title: Adolescent-parent disagreement on health-related quality of life of food-allergic adolescents: who makes the difference?
abstract: BACKGROUND
  Food-allergic adolescents are at highest risk for food allergy fatalities, which may be partly due to compromised self-management behavior. Such behavior may be negatively influenced by conflictual situations caused by adolescent-parent disagreement on the adolescent's health-related quality of life (HRQL). Comparisons of adolescent-self-reported and parent-proxy-reported HRQL of food-allergic adolescents have never extensively been studied. The aims of this study were to investigate disagreement in adolescent-self-reports and parent-proxy-reports on the HRQL of food-allergic adolescents and to investigate the factors influencing adolescent-parent disagreement.
  
  
  METHODS
  Teenager Form (TF) and Parent Form (PFA) of the Food Allergy Quality of Life Questionnaire (FAQLQ), Food Allergy Independent Measure (FAIM), and Brief-Illness Perception Questionnaire (Brief-IPQ) were sent to food-allergic Dutch adolescents (13-17 years) and their parents. ICCs, t-tests, and Bland-Altman plots were used to investigate adolescent-parent disagreement. Participant characteristics, illness expectations, and illness perceptions influencing adolescent-parent disagreement were studied using regression analysis.
  
  
  RESULTS
  Seventy adolescent-parent pairs were included. There were a moderate correlation (ICC = 0.61, P < 0.001) and no significant difference (3.78 vs 3.56, P = 0.103) between adolescent-self-reported and parent-proxy-reported HRQL at group level. However, Bland-Altman plots showed relevant differences (exceeding the minimal important difference) for 63% of all adolescent-parent pairs. Adolescent's age (> 15 years), poorer adolescent-reported illness comprehension (Brief-IPQ-TF, coherence), and higher adolescent-reported perceived disease severity (Food Allergy Independent Measure-Teenager Form & -Parent Form) were associated with adolescent-parent disagreement.
  
  
  CONCLUSIONS
  Adolescent-parent disagreement on the adolescent's HRQL was mainly associated with adolescents' rather than parents' perceptions and characteristics. Illness comprehension of the adolescent may be an important target for intervention aimed at reducing adolescent-parent disagreement.
authors.affiliation: Division of Pediatric Pulmonology and Pediatric Allergy, Department of Pediatrics, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. j.l.van.der.velde@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: Hamp
authors.forename: R C
authors.initials: RC
authors.lastname: Knibb
authors.forename: E J
authors.initials: EJ
authors.lastname: Duiverman
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
mesh_terms: D000293:Adolescent; D000328:Adult; D034462:Dissent and Disputes; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D005512:Food Hypersensitivity / Q000523:psychology*; D006801:Humans; D008297:Male; D010465:Perception; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult