Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures.

STUDY OBJECTIVE To clarify concepts and methodological problems in existing multidimensional health status measures for children. DESIGN Thematic review of instruments found by computerised and manual searches, 1979-95. SUBJECTS Nine health status instruments. MAIN RESULTS Many instruments did not satisfy criteria of being child centered or family focussed; few had sufficient psychometric properties for research or clinical use; underlying conceptual assumptions were rarely explicit. CONCLUSIONS Quality of life measures should be viewed cautiously. Interdisciplinary discussion is required, as well as discussion with children and parents