Reliability in the ratings of quality of life between parents and their children of school age with cerebral palsy.
BACKGROUND
Quality of life is recognized as an important outcome of health services. Ideally, the child's perspectives should be sought directly to define their quality of life; however, this may be limited by age and cognitive and language abilities.


OBJECTIVE
In a sample of school-aged children with cerebral palsy (CP), we compared a parent's perspective of their child's quality of life with their child's own perspective, when feasible.


METHODS
Forty-eight children completed the Pediatric Quality of Life Inventory (PedsQL) measure independently (n = 33/48, 69% Gross Motor Function Classification System (GMFCS) I; n = 6/48, 12% III-V). A parent completed the proxy version and the scores were compared.


RESULTS
Intraclass correlation (ICC) coefficients were high for physical (ICC = 0.72, confidence interval [CI]: 0.55-0.83) and moderate for psychosocial (ICC = 0.54, CI: 0.30-0.71) well-being, with the weakest agreement on school functioning and the strongest agreement for ratings of physical health. Parental ratings were more often lower, especially for social functioning, although children rated themselves lower on emotional functioning. Factors associated with a closer agreement between parent-child pairs included older age, male gender, higher social competency, functional abilities, and fewer emotional symptoms (r (2) = 0.07-0.30).


CONCLUSIONS
In children with CP, parents' ratings of their children's quality of life are generally comparable as a group to their child's self-report. Disparities do exist, particularly in psychosocial domains, and, therefore, the child's own perspective should be considered whenever feasible.
Majnemer
Annette
A
School of Physical & Occupational Therapy, McGill University, Montreal Children's Hospital, 2300 Tupper St. A-509, Montreal, QC, Canada, H3H 1P3. Annette.majnemer@mcgill.ca
Shevell
Michael
M
Law
Mary
M
Poulin
Chantal
C
Rosenbaum
Peter
P
D002547:Cerebral Palsy; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D011788:Quality of Life; D011792:Quebec; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires