Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis.
OBJECTIVE
To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN).


METHODS
The KIDSCREEN-52 questionnaire was filled in by 21,590 children and adolescents aged 8-18 from 12 countries. We used multilevel regression analyses to model the hierarchical structure of the data. In addition, effect sizes were computed to test for gender differences within each age group.


RESULTS
Children generally showed better HRQOL than adolescents (P < 0.001). While boys and girls had similar HRQOL at young age, girls' HRQOL declined more than boys' (P < 0.001) with increasing age, depending on the HRQOL scale. There was significant variation between countries both at the youngest age and for age trajectories.


CONCLUSIONS
For the first time, gender and age differences in children's and adolescents' HRQOL across Europe were assessed using a comprehensive and standardised instrument. Gender and age differences exist for most HRQOL scales. Differences in HRQOL across Europe point to the importance of national contexts for youth's well-being.
Department of Social and Behavioural Health Research, Institute of Social and Preventive Medicine, University of Bern, Niesenweg 6, 3012 Bern, Switzerland. michel@ispm.unibe.ch
Gisela
G
Michel
Corinna
C
Bisegger
Daniela C
DC
Fuhr
Thomas
T
Abel
D000293:Adolescent; D000367:Age Factors; D002648:Child; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires