Introduction
Methods
Study population
Weight status of the child
Health-related quality of life
CHQ-PF28 scales | Overall (n = 3,227) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Number of items | Description low score | Description high score | Missings | Mean [SD] | Median [IQR] | Score range | % minb
| % maxb
| Cronbach’s αc
| |
Physical summarya
| Lower summary score represents lower physical healtha
| Higher summary score represents higher physical healtha
| 101 | 56.8 [6.5] | 58.4 [4.9] | −8.6–67.2 | na | na | 0.71d
| |
Psychosocial summarya
| Lower summary score represents lower psychosocial healtha
| Higher summary score represents higher psychosocial healtha
| 101 | 53.0 [6.6] | 53.8 [8.1] | 12.2–66.2 | na | na | 0.83d
| |
Physical functioning | 3 | Child is limited a lot in performing all physical activities, including self care, because of health | Child performs all types of physical activities, including the most vigorous, without limitations attributable to health | 28 | 97.2 [11.0] | 100.0 [0.0] | 0–100 | 0.2 | 90.6 | 0.86 |
Role funct.-emo/behav. | 1 | Child is limited a lot in school work or activities with friends as a result of emotional or behaviour problems | Child has no limitations in schoolwork or activities with friends as a result of emotional or behaviour problems | 26 | 97.5 [10.9] | 100.0 [0.0] | 0–100 | 0.2 | 94.2 | na |
Role funct.-physical | 1 | Child is limited a lot in school work or activities with friends as a result of physical health | Child has no limitations in schoolwork or activities with friends as a result of physical health | 27 | 97.0 [11.9] | 100.0 [0.0] | 0–100 | 0.2 | 93.1 | na |
Bodily pain | 1 | Child has extremely severe, frequent, and limiting bodily pain | Child has no pain or limitations because of pain | 28 | 85.7 [16.1] | 80.0 [20.0] | 0–100 | 0.6 | 44.7 | na |
General behavior | 4 | Child very often exhibits aggressive, immature, delinquent behaviour | Child never exhibits aggressive, immature, delinquent behaviour | 17 | 71.8 [14.3] | 71.3 [18.75] | 0–100 | 0.0 | 2.6 | 0.69 |
Mental health | 3 | Child has feelings of anxiety and depression all of the time | Child feels peaceful, happy, and calm all of the time | 28 | 81.7 [14.2] | 83.3 [16.7] | 0–100 | 0.0 | 20.5 | 0.64 |
Self-esteem | 3 | Child is very dissatisfied with abilities, looks, family/peer relationships, and life overall | Child is very satisfied with abilities, looks, family/peer relationships’ and life overall | 22 | 82.1 [13.1] | 75.0 [16.7] | 0–100 | 0.1 | 24.3 | 0.82 |
Gen health perc. | 4 | Parent believes child’s health is poor and likely to get worse | Parent believes child’s health is excellent and will continue to be so | 17 | 85.1 [15.7] | 90.0 [18.8] | 7.5–100 | 0.0 | 21.7 | 0.49 |
