Health-related quality of life and subjective well-being among children aged 9-12 years in eastern China

Abstract

Purpose To investigate the health-related quality of life (HRQoL) and subjective well-being (SWB) of children aged 9–12 years in eastern China, and examine concordance within parent-child dyads. Methods Data was collected from 9–12 years students (including their parents) in Shandong Province in 2018. Participants self-completed a hard-copy questionnaire including Child Health Utility 9 Dimension instrument (CHU9D), Pediatric Quality of Life Inventory (PedsQL)™ 4.0 Short Form 15 Generic Core Scales (hereafter the PedsQL), Student’s Life Satisfaction Scale (SLSS), as well as information on socio-demographic characteristics and self-report health status. Spearman’s correlation coefficients and the difference between sub-groups were conducted to assess and compare the agreement on HRQoL and SWB instruments. The concordance of within parent-child was analyzed using Cohen’s kappa coefficient and Bland-Altman plots. Results A total of 810 students and 810 parents were invited to participate in the survey. A valid sample of 799 (98.6%) students and 643 (79.4%) parents completed the questionnaire. Students’ mean self-reported CHU9D/PedsQL/SLSS scores were 0.87/83.48/30.90, respectively. The parent proxy’s PedsQL and SLSS scores were 68.61 and 31.23, respectively. The CHU9D was moderately correlated with the PedsQL (r = 0.52). There was a weak correlation between CHU9D and SLSS (r = 0.27). A low level of concordance was observed across all comparisons and in all domains (kappa < 0.20) between parents and their children. Besides, a high level of disagreement was observed between children’s own and fathers’ assessment. Conclusions CHU9D and PedsQL instruments have a higher agreement in measuring the HRQoL in children. CHU9D/PedsQL and SLSS instruments showed a low agreement and this suggests that measuring SWB in children potentially may provide further information that might be overlooked by using HRQoL instruments exclusively. Concordance between parents and children was poor. Overall, mothers-children dyads showed a higher concordance than fathers-children dyads.