Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Skip to main content

Advertisement

Springer Nature Link
Log in

Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objectives

To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN).

Methods

The KIDSCREEN-52 questionnaire was filled in by 21,590 children and adolescents aged 8–18 from 12 countries. We used multilevel regression analyses to model the hierarchical structure of the data. In addition, effect sizes were computed to test for gender differences within each age group.

Results

Children generally showed better HRQOL than adolescents (P < 0.001). While boys and girls had similar HRQOL at young age, girls’ HRQOL declined more than boys’ (P < 0.001) with increasing age, depending on the HRQOL scale. There was significant variation between countries both at the youngest age and for age trajectories.

Conclusions

For the first time, gender and age differences in children’s and adolescents’ HRQOL across Europe were assessed using a comprehensive and standardised instrument. Gender and age differences exist for most HRQOL scales. Differences in HRQOL across Europe point to the importance of national contexts for youth’s well-being.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

AT:

Austria

CH:

Switzerland

CZ:

Czech Republic

DE:

Germany

EL:

Greece

ES:

Spain

FR:

France

HU:

Hungary

HRQOL:

Health-related quality of life

NL:

The Netherlands

PL:

Poland

SE:

Sweden

UK:

United Kingdom

UNICEF:

United Nations International Children’s Emergency Fund

WHO:

World Health Organisation

References

  1. Evans, D. R. (1994). Enhancing quality of life in the population at large. Social Indicators Research, 33(1), 47–88.

    Article  Google Scholar 

  2. Bisegger, C., Cloetta, B., von Rueden, U., Abel, T., & Ravens-Sieberer, U. (2005). Health-related quality of life: Gender differences in childhood and adolescence. Sozial- und Praventivmedizin, 50(5), 281–291.

    Article  PubMed  Google Scholar 

  3. Cavallo, F., Zambon, A., Borraccino, A., Raven-Sieberer, U., Torsheim, T., & Lemma, P. (2006). Girls growing through adolescence have a higher risk of poor health. Quality of Life Research, 15(10), 1577–1585.

    Article  PubMed  Google Scholar 

  4. Jorngarden, A., Wettergen, L., & von Essen, L. (2006). Measuring health-related quality of life in adolescents and young adults: Swedish normative data for the SF-36 and the HADS, and the influence of age, gender, and method of administration. Health and Quality of Life Outcomes, 4, 91.

    Article  PubMed  Google Scholar 

  5. Kirchengast, S., & Haslinger, B. (2008). Gender differences in health-related quality of life among healthy aged and old-aged Austrians: Cross-sectional analysis. Gender Medicine, 5(3), 270–278.

    Article  PubMed  Google Scholar 

  6. European Commission: Directorate-General Health and Consumer Protection. (2000). Report on the state of young people’s health in the European Union. A Commission Services Working Paper. Retrieved 13 January, 2009 from http://ec.europa.eu/health/ph_information/reporting/ke01_en.pdf.

  7. Torsheim, T., Ravens-Sieberer, U., Hetland, J., Valimaa, R., Danielson, M., & Overpeck, M. (2006). Cross-national variation of gender differences in adolescent subjective health in Europe and North America. Social science & medicine, 62(4), 815–827.

    Article  Google Scholar 

  8. Verhulst, F. C., Achenbach, T. M., van der Ende, J., Erol, N., Lambert, M. C., Leung, P. W., et al. (2003). Comparisons of problems reported by youths from seven countries. The American journal of psychiatry, 160(8), 1479–1485.

    Article  PubMed  Google Scholar 

  9. Bergman, M. M., & Scott, J. (2001). Young adolescents’ wellbeing and health-risk behaviours: Gender and socio-economic differences. Journal of Adolescence, 24(2), 183–197.

    Article  PubMed  CAS  Google Scholar 

  10. Simeoni, M. C., Auquier, P., Antoniotti, S., Sapin, C., & San Marco, J. L. (2000). Validation of a French health-related quality of life instrument for adolescents: The VSP-A. Quality of Life Research, 9(4), 393–403.

    Article  PubMed  CAS  Google Scholar 

  11. Schmidt, S., & Power, M. (2006). Cross-cultural analyses of determinants of quality of life and mental health: Results from the Eurohis Study. Social Indicators Research, 77(1), 95–138.

    Article  Google Scholar 

  12. Sapin, C., Simeoni, M. C., El Khammar, M., Antoniotti, S., & Auquier, P. (2005). Reliability and validity of the VSP-A, a health-related quality of life instrument for ill and healthy adolescents. Journal of Adolescent Health, 36(4), 327–336.