Parental-emotional | 2 | Parent experiences a great deal of emotional worry/concern as a result of child’s physical and/or psychosocial health | Parent doesn’t experience feelings of emotional worry/concern as a result of child’s physical and/or psychosocial health | 20 | 89.2 [14.5] | 100.0 [12.5] | 0–100 | 0.1 | 51.3 | 0.38 |
Parental-time | 2 | Parent experiences a lot of limitations in time available for personal needs because of child’s physical and/or psychosocial health | Parent doesn’t experience limitations in time available for personal needs because of child’s physical and/or psychosocial health | 27 | 95.2 [12.8] | 100.0 [0.0] | 0–100 | 0.2 | 82.7 | 0.56 |
Family activities | 2 | The child’s health very often limits and interrupts family activities or is a source of family tension | The child’s health never limits or interrupts family activities or is a source of family tension | 24 | 89.2 [16.3] | 100.0 [25.0] | 0–100 | 0.2 | 59.6 | 0.70 |
Family cohesion | 1 | Family’s ability to get along is rated “poor” | Family’s ability to get along is rated “excellent” | 63 | 73.6 [17.8] | 85.0 [25.0] | 0–100 | 0.1 | 14.8 | na |
Change in health | 1 | Child’s health is much worse now than 1 year ago | Child’s health is much better now than 1 year ago | 34 | 56.2 [15.4] | 50.0 [0.0] | 0–100 | 0.2 | 7.9 | na |
Child and maternal characteristics
Total (n = 3,227) | Underweighta (n = 449) | Normal weighta (n = 2,278) | Overweighta (n = 405) | Obesitya (n = 50) | Severe obesitya (n = 45) | |
---|---|---|---|---|---|---|
Child characteristics | ||||||
Age in years, mean ± SD | 5.7 ± 0.4 | 5.8 ± 0.4 | 5.7 ± 0.4 | 5.8 ± 0.4 | 5.8 ± 0.4 | 5.9 ± 0.4 |
Gender** | ||||||
% boys | 49.3 | 50.8 | 51.4 | 37.0 | 26.0 | 66.7 |
Ethnicity (34 missings) | ||||||
% Dutch | 98.3 | 97.3 | 98.4 | 99.0 | 95.9 | 97.7 |
BMI**, mean ± SD | 15.7 ± 1.7 | 13.4 ± 0.5 | 15.45 ± 0.9 | 18.2 ± 0.6 | 20.2 ± 0.4 | 21.7 ± 1.1 |
Number of chronic conditions, mean ± SD | 0.6 ± 0.9 | 0.6 ± 0.8 | 0.5 ± 0.9 | 0.6 ± 0.9 | 0.7 ± 1.2 | 0.6 ± 0.8 |
Number of chronic conditions | ||||||
% no chronic condition | 62.4 | 60.9 | 62.9 | 61.5 | 68.0 | 57.8 |
Characteristics of the mother | ||||||
Age in years, mean ± SD (n = 38 missings) | 36.5 ± 4.3 | 36.7 ± 4.0 | 36.5 ± 4.3 | 35.3 ± 3.9 | 36.0 ± 5.2 | 36.1 ± 6.0 |
Gender (n = 32 missings) | ||||||
% mother is respondent | 89.3 | 88.5 | 89.5 | 89.3 | 83.7 | 93.2 |
Born in the Netherlands*** (n = 32 missings) | ||||||
% yes | 90.9 | 91.0 | 92.0 | 87.4 | 79.6 | 77.3 |
Educational level*** (n = 49 missings) | ||||||
% low | 3.1 | 2.3 | 2.6 | 4.8 | 8.2 | 14.3 |
% mid-low | 17.7 | 14.9 | 16.8 | 23.1 | 26.5 | 35.7 |
