Psych 1966; Reports 19: 3–11.
Shrout PE, Fleiss JL (1979). Intraclass correlation: Uses in assessing rater reliability. Psych Bull 1979; 86(2): 420–428.
Sneeuw K, Albertsen P, Aaronson N. Comparison of patient and spouse assessments of health-related quality of life in men with metastatic prostate cancer. J Urol 2001; 165: 478–482.
Sneeuw K, Aaronson M, de Haan R, Limburg M. Assessing quality of life after stroke: the value and limitations of proxy ratings. Stroke 1997; 28: 1541–1549.
Rossi PH, Wright JD, Anderson AB (eds).Handbook of Survey Research. London: Academic Press, 1983.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jokovic, A., Locker, D. & Guyatt, G. How well do parents know their children? implications for proxy reporting of child health-related quality of life. Qual Life Res 13, 1297–1307 (2004). https://doi.org/10.1023/B:QURE.0000037480.65972.eb
Issue Date:
DOI: https://doi.org/10.1023/B:QURE.0000037480.65972.eb