Cultural Differences in Parent-Adolescent Agreement on the Adolescent's
Asthma-Related Quality of Life
Mary Kay Rayens, Erla Kolbrun Svavarsdottir, and Patricia V. Burkart
The primary purpose of this exploratory, cross-sectional study was to determine
the degree of agreement between parents' and adolescents' rating of adolescents'
asthma-related quality of life (QOL). A secondary aim was to compare the
degree of agreement between parent-adolescent dyads in two countries; 15
dyads each were recruited from Kentucky and Iceland. Both adolescent and adult
participants completed separate paper surveys at the time of the adolescent's
clinic appointment. The QOL instrument used (PedsQL™ 3.0 Asthma Module)
contains the subscales of asthma symptoms, asthma treatment, worry, and communication.
Parent-adolescent differences were determined using paired t-tests;
associations were assessed with intraclass correlation coefficients (ICCs). Twosample
t-tests investigated between-country differences in parent-child consistency
in the assessment of the adolescent's asthma-related QOL. Adolescents
rated their QOL higher than their parents did, but not significantly. The ICC of the
QOL score for the 30 dyads was 0.39. The degree of agreement was high for
asthma symptoms, but low for asthma treatment, worry, and communication. U.S.
parents tended to underrate their child's QOL, while parents from Iceland overrated
it (p = 0.007). Family-centered interventions may improve parents' understanding
of how asthma affects QOL in adolescents, and such interventions may
have to be tailored for cultural differences.