% mid-high | 46.1 | 46.8 | 46.1 | 47.0 | 44.9 | 31.0 |
% high | 33.1 | 36.0 | 34.4 | 25.1 | 20.4 | 19.0 |
Marital status*** (n = 46 missings) | ||||||
% married or living together | 93.5 | 92.7 | 94.5 | 92.1 | 85.3 | 80.5 |
Weight status*** (n = 93 missings) | ||||||
% normal weight | 70.4 | 81.5 | 72.5 | 52.7 | 47.5 | 41.0 |
Analyses
Results
Normal weighta,b (n = 2,278) | Overweighta (n = 405) | Obesitya (n = 50) | Severe obesitya (n = 45) | Underweighta (n = 449) | Kruskal–Wallis p valuec
| ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Mean [SD] | Median [IQR] | Mean [SD] | Median [IQR] | Mean [SD] | Median [IQR] | Mean [SD] | Median [IQR] | Mean [SD] | Median [IQR] | ||
Physical summary | 57.1 [6.1] | 58.6 [4.6] | 56.3 [7.2] | 58.1 [5.5] | 56.0 [8.7] | 58.1 [6.5] | 54.4 [7.3] | 56.2 [7.7]** | 55.9 [7.3] | 58.0 [5.2]*** | 0.000 |
Psychosocial summary | 53.0 [6.6] | 53.8 [8.2] | 52.9 [7.3] | 54.1 [8.0] | 51.4 [7.1] | 52.3 [7.3] | 52.5 [6.1] | 52.9 [6.5] | 53.2 [6.3] | 53.7 [7.7] | 0.552 |
Physical functioning | 97.7 [9.8] | 100.0 [0.0] | 96.1 [13.6] | 100.0 [0.0]* | 93.9 [17.0] | 100.0 [0.0]*** | 91.1 [15.8] | 100.0 [11.1]*** | 96.6 [12.2] | 100.0 [0.0] | 0.000 |
Role funct.-emo/behav. | 97.5 [10.8] | 100.0 [0.0] | 97.5 [11.5] | 100.0 [0.0] | 96.0 [14.5] | 100.0 [0.0] | 96.2 [12.9] | 100.0 [0.0] | 98.1 [10.0] | 100.0 [0.0] | 0.432 |
Role funct.- physical | 97.3 [11.1] | 100.0 [0.0] | 96.6 [13.6] | 100.0 [0.0] | 95.3 [16.5] | 100.0 [0.0] | 96.2 [12.9] | 100.0 [0.0] | 96.1 [13.7] | 100.0 [0.0] | 0.483 |
Bodily pain | 85.9 [15.7] | 80.0 [20.0] | 86.7 [15.9] | 80.0 [20.0] | 82.8 [23.2] | 80.0 [20.0] | 90.2 [13.4] | 100.0 [20.0] | 84.1 [17.2] | 80.0 [20.0] | 0.036 |
General behavior | 71.8 [14.2] | 71.3 [18.8] | 71.2 [14.9] | 71.3 [16.3] | 68.3 [13.9] | 65.0 [18.8] | 72.4 [15.0] | 75.0 [18.8] | 72.3 [14.1] | 71.3 [18.8] | 0.287 |
Mental health | 81.8 [14.1] | 83.3 [16.7] | 81.6 [14.8] | 83.3 [16.7] | 77.6 [17.3] | 83.3 [19.2] | 83.7 [13.1] | 83.3 [16.7] | 81.4 [13.5] | 83.3 [16.7] | 0.390 |
Self-esteem | 82.1 [13.1] | 75.0 [16.7] | 82.4 [13.4] | 75.0 [25.0] | 78.2 [11.9] | 75.0 [8.3]* | 79.8 [12.4] | 75.0 [12.5] | 82.4 [13.1] | 75.0 [25.0] | 0.128 |
Gen. health perc. | 86.1 [14.9] | 90.0 [18.8] | 83.4 [16.9] | 90.0 [22.2]** | 78.9 [19.4] | 87.5 [25.0]** | 78.6 [18.1] | 83.8 [31.3]** | 83.4 [17.0] | 90.0 [25.0]*** | 0.000 |
Parental-emotional | 89.4 [14.1] | 100.0 12.5] | 89.7 [15.2] | 100.0 [12.5] | 84.7 [17.7] | 87.5 [25.0] | 82.2 [20.4] | 87.5 [25.0]** | 88.8 [14.5] | 87.5 [12.5] | 0.010 |
Parental- time | 95.6 [11.9] | 100.0 [0.0] | 94.0 [16.1] | 100.0 [0.0] | 94.6 [12.5] | 100.0 [0.0] | 90.5 [17.8] | 100.0 [16.7]* | 94.6 [13.4] | 100.0 [0.0] | 0.070 |
