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Adolescent-parent disagreement on health-related quality of life in food allergic adolescents; who makes the difference?


Food allergic adolescents are at highest risk for food allergy fatalities, which may be partly due to compromised self-management behaviour. Such behaviour may be negatively influenced by conflictual situations caused by child-parent disagreement on the adolescent’s Health-Related Quality of Life (HRQL). Comparisons of self- and parent-proxy-reported HRQL have never extensively been studied in food allergic adolescents. Therefore, the aims of this study were to investigate disagreement in self- and parent-proxy-reported HRQL of food allergic adolescents and to investigate the influence of participant characteristics, illness expectations and perceptions on adolescent-parent disagreement.


Teenager Form (-TF) and -Parent Form (-PFA) of the Food Allergy Quality of Life Questionnaire (FAQLQ), Food Allergy Independent Measure (FAIM) and Brief-Illness Perception Questionnaire (Brief-IPQ) were sent to Dutch food allergic adolescents (13-17 years) and their parents. ICCs, t-tests and Bland-Altman plots were used to examine adolescent-parent agreement. Factors influencing agreement were studied (linear regression).


Seventy adolescent-parent pairs were included. There was a moderate correlation (ICC=0.61, p<0.001) and no significant difference (3.78 versus 3.56, p=0.136) between adolescent- and parent-proxy-reported HRQL. However, Bland-Altman plots showed relevant differences (exceeding minimal important difference) for 64% of all adolescent-parent pairs. Regression analysis showed that an older age of adolescents, poorer adolescent-reported illness comprehension (Brief-IPQ-TF, coherence) and higher adolescent-reported perceived disease severity (FAIM-TF) were associated with adolescent-parent disagreement on HRQL.


Adolescent-parent agreement on HRQL was moderate. Adolescent-parent disagreement on HRQL was mainly determined by the adolescent’s rather than the parent's perceptions and characteristics. Illness comprehension may be an important target for intervention aimed at improving adolescent-parent agreement on HRQL. This may contribute to improved self-management of food allergic adolescents.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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van der Velde, J.L., Flokstra-de Blok, B.M., Hamp, A. et al. Adolescent-parent disagreement on health-related quality of life in food allergic adolescents; who makes the difference?. Clin Transl Allergy 1 (Suppl 1), O40 (2011).

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