The Child Health Questionnaire in children with diabetes: cross-sectional survey of parent and adolescent-reported functional health status

AIMS: To study parent and adolescent-reported physical, psychosocial and family wellbeing in children aged 5-18 years with diabetes. METHODS: SUBJECTS: 5-18-year-olds attending a diabetes clinic at a tertiary children's hospital. MEASURES: (1) Child Health Questionnaire (CHQ) PF-50, a functional heath status measure for children aged 5-18 years (parents); (2) CHQ CF-80, a similar self-report measure (adolescents aged 12-18 years); (3) 11 study-designed questions related to diabetes-specific concerns (parents); (4) global ratings of physical and psychosocial health (clinicians); (5) HbA1c level (all subjects). CHQ data were compared with Australian normative data collected six months earlier. RESULTS: Reports were obtained from 128 parents and 71 adolescents (90 and 92% response). The CHQ demonstrated good psychometric properties in this sample of children with diabetes. Parents reported children with diabetes to have generally poorer health than children in the normative sample, especially on psychosocial and parent/family scales. Psychosocial health was markedly lower in 5-11-year-olds with HbA1c > 8.8%, but not in 12-18-year-olds. Presence of diabetes-related symptoms and concerns correlated with lower physical and psychosocial functioning. Parents and clinicians concurred in their ratings of health for 12-18-year-olds but not 5-11-year-olds. Adolescents reported their own health similarly to adolescents in the normative sample. CONCLUSIONS: Parents report children aged 5-18 years with diabetes to have poorer health than children in the normative sample across all domains. Clinicians may underrate the impact of diabetes for younger children, with possible therapeutic implications. In providing an overall description of health, instruments like the CHQ may add another dimension to the care of children with diabetes and can feasibly be used within clinical settings.