RESUMEN
PURPOSE: This meta-analysis was conducted to assess differences in a child's health-related quality of life (HRQOL) as reported by the child and their parents using the Pediatric Quality of Life InventoryTM, and the effects in both children with attention deficit hyperactivity disorder (ADHD) and those with typical development. METHODS: Eight studies encompassing 16 independent groups met the inclusion criteria and were combined and compared in this meta-analysis. Fixed effect analysis was applied in the subgroup analysis to compare differences between children with ADHD and those with typical development. RESULTS: Small to moderate magnitudes of parent-child discrepancies were found in the ratings of the children's HRQOL both in those with ADHD (g = -0.23 [-0.33, -0.13], p < 0.001, physical HRQOL; g = -0.60 [-0.71, -0.48], p < 0.001, psychosocial HRQOL) and in those with typical development (g = -0.27 [-0.31, -0.23], p < 0.001, physical HRQOL; g = -0.29 [-0.33, -0.25], p < 0.001, psychosocial HRQOL) except for emotional HRQOL in children with typical development (g = 0.003 [-0.04, 0.04], p = 0.90). The parent-child discrepancy in rating the child's psychosocial HRQOL was significantly larger in the children with ADHD than in those with typical development. CONCLUSIONS AND IMPLICATIONS: This meta-analysis suggests that a child's HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports. Parent-child discrepancies, especially in psychosocial HRQOL, and sources of discrepancy need to be addressed when assessing the child's HRQOL and planning interventions in children with ADHD. Implications for Rehabilitation Parents reported a significantly worse health-related quality of life of their children than both the children with attention deficit hyperactivity disorder and those with typical development. A child's health-related quality of life needs to be assessed both by parent proxy and self-reports of the children. Children with attention deficit hyperactivity disorder and those with typical development differed significantly in parent-child discrepancy in child's psychosocial health-related quality of life, but not in physical health-related quality of life. Parent-child discrepancies, especially in psychosocial health-related quality of life, and sources of discrepancy (e.g., child, parent or family characteristics) need to be addressed when assessing the child's health-related quality of life and planning interventions in children with attention deficit hyperactivity disorder.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Calidad de Vida , Encuestas y Cuestionarios/normas , Humanos , AutoinformeRESUMEN
Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent-child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent-child agreement in children and adolescents.