Parents' perception of health-related quality of life in children and adolescents with excess weight

Nascimento, Melissa Maria Romero; Melo, Tatiana Rocha; Pinto, Rogério Melo Costa; Morales, Nívea Macedo Oliveira; Mendonça, Tânia Maria Silva; Paro, Helena Borges Martins da Silva; Silva, Carlos Henrique Martins

doi:10.1016/j.jped.2015.04.006

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ORIGINAL ARTICLES • J. Pediatr. (Rio J.) 92 (1) • Jan-Feb 2016 • https://doi.org/10.1016/j.jped.2015.04.006 copy

Parents' perception of health-related quality of life in children and adolescents with excess weight^☆ ☆ Please cite this article as: Nascimento MM, Melo TR, Pinto RM, Morales NM, Mendonça TM, Paro HB, et al. Parents' perception of health-related quality of life in children and adolescents with excess weight. J Pediatr (Rio J). 2016;92:65-72. ^☆☆ ☆☆ Study conducted at Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception.

METHODS:

This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n = 170) and with overweight/obesity (n = 127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores.

RESULTS:

Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p < 0.01; d = 0.49), self-esteem (p < 0.01; d = 0.38), parental impact-emotional (p < 0.05; d = 0.29), family cohesion (p < 0.05; d = 0.26), physical summary score (p < 0.05; d = 0.29), and psychosocial summary score (p < 0.05; d = 0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (ß = 0.23; p < 0.05); self-esteem, nutritional status (ß = -0.18; p ≤ 0.01); emotional impact on parents, impact on parents' time (ß = 0.31; p < 0.05); and in family cohesion, global behavior (ß = 0.30; p < 0.05).

CONCLUSIONS:

A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.

Keywords:
Quality of life; Child; Adolescents; Overweight; Obesity; Self-image

Characteristics	Normal weight n = 170	Overweight/Obesity n = 127	p-value
Children
Mean age in years (SD)	10.62 (1.08)	10.61 (1.40)	0.98^a
Female gender n (%)	101 (59.4%)	54 (42.5%)	<0.01^b

Caregivers
Mean age in years (SD)	36.78 (7.23)	37.98 (6.85)	0.15^a
Primary caregiver
Mother n (%)	153 (90.0%)	120 (94.5%)	0.34^b
Educational level n (%)			0.61^b
Illiterate	2 (1.2%)	1 (0.8%)
Elementary School	69 (40.6%)	51 (40.2%)
High School	55 (32.4%)	49 (38.6%)
College/University	44 (25.9%)	26 (20.5%)
Marital status n (%)			0.64^b
Married	106 (62.4%)	83 (65.4%)	0.64^b

Domains and summaries	Mean (SD)		F	p ^a	d ^b
	Normal weight	Overweight/obesity
GGH	83.06 (18.29)	78.78 (19.79)	5.88	0.06
PF	95.16 (12.54)	88.98 (20.97)	27.51	<0.01	0.49
REB	90.39 (19.26)	89.59 (19.23)	0.06	0.72
RP	94.61 (16.87)	91.60 (17.68)	4.51	0.14
BP	83.71 (20.55)	81.81 (22.59)	2.76	0.45
BE	72.26 (17.35)	69.92 (17.05)	0.24	0.25
GBE	80.93 (20.54)	78.74 (22.02)	1.87	0.38
MH	74.35 (14.80)	73.98 (14.98)	0.49	0.83
SE	89.00 (17.66)	82.32 (16.01)	0.86	<0.01	0.38
GH	72.35 (14.45)	70.77 (14.72)	0.06	0.36
CH	74.12 (24.31)	70.08 (25.79)	3.34	0.17
PE	75.93 (22.67)	69.36 (25.37)	5.10	0.02	0.29
PT	90.39 (17.13)	87.05 (18.51)	3.45	0.11
FA	88.43 (12.79)	87.66 (15.00)	5.40	0.64
FC	75.00 (22.31)	69.17 (24.83)	4.98	0.04	0.26
PhS	51.86 (5.71)	50.18 (7.70)	7.37	0.03	0.29
PsS	48.46 (7.46)	46.56 (7.52)	1.71	0.03	0.25

