Health-related quality of life among Swedish children with Juvenile Idiopathic Arthritis: Parent-child discrepancies, gender differences and comparison with a European cohort

Abstract

Background: This study investigates gender differences in self-reports and between parent and child reports in Health-related Quality of Life (HRQOL), measured with disease-specific and generic instruments for chronic disease. Comparison of HRQOL results in this Juvenile Idiopathic Arthritis (JIA) sample to a European cohort of children with JIA and one of children with other health conditions are also made. Methods: Fifty-three children with juvenile idiopathic arthritis (JIA), aged 8-18 years, and their parents completed the condition-specific DISABKIDS for JIA, and the DISABKIDS generic instrument for chronic conditions (DCGM-37) in a cross-sectional study. European reference data were used for comparison of child and parental reports. Results: Child self-reports in DCGM-37 and DISABKIDS for JIA showed no gender differences. Parental and child reports of the child's HRQOL differed only in DCGM-37; this was among girls who scored their independence (p=0.03), physical limitation (p=0.01), social exclusion (p=0.03), emotions (p <0.01), and general transformed score (p <0.01) higher than did their parents. Our sample of children with JIA reported more physical limitation compared to samples of European children with JIA (p=0.01), European children with chronic conditions (p<0.01), and their parents (p=0.01 and p<0.01). The Swedish children reported more problem with understanding compared to the European JIA sample (p=0.03). Swedish parents perceived their children's independence significantly lower than did the European parents of JIA children (p<0.01), as well as European parents of children with chronic conditions (p=0.03). The Swedish parents also perceived their children to have significantly lower social inclusion (p<0.05) and general transformed score (p=0.04), in comparison to European parents of children with chronic conditions. Conclusions: Parent-child differences in assessment of quality of life depend on the HRQOL instrument used, especially among girls. In comparison to European cohorts, our sample of children with JIA experienced more physical limitations and less understanding.