Agreement between adolescent self-report and parent reports of health and well-being: results of an epidemiological study.
OBJECTIVE
To examine parent and adolescent agreement on physical, emotional, mental and social health and well-being in a representative population.


METHODS
An epidemiological design was used to obtain parent-child/adolescent dyad data on comparable items and scales of a generic measure of health and well-being, the Child Health Questionnaire (parent/proxy report 50 item, self-report 80 item). Scale analysis included intraclass correlations (ICCs) to examine strength of parent-child associations and independent t-tests for differences between adolescents (with or without an illness). Where there were significant differences in scale scores, analysis of variance and two sample t-tests were used to examine the influence of social, demographic, health concern and school variables. Single items were examined for trends in response categories.


RESULTS
2096 parent-adolescent dyads (adolescent mean age of 15.1 years, males 50%, maternal parent 83.2%, biological parent 93.5%). ICCs were strong. Overall, adolescents reported poorer emotional and social health, and clinically significant differences were observed for perceptions of general health (mean difference 8.1/100), frequency and amount of body pain (5.94/100), experience of mental health (5.14/100), and impact of health on family activities (12.43/100), which widen significantly for adolescents with illness. Social, health and school enjoyment and performance significantly widened parent-child differences.


CONCLUSIONS
All adolescents were much less optimistic about their health and well-being than their parents, and were only in close agreement on aspects of health and well-being they rated highly. Adolescent reports are more likely to be sensitive to pain, mental health problems, health in general and the impact of their health on family activities.
Waters
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E
Centre for Community Child Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia. elizabeth.waters@rch.org.au
Stewart-Brown
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S
Fitzpatrick
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D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D019964:Mood Disorders / Q000523:psychology; D010146:Pain / Q000523:psychology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D000297:Psychology, Adolescent; D012649:Self Concept; D012647:Self-Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014739:Victoria