    Article  PubMed  Google Scholar 

  13. Goldbeck, L., Schmitz, T. G., Besier, T., Herschbach, P., & Henrich, G. (2007). Life satisfaction decreases during adolescence. Quality of Life Research, 16(6), 969–979.

    Article  PubMed  Google Scholar 

  14. Gillison, F., Skevington, S., & Standage, M. (2008). Exploring response shift in the quality of life of healthy adolescents over 1 year. Quality of Life Research, 17(7), 997–1008.

    Article  PubMed  Google Scholar 

  15. Centers for Disease Control, Prevention. (2000). Measuring healthy days: Population assessment of health-related quality of life. Atlanta: U.S. Department of Health and Human Services.

    Google Scholar 

  16. Bullinger, M., & Ravens-Sieberer, U. (1995). Health-related QOL assessment in children: A review of the literature. European Review of Applied Psychology, 45(4), 245–254.

    Google Scholar 

  17. Eiser, C., & Morse, R. (2001). Quality-of-life measures in chronic diseases of childhood. Health technology assessment (Winchester, England), 5(4), 1–157.

    CAS  Google Scholar 

  18. Rajmil, L., Alonso, J., Berra, S., Ravens-Sieberer, U., Gosch, A., Simeoni, M. C., et al. (2006). Use of a children questionnaire of health-related quality of life (KIDSCREEN) as a measure of needs for health care services. Journal of Adolescent Health, 38(5), 511–518.

    Article  PubMed  Google Scholar 

  19. Robitail, S., Simeoni, M. C., Erhart, M., Ravens-Sieberer, U., Bruil, J., & Auquier, P. (2006). Validation of the European proxy KIDSCREEN-52 pilot test health-related quality of life questionnaire: First results. Journal of Adolescent Health, 39, 596 e1–596 e10.

    Article  Google Scholar 

  20. The KIDSCREEN Group Europe. (2006). The KIDSCREEN questionnaires. Quality of life questionnaire for children and adolescents. Handbook. Lengerich: Pabst Science.

    Google Scholar 

  21. World Health Organization. (1646). Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946. New York.

  22. Berra, S., Ravens-Sieberer, U., Erhart, M., Tebe, C., Bisegger, C., Duer, W., et al. (2007). Methods and representativeness of a European survey in children and adolescents: the KIDSCREEN study. BMC Public Health, 7, 182.

    Article  PubMed  Google Scholar 

  23. Ravens-Sieberer, U., Gosch, A., Rajmil, L., Erhart, M., Bruil, J., Power, M., et al. (2008). The KIDSCREEN-52 Quality of Life Measure for Children and Adolescents: Psychometric Results from a Cross-Cultural Survey in 13 European Countries. Value Health, 11(4), 645–658.

    Article  PubMed  Google Scholar 

  24. Rasbash, J., Browne, W., Goldstein, H., Yang, M., Plewis, I., Healy, M., et al. (2000). A user’s guide to MLwiN, Version 2.1. London: Institute of Education.

    Google Scholar 

  25. World Health Organisation. (1999). Gender and health in adolescence. Copenhagen. Copenhagen: World Health Organisation.

    Google Scholar 

  26. Palacio-Vieira, J. A., Villalonga-Olives, E., Valderas, J. M., Espallargues, M., Herdman, M., Berra, S., et al. (2008). Changes in health-related quality of life (HRQoL) in a population-based sample of children and adolescents after 3 years of follow-up. Quality of Life Research, 17(10), 1207–1215.

    Article  PubMed  CAS  Google Scholar 

  27. Hampel, P. (2007). Brief report: Coping among Austrian children and adolescents. Journal of Adolescence, 30(5), 885–890.

    Article  PubMed  Google Scholar 

  28. Plancherel, B., & Bolognini, M. (1995). Coping and mental health in early adolescence. Journal of Adolescence, 18(4), 459–474.

    Article  Google Scholar 

  29. Eccles, J. S. (1999). The development of children ages 6 to 14. The Future of Children, 9(2), 30–44.

    Article  PubMed  CAS  Google Scholar 

  30. Patton, G. C., & Viner, R. (2007). Pubertal transitions in health. Lancet, 369(9567), 1130–1139.

    Article  PubMed  Google Scholar 

  31. Petersen, A. C., Sarigiani, P. A., & Kennedy, R. E. (1991). Adolescent depression: Why more girls? Journal of Youth and Adolescence, 20(2), 247–271.

    Article  Google Scholar 

  32. Nolen-Hoeksema, S., Girgus, J. S., & Seligman, M. E. P. (1991). Sex differences in depression and explanatory style in children. Journal of Youth and Adolescence, 20(2), 233–245.

