title: Health-related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy-report.
abstract: OBJECTIVE
  Health-related quality of life (HrQoL) is a multidimensional concept including self-reported measures of physical and mental health. Throughout the last decades, HrQoL has become a more and more important outcome measure not only in clinical conditions. This study evaluates current HrQoL of healthy children and adolescents, determinants of HrQoL, and the agreement between self- and proxy-report.
  
  
  METHODS
  From April 2012 to July 2013, we prospectively examined 530 healthy children (13.2 ± 2.1 years, 236 girls) and their parents on their childrens HrQoL using the KINDL-R self-report questionnaire and the parent's proxy-report. Data was compared to the established reference value from 2007 and the agreement of self- and parent's proxy-report was assessed by calculation of intraclass correlation coefficient (ICC).
  
  
  RESULTS
  In general, the HrQoL improved compared to references in both children's (104.5 ± 12.6 % of predicted reference value, P < .001) and parent's proxy-report (104.3 ± 12.3 % of predicted reference value, P < .001). HrQoL declined with proceeding age (r = -.247, P < .001) but was not associated with BMI (r = -.035, P = .420). There was good accordance between children's reported HrQoL and the parent's proxy-report (ICC: .774). Only in the domains 'self-esteem' (ICC: .558) and 'Emotional well-being' (ICC: .612) the agreements were moderate.
  
  
  CONCLUSIONS
  HrQoL perception has increased throughout the past 10 years and worsens with increasing age. Moreover, the parent's proxy-report of the KINDL-R questionnaire is a good supplementary method to provide additional information regarding to children's HrQoL.
authors.affiliation: Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Meyer
authors.affiliation: Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Oberhoffer
authors.affiliation: Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Hock
authors.affiliation: Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Giegerich
authors.affiliation: Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011446:Prospective Studies; D019727:Proxy; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: KINDL-R; children; cross-sectional; health-related quality of life; proxy-report; self-report