	NS	GGH	PF	REB	RP	BE	GBE	MH	SE	PE	PT	FA	FC
NS	1
GGH	-0.1	1
PF	-0.2^b	0.2^b	1
REB	0.0	0.2^b	0.4^b	1
RP	-0.1^a	0.2^b	0.3^b	0.6^b	1
BE	-0.1	0.4^b	0.2^b	0.3^b	0.2^b	1
GBE	0.0	0.4^b	0.1	0.2^b	0.1	0.5^b	1
MH	0.0	0.3^b	0.2^b	0.2^b	0.1^a	0.5^b	0.3^b	1
SE	0.3^b	0.2^b	0.2^b	0.2^b	0.2^b	0.3^b	0.2^b	0.3^b	1
PE	-0.1^a	0.3^b	0.3^b	0.3^b	0. 2^b	0.4^b	0.2^b	0.3^b	0.3^b	1
PT	-0.1	0.2^b	0.4^b	0.4^b	0.3^b	0.3^b	0.2^b	0.2	0.2^b	0.5^b	1
FA	0.0	0.3^b	0.4^b	0.4^b	0. 3^b	0.4^b	0.4^b	0.4^b	0.3^b	0.5^b	0.5^b	1
FC	-0.1^a	0.3^b	0.1	0.0	0.1	0.3^b	0.4b	0.2^b	0.1	0.2^b	0.1^a	0.2^b	1

	Model 1			Model 2
Physical function
Adjusted R²	0.03			0.38
p ^a	<0.01			<0.01
	ß	p	95%CI	ß	p	95% CI
Constant		<0.01	[92.65; 97.68]		<0.01	[12.06; 35.17]
NS^b	-0.18	<0.01	[-10.04; -2.34]	-0.13	<0.01	[-7.69; -1.48]
REB				0.18	<0.01	[0.06; 0.27]
RP				0.19	<0.01	[0.08; 0.30]
PT				0.23	<0.01	[0.12; 0.33]
FA				0.18	<0.01	[0.08; 0.35]

Self-esteem
Adjusted R²	0.03			0.09
p ^a	<0.01			<0.01
	ß	p	95%CI	ß	p	95% CI
Constant		<0.01	[86.43; 91.56]		<0.01	[54.92; 75.91]
NS^b	-.192	<0.01	[-10.60; -2.76]	-0.18	<0.01	[-10.10; -2.48]
BE				0.14	0.03	[0.01; 0.26]
MH				0.16	0.01	[0.04; 0.33]

Emotional impact on parents
Adjusted R²	0.02			0.27
p ^a	0.02			<0.01
	ß	p	95%CI	ß	p	95% CI
Constant		<0.01	[72.33; 79.53]		0.22	[-28.77; 6.58]
NS^b	-0.14	0.02	[-12.08; -1.07]	-0.09	0.06	[-9.28; 0.26]
BE				0.11	0.06	[-0.01; 0.32]
MH				0.06	0.26	[-0.08; 0.29]
FA				0.19	<0.01	[0.13; 0.56]
PT				0.31	<0.01	[0.26; 0.57]

Family cohesion
Adjusted R²	0.01			0.22
p ^a	0.03			<0.01
	ß	p	95%CI	ß	p	95% CI
Constant		<0.01	[71.46; 78.54]		<0.01	[6.60; 32.97]
NS^b	-0.12	0.03	[-11.23; -0.42]	-0.08	0.11	[-8.76; 0.91]
GH				0.13	0.02	[0.02; 0.30]
BE				0.15	0.02	[0.04; 0.36]
GB				0.30	<0.01	[0.21; 0.47]

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[1] Corresponding author. E-mail:helenaparo@famed.ufu.br (H.B.M.S. Paro).