    Article  Google Scholar 

  33. Gadin, K. G., & Hammarstrom, A. (2005). A possible contributor to the higher degree of girls reporting psychological symptoms compared with boys in grade nine? European Journal of Public Health, 15(4), 380–385.

    Article  PubMed  Google Scholar 

  34. Kuehner, C. (2003). Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta psychiatrica Scandinavica, 108(3), 163–174.

    Article  PubMed  CAS  Google Scholar 

  35. Steinberg, L., & Morris, A. S. (2001). Adolescent development. Annual Review of Psychology, 52, 83–110.

    Article  PubMed  CAS  Google Scholar 

  36. Nolen-Hoeksema, S., & Girgus, J. S. (1994). The emergence of gender differences in depression during adolescence. Psychological bulletin, 115(3), 424–443.

    Article  PubMed  CAS  Google Scholar 

  37. Paikoff, R. L., & Brooks-Gunn, J. (1991). Do parent–child relationships change during puberty? Psychological bulletin, 110(1), 47–66.

    Article  PubMed  CAS  Google Scholar 

  38. Colarossi, L. G., & Eccles, J. S. (2000). A prospective study of adolescents’ peer support: Gender differences and the influence of parental relationships. Journal of Youth and Adolescence, 29(6), 661–678.

    Article  Google Scholar 

  39. Phillipsen, L. C. (1999). Associations between age, gender, and group acceptance and three components of friendship quality. The Journal of Early Adolescence, 19(4), 438–464.

    Article  Google Scholar 

  40. Newman, M. L., Holden, G. W., & Delville, Y. (2005). Isolation and the stress of being bullied. Journal of Adolescence, 28(3), 343–357.

    Article  PubMed  Google Scholar 

  41. Rigby, K. (2000). Bullying in childhood. In P. K. Smith & C. H. Hart (Eds.), Blackwell handbook of childhood social development (pp. 549–568). Oxford: Blackwell.

    Google Scholar 

  42. UNICEF Innocenti Research Center. (2007). Child poverty in perspective: An overview of child well-being in rich countries. A comprehensive assessment of the lives and well-being of children and adolescents in the economically advanced nations. UNICEF Innocenti Research Center.

  43. The Lancet. (2004). Who is responsible for adolescent health? Lancet, 363(9426), 2009.

Download references

Acknowledgements

The authors are grateful to the children, adolescents, and families in the participating European countries and to the members of the KIDSCREEN group. Members of the KIDSCREEN group are Austria: Wolfgang Duer, Kristina Fuerth; Czech Republic: Ladislav Czerny; France: Pascal Auquier, Marie-Claude Simeoni, Stephane Robitail; Germany: Ulrike Ravens-Sieberer (international coordinator-in-chief), Michael Erhart, Jennifer Nickel, Bärbel-Maria Kurth, Angela Gosch, Ursula von Rüden; Greece: Yannis Tountas, Christina Dimitrakakis; Hungary: Agnes Czimbalmos, Anna Aszman; Ireland: Jean Kilroe, Celia Keenaghan; The Netherlands: Jeanet Bruil, Symone Detmar, Eric Verrips; Poland: Joanna Mazur, Ewa Mierzejeswka; Spain: Luis Rajmil, Silvina Berra, Cristian Tebé, Michael Herdman, Jordi Alonso; Sweden: Curt Hagquist; Switzerland: Thomas Abel, Corinna Bisegger, Bernhard Cloetta, Claudia Farley; and United Kingdom: Mick Power, Clare Atherton, Katy Phillips.

Conflict of interests

No conflict of interest. We also declare that we have full control of all primary data, and we agree to allow the journal to review their data if requested.

Funding

The KIDSCREEN project was financed by a grant from the European Commission (QLG-CT-2000-00751) within the EC 5th Framework-Programme “Quality of Life and Management of Living Resources”. In Switzerland, the project was funded by the Swiss Federal Office for Education and Science. Gisela Michel was funded by a fellowship of the Swiss National Science Foundation (PA001–117433/1).

Author information

Authors and Affiliations

  1. Department of Social and Behavioural Health Research, Institute of Social and Preventive Medicine, University of Bern, Niesenweg 6, 3012, Bern, Switzerland

    Gisela Michel, Corinna Bisegger, Daniela C. Fuhr & Thomas Abel

  2. Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK

    Gisela Michel

Authors
  1. Gisela Michel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corinna Bisegger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela C. Fuhr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Abel
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The KIDSCREEN group

Corresponding author

Correspondence to Gisela Michel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Michel, G., Bisegger, C., Fuhr, D.C. et al. Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res 18, 1147–1157 (2009). https://doi.org/10.1007/s11136-009-9538-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-009-9538-3

Keywords

Search

Navigation