Six Years Beyond Pediatric Trauma: Child and Parental Ratings of Children's Health-related Quality of Life in Relation to Parental Mental Health

Purpose: To examine the relationship between child self-report and parent proxy report of health-related quality of life (HRQL) and how parents' mental health status relates to the HRQL ratings 6 years after minor to severe injury of the child.

Materials And Methods: This cross-sectional cohort study was performed at a regional pediatric trauma center in Stockholm, Sweden. The PedsQL 4.0 versions for ages 5-7, 8-12, and 13-18 years were completed by 177 child-parent dyads 6 years after injury to the child. The parents also rated their own mental health through the mental health domain (MH) in the SF-36 Health Survey.

Results: The children's median age was 13 years (IQR 10-16 years), 54 % were males, and the median ISS was 5 (IQR 2-9). Most of the parents were female (77 %), born in Sweden (79 %), and half had university degrees. There was no statistically significant difference between child self-report and parent proxy report in any of the PedsQL 4.0 scales or summary scales. The levels of agreement between child self-report and parent proxy reports were excellent (ICC ≥ 0.80) for all scales with the exception of emotional functioning (ICC 0.53) which also was the scale with the lowest internal consistency in child self-report (α 0.60). Multiple regression analyses showed that worse parental mental health status correlated with worse child self-report and parent proxy report of children's HRQL.

Conclusions: Children and their parents' reports on child's HRQL were in agreement. Decreased mental health in parents was associated with lower scores on parent proxy reports and child self-reports of HRQL after injury. The current investigation highlights the possible relationship between parent's mental health status and children's HRQL long after an injury, which should be considered in future investigations and in clinical care.