Family activities | 89.3 [16.4] | 100.0 [25.0] | 89.1 [16.5] | 100.0 [25.0] | 90.1 [15.9] | 100.0 [25.0] | 88.9 [15.6] | 100.0 [25.0] | 88.7 [16.2] | 100.0 [25.0] | 0.892 |
Family cohesion | 73.5 [17.9] | 85.0 [25.0] | 73.0 [18.1] | 85.0 [25.0] | 70.0 [16.9] | 60.0 [25.0] | 71.1 [17.2] | 60.0 [25.0] | 74.9 [17.3] | 85.0 [25.0] | 0.166 |
Change in health | 56.0 [14.9] | 50.0 [0.0] | 57.1 [17.1] | 50.0 [0.0] | 57.1 [17.7] | 50.0 [0.0] | 60.0 [20.2] | 50.0 [25.0] | 56.3 [15.2] | 50.0 [0.00] | 0.605 |
Overweighta (n = 405) |
p value | Obesitya (n = 50) |
p value | Severe obesitya (n = 45) |
p value | Underweighta (n = 449) |
p value | |
---|---|---|---|---|---|---|---|---|
Physical summary | ||||||||
Bootstrap unadjusted** |
−0.80 (−1.61; −0.06)
|
0.038
| −1.04 (−3.79; 1.27) | 0.424 |
−2.72 (−5.14; −0.65)
|
0.008
|
−1.15 (-−.95; −0.42)
|
0.000
|
Bootstrap adjusted** | −0.59 (−1.37; 0.17) | 0.138 | −1.12 (−3.56; 1.27) | 0.380 |
−2.60 (−4.80; −0.57)
|
0.006
|
−1.11 (−1.85; −0.39)
|
0.002
|
Psychosocial summary | ||||||||
Bootstrap unadjusted | −0.15 (−0.92; 0.66) | 0.692 | −1.70 (−3.89; 0.30) | 0.114 | −0.57 (−2.43; 1.27) | 0.564 | 0.22 (−0.45; 0.89) | 0.506 |
Bootstrap adjusted | −0.13 (−0.96; 0.69) | 0.734 | −1.39 (−4.00; 0.91) | 0.280 | −0.28 (−2.32; 1.77) | 0.794 | 0.27 (−0.43; 0.95) | 0.454 |
Physical functioning | ||||||||
Bootstrap unadjusted** |
−1.66 (−3.12; −0.29)
|
0.014
| −3.95 (−9.40; 0.16) | 0.062 |
−6.71 (−11.47; −2.25)
|
0.000
| −1.16 (−2.40; 0.06) | 0.058 |
Bootstrap adjusted** |
−1.56 (−3.04; −0.08)
|
0.040
| −3.78 (−9.57; 0.96) | 0.124 |
−5.93 (−10.32; −1.94)
|
0.002
| −1.00 (−2.23; 0.08) | 0.060 |
Role funct.-emo/behav. | ||||||||
Bootstrap unadjusted | 0.03 (−1.19; 1.13) | 0.930 | −1.46 (−6.00; 1.98) | 0.512 | −1.34 (−5.88; 1.98) | 0.526 | 0.59 (−0.47; 1.54) | 0.268 |
Bootstrap adjusted | 0.07 (−1.40; 1.38) | 0.874 | −1.37 (−7.05; 2.95) | 0.624 | −0.49 (−4.96; 3.02) | 0.862 | 0.64 (−0.38; 1.65) | 0.246 |
Role funct.-physical | ||||||||
Bootstrap unadjusted | −0.69 (−2.21; 0.71) | 0.340 | −2.00 (−6.66; 1.82) | 0.390 | −1.19 (−5.20; 2.15) | 0.572 | −1.15 (−2.52; 0.17) | 0.088 |
Bootstrap adjusted | −0.95 (−2.82; 0.65) | 0.234 | −2.32 (−7.81; 2.15) | 0.396 | −1.38 (−5.75; 2.28) | 0.544 | −1.18 (−2.65; 0.14) | 0.082 |
Bodily pain | ||||||||
Bootstrap unadjusted* | 0.85 (−0.89; 2.40) | 0.320 | −3.19 (−10.25; 2.87) | 0.344 |
4.27 (0.09; 8.23)
|
0.048
|
−1.80 (−3.68; −0.09)
|
0.034
|
Bootstrap adjusted* | 0.84 (−0.93; 2.53) | 0.340 | −3.15 (−10.58; 3.16) | 0.360 | 1.85 (−2.52; 5.88) | 0.400 |
−2.42 (−4.28; −0.65)
|
0.008
|
General behavior | ||||||||
Bootstrap unadjusted | −0.66 (−2.23; 0.76) | 0.382 | −3.60 (−7.51; 0.40) | 0.080 | 0.48 (−4.01; 4.66) | 0.808 | 0.48 (−0.95; 1.87) | 0.520 |
