Factors associated with discrepancy of child-adolescent/parent reported quality of life in the era of COVID-19
Authors: Jeanbert Elodie , Baumann Cédric , Tarquinio Cyril , Rousseau Hélène , Bourion-Bédès Stéphanie 
Published: May 2022

Abstract
ObjectivesBillions of children and adolescents experienced unprecedented changes in their daily lives that impacted their health-related quality of life during the first wave of coronavirus disease 2019. The purpose of this study was to describe child-parent discrepancies in reporting quality of life and explore factors associated with such discrepancies at the end of the first lockdown in France. Methods A cross-sectional study was conducted among French school-aged children from 8 to 18 years and their parents living in the Grand Est region in France during the first wave of the epidemic. Data were obtained through an online survey. Child-reported and parent-rated health-related quality of life were assessed by the KIDSCREEN-27 scale. Sociodemographic data, living and learning conditions data and parent’s levels of anxiety, stress, social support, quality of life and resilience were also collected. Multinomial multivariate logistic regression analyses were used to determine the factors associated with discrepant parent-child reports of health-related quality of life. ResultsA total of 471 parent-child pairs were included. In each dimension, there were about 50% of discordant pairs which ranged from 42.9% for the physical well-being dimension to 51.8% for the peers and social support dimension. There were more discrepancies in the sense of under-estimation of the quality of life of children by parents, which ranged from 30.8% for the autonomy and parents’ dimension to 41.4% for the physical well-being dimension, than over-estimation. Factors associated with parental overestimation included tensions and conflicts with neighbors reported by children for physical well-being dimension, parents' professional activity (whether they work full time, part time or not at all) and MSPSS significant others score for psychological well-being dimension, parents' highest diploma for autonomy and parents dimension, children’s education level and home location for peers and social support dimension and the access or not to a garden for school environment. Factors associated with parental underestimation were SF12 score, home location and whether a household member was infected by COVID-19 or not for physical well-being dimension, children gender for psychological well-being dimension, presence of noise in the residence reported by children, parent’s highest diploma and family structure for autonomy and parents dimension, children’s education level for peers and social support dimension, and SF12 score and the access or not to a garden for school environment.ConclusionAgreement between child and parent reports was mostly good. However, discrepancies may occur and the directional discrepancy showed parents’ tendency to underestimate their child’s health-related quality of life. These discrepancies can be explained by living and sociodemographic factors. It will therefore be important to take these factors into account in the use of parent-estimated child health-related quality of life in future studies.