title: Parents report better health-related quality of life for their food-allergic children than children themselves.
abstract: BACKGROUND
  Food allergy affects 5-6% of children and impairs health-related quality of life (HRQL). Children and parents may differ in their views concerning the child's HRQL. In food allergy, child- and parent-proxy-reported HRQL have never been compared using valid disease-specific instruments.
  
  
  OBJECTIVE
  The aim of this study was to compare child- and parent-proxy reports on HRQL in food-allergic children (8-12 years).
  
  
  METHODS
  The Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF), and -Parent Form (FAQLQ-PF) and the Food Allergy Independent Measure-Child Form and -Parent Form (FAIM-CF and -PF) were completed by Dutch food-allergic child-parent pairs. Child- and parent-proxy reports were correlated and tested for significant differences. Construct validity (Spearman's correlation coefficient between the FAQLQs and FAIMs) and internal consistency (Cronbach's α) were assessed and compared.
  
  
  RESULTS
  Seventy-four child-parent pairs were included. The FAQLQ-CF score was significantly higher than the FAQLQ-PF score (3.74 vs. 2.68, P<0.001, where 1 indicates no impairment and 7 indicates extreme impairment). FAIM-CF and -PF scores were almost identical (3.29 vs. 3.33, P=0.594). There was moderate agreement between the FAQLQ-CF and -PF scores (ICC=0.57 [P<0.001]) and good agreement between the FAIM-CF and -PF scores (ICC=0.80 [P<0.001]). Construct validity was confirmed for the FAQLQ-CF (ρ=0.60, P<0.001) and -PF (ρ=0.58, P<0.001). Internal consistency was excellent for the FAQLQ-CF (α=0.95) and -PF (α=0.95).
  
  
  CONCLUSIONS
  Parents reported significantly less impact of food allergy on the child's HRQL than children themselves, while reported perceptions of disease severity were nearly identical. This may reflect real differences in perspectives between children and parents and may indicate that parents tend to underestimate their child's HRQL impairment. It is important for clinicians to include both the child's and their parent's perceptions in order to perform a complete assessment of the impact of food allergy on the child's HRQL and to identify areas of disagreement that need special attention in clinical practice.
authors.affiliation: Department of Pediatrics, Division of Pediatric Pulmonology and Pediatric Allergy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. j.l.van.der.velde@bkk.umcg.nl
authors.forename: J L
authors.initials: JL
authors.lastname: van der Velde
authors.forename: B M J
authors.initials: BM
authors.lastname: Flokstra-de Blok
authors.forename: A
authors.initials: A
authors.lastname: Dunngalvin
authors.forename: J O'B
authors.initials: JO
authors.lastname: Hourihane
authors.forename: E J
authors.initials: EJ
authors.lastname: Duiverman
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology / Q000523:psychology*; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012647:Self-Assessment; D011795:Surveys and Questionnaires