Testing parent dyad interchangeability in the parent proxy-report of PedsQL™ 4.0: a differential item functioning...

Area of Science:

• Pediatric Health Research
• Psychometrics
• Child Psychology

Background:

• Parental proxy reports are crucial for assessing pediatric health-related quality of life (HRQoL).
• Limited research has explored gender differences in parental proxy ratings of children's HRQoL.
• The PedsQL™ 4.0 instrument is widely used for measuring HRQoL in children.

Purpose of the Study:

• To investigate the interchangeability of mothers' and fathers' proxy reports of children's HRQoL.
• To examine gender-specific agreement at both item and scale levels using differential item functioning (DIF).
• To assess the impact of parental gender on child-parent agreement in HRQoL studies.

Main Methods:

• Utilized data from 576 father-mother dyads completing the PedsQL™ 4.0 Generic Core Scales.
• Employed a polytomous item response theory (IRT) graded response model to detect DIF.
• Analyzed agreement at item and scale levels to identify measurement invariance between parental genders.

Main Results:

• Fathers and mothers demonstrated consistent understanding of PedsQL™ 4.0 items.
• High agreement was found between maternal and paternal reports across all subscales.
• While fathers reported slightly higher scores for physical and emotional functioning, effect sizes were small and likely not clinically significant.

Conclusions:

• Discrepancies in parental ratings reflect genuine differences, not measurement artifacts.
• Paternal proxy reports are comparable to maternal reports, supporting their combined use in research.
• Parental gender does not significantly affect child-parent agreement in HRQoL studies, validating interchangeability assumptions.