Cultural differences in parent-adolescent agreement on the adolescent's asthma-related quality of life

The purpose was to determine the degree of agreement between parent's and adolescent's ratings of the adolescent's asthma-related quality of life (QOL); and to assess whether consensus among parent-child dyads differs by country. The sample was comprised of 30 adolescents with asthma, each with one parent who participated, were recruited from pediatric practices in Kentucky and Iceland; half were from each country. Adolescents ranged from 13-17 years and were mostly male. Parents were between 33-55 years; all but one were female. The adolescent's QOL was assessed by both the teen and their parent using analogous versions of the Pediatric Quality of Life Questionnaire, Asthma Module. Parent-adolescent differences were determined using paired t-tests, and associations were assessed with intraclass correlation coefficients (ICCs). Differences between countries were determined using two-sample t-tests. The mean bias was -85.8, small compared to the maximum possible score of 2800; this difference was not significant. The ICC of the QOL score was fair (0.39). Parents from the U.S. tended to underrate their child's QOL, while parents from Iceland tended to overrate it, a significant cultural difference (p = .007). While average bias was low, the range of dyad-specific differences, particularly between countries, was considerable; this contributed to the relatively low ICC. Family-centered interventions for adolescents with asthma may benefit from improving parents' understanding of how this chronic condition affects QOL, and such interventions may have to be tailored for cultural differences.