Adolescent-parent disagreement on health-related quality of life of food-allergic adolescents: who makes the difference?

TLDR: 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 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.

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ORAL PRESENTATION Open Access
Adolescent-parent disagreement on health-
related quality of life in food allergic adolescents;
who makes the difference?
Jantina L van der Velde
1*
, Bertine MJ Flokstra-de Blok
2
, Ann Hamp
3
, Rebecca C Knibb
3
, Eric J Duiverman
4
,
Anthony EJ Dubois
1
From Food Allergy and Anaphylaxis Meeting 2011
Venice, Italy. 17-19 February 2011
Background
Food allergic adolescents are at highest risk for food
allergy fatalities, which may be partly due to compro-
mised self-management behaviour. Such behaviour may
be negatively influenced by conflictual situations cau sed
by child-parent disagreement on the adolescent’ s
Hea lth-Related Quality of Life (HRQL). Comparisons o f
self- and parent-proxy-repo rted HRQL have never
extensively been studied in food allergic adolescents.
Therefore, the aims of this study were to investigate dis-
agreement in se lf- and parent-proxy-reported HRQL of
food allergic adolescents and to inv estigate the influence
of participant characteristics, illness expectations and
perceptions on 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 Dutch food a llergic adolescents (13-17 years) and
their parents. ICCs, t- tests and Bland-Altman plots were
used to exa mine adole scent-parent agreement. Fa ctors
influencing agreement were studied (linear regression).
Results
Seventy ado lescent-parent p airs were included. There
was a moderate correlation (ICC=0.61, p<0.001) and no
significant difference (3.78 versus 3.56, p=0.136)
between adolescent- and parent-proxy-reported HRQL.
However, Bland-Altman plots showed relevant
differences (exceeding minima l important difference) for
64% of all adolescent-parent pairs. Regression analysis
showed that an older age of adolescents, poorer adoles-
cent-reported illness comprehension (Brief-IPQ-TF,
coherence) and higher a dolescent-reported perceived
disease severity ( FAIM-TF) were associated with adoles-
cent-parent disagreement on HRQL.
Conclusions
Adolescent-parent agreement on HRQL w as moderate.
Adolescent-parent disagreement on HRQL was ma inly
determined by the adolescent’s rather t han the parent’ s
perceptions and characteristics. Illness comprehension
maybeanimportanttargetfor intervention aimed at
improving adolescent-parent agreement on HRQL. This
may contribut e to improved self-management of food
allergic adolescents.
Author details
1
University Medical Centre Groningen, University of Groningen, Pediatric
Allergy and Pulmonology, Groningen, Netherlands.
2
University Medical
Centre Groningen, University of Groningen, General practice, Groningen,
Netherlands.
3
University of Derby, Department of Psychology, Derby, United
Kingdom.
4
University Medical Centre Groningen, University of Groningen,
Department of Pediatric Allergy and Pulmonology, Groningen, Netherlands.
Published: 12 August 2011
doi:10.1186/2045-7022-1-S1-O40
Cite this article as: van der Velde et al.: Adolescent-parent disagreement
on health-related quality of life in food allergic adolescents; who makes
the difference? Clinical and Trans lational Allergy 2011 1(Suppl 1):O40.
1
University Medical Centre Groningen, University of Groningen, Pediatric
Allergy and Pulmonology, Groningen, Netherlands
Full list of author information is available at the end of the article
van der Velde et al. Clinical and Translational Allergy 2011, 1(Suppl 1):O40
http://www.ctajournal.com/content/1/S1/O40
© 2011 van der Velde et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creat ive
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reproduction in any medium, provided the original work is properly cited.