Bootstrap adjusted | −0.56 (−2.29; 1.18) | 0.526 | −3.28 (7.71; 1.22) | 0.156 | 1.19 (−3.94; 5.81) | 0.632 | 0.28 (−1.29; 1.88) | 0.718 |
Mental health | ||||||||
Bootstrap unadjusted | −0.24 (−1.75; 1.29) | 0.790 | −4.30 (−9.29; 0.43) | 0.076 | 2.00 (−2.09; 5.69) | 0.324 | −0.48 (−1.94; 0.91) | 0.488 |
Bootstrap adjusted | −0.27 (−1.93; 1.45) | 0.782 | −2.20 (−7.23; 2.81) | 0.408 | 2.39 (−2.04; 6.30) | 0.282 | −0.03 (−1.52; 1.44) | 1.000 |
Self-esteem | ||||||||
Bootstrap unadjusted | 0.29 (−1.09; 1.59) | 0.684 |
−3.93 (−7.37; −0.35)
|
0.026
| −2.26 (−5.91; 1.25) | 0.228 | 0.28 (−1.09; 1.58) | 0.690 |
Bootstrap adjusted | 0.25 (−1.23; 1.69) | 0.736 |
−4.18 (−7.87; −0.78)
|
0.012
| −1.25 (−4.96; 2.59) | 0.512 | 0.27 (−1.29; 1.67) | 0.712 |
Gen. health perc. | ||||||||
Bootstrap unadjusted*** |
−2.68 (−4.50; −0.90)
|
0.002
|
−7.06 (−12.55; −1.89)
|
0.006
|
−7.65 (−12.96; −2.58)
|
0.000
|
−2.62 (−4.16; −1.07)
|
0.000
|
Bootstrap adjusted** | −1.90 (−3.67; 0.005) | 0.052 |
−5.39 (−10.33; −0.78)
|
0.018
| −4.41 (−9.91; 0.79) | 0.090 |
−2.07 (−3.77; −0.45)
|
0.008
|
Parental-emotional | ||||||||
Bootstrap unadjusted* | 0.32 (−1.24; 1.89) | 0.670 | −4.81 (−10.01; 0.20) | 0.054 |
−7.41 (−13.79; −1.75)
|
0.008
| −0.68 (−2.19; 0.74) | 0.378 |
Bootstrap adjusted | −0.18 (−1.96; 1.60) | 0.852 | −4.55 (−10.43; 0.71) | 0.094 |
−6.77 (−13.45; −0.69)
|
0.020
| −0.60 (−2.15; 0.89) | 0.450 |
Parental-time | ||||||||
Bootstrap unadjusted |
−1.65 (−3.47; −0.08)
|
0.042
| −1.04 (−4.55; 1.92) | 0.610 |
−5.09 (−10.87; −0.34)
|
0.034
| −1.00 (−2.34; 0.34) | 0.160 |
Bootstrap adjusted | −0.53 (−2.22; 1.04) | 0.548 | −0.06 (−4.08; 3.32) | 0.980 |
−5.35 (−11.92; −0.24)
|
0.046
| −1.41 (−2.91; 0.07) | 0.060 |
Family activities | ||||||||
Bootstrap unadjusted | −0.13 (−1.90; 1.68) | 0.870 | 0.82 (−3.72; 4.93) | 0.728 | −0.43 (−5.20; 4.02) | 0.894 | −0.49 (−2.17; 1.17) | 0.572 |
Bootstrap adjusted | −0.004 (−1.86; 1.98) | 0.996 | 1.90 (−3.08; 6.61) | 0.434 | 0.85 (−4.80; 5.55) | 0.736 | –0.44 (−2.22; 1.26) | 0.628 |
Family cohesion | ||||||||
Bootstrap unadjusted | −0.55 (−2.60; 1.54) | 0.564 | −3.45 (−8.01; 0.88) | 0.134 | −2.62 (−7.30; 2.67) | 0.316 | 1.41 (−0.36; 3.16) | 0.116 |
Bootstrap adjusted | 0.07 (−2.08; 2.13) | 0.962 | −4.43 (−9.31; 0.51) | 0.082 | −1.56 (−7.34; 4.91) | 0.594 | 0.74 (−1.31; 2.78) | 0.504 |
Change in health | ||||||||
Bootstrap unadjusted | 1.08 (−0.57; 2.91) | 0.214 | 1.20 (−3.38; 6.38) | 0.652 | 3.89 (−1.76; 10.20) | 0.202 | 0.28 (−1.15; 1.80) | 0.726 |
Bootstrap adjusted | 0.43 (−1.30; 2.35) | 0.642 | −0.06 (−5.18; 5.49) | 0.970 | 0.86 (−4.73; 7.21) | 0.814 | 0.15 (1.44; 1.71) | 0.832 |