The relationship between proxy reported
health-related quality of life and parental distress:
gender differences
E. Davis,* B. Davies,† E. Waters* and N. Priest*
*McCaughey Centre,VicHealth Centre for the Promotion of Mental Health and Community Wellbeing, School of Population Health,
University of Melbourne, Carlton, and
†School of Health and Social Development, Burwood, Vic., Australia
Accepted for publication 30 April 2008
Keywords
parental gender, parental
mental health, proxy
reports and
health-related quality
of life
Correspondence:
Elise Davis, McCaughey
Centre, VicHealth Centre
for the Promotion of
Mental Health and
Community Wellbeing,
School of Population
Health, University of
Melbourne, Level 5, 207
Bouverie St, Carlton 3053,
Australia
E-mail:
eda@unimelb.edu.au
Abstract
Objective Although primary caregiver proxy reports of health-related quality of life (HRQOL) are
often used for healthcare decision making when child self-reports are unable to be collected
(because of a variety of reasons such as child illness, disability or age), we have little understanding
of the correlates of parent-proxy reports. The aim of this study was to examine the relationship
between parental depression and parent-proxy reported QOL for primary caregivers (mothers and
fathers), using a multidimensional HRQOL instrument. It was hypothesized that maternal depression
would be negatively correlated with maternal reported HRQOL, but that paternal depression would
not be correlated with paternal reported HRQOL.
Methods Data were from parents of children aged 4–5 years (n = 4983) involved in the
Longitudinal Study of Australian Children. A questionnaire assessing parental depression (Kessler-6)
and proxy reported HRQOL (Pediatric Quality of Life Inventory) was completed by the primary
caregiver.
Results For maternal primary caregivers, maternal depression was negatively correlated with
all domains of maternal proxy reports of HRQOL (r =-0.24 to r =-0.36). For paternal primary
caregivers, there was no relationship between paternal depression and paternal proxy reports of
HRQOL. Multiple regression analyses demonstrated that maternal depression was a significant
predictor of total HRQOL, accounting for 12% of the variance. For paternal mental health,
depression did not predict parent-proxy reported total HRQOL.
Conclusion These results highlight the importance of assessing maternal mental health when
measuring proxy reported QOL. Further research is needed in this area to examine the relationship
between parental depression and proxy reported HRQOL (including both mothers and fathers,
where possible), as well as child self-reported HRQOL.
Introduction
There is increasing interest in measuring the quality of life
(QOL) and health-related quality of life (HRQOL) of children,
particularly in the field of psychology, medicine and public
health. QOL is the ‘individuals’ perceptions of their position in
life in the context of the culture and value systems in which they
live, and in relation to their goals, expectations and concerns’
[World Health Organisation (WHO) QOL Group 1993, p. 153].
For children, ‘QOL includes, but is not limited to the social,
Child:
care, health and development
Original Article doi:10.1111/j.1365-2214.2008.00866.x
© 2008 The Authors
Journal compilation © 2008 Blackwell Publishing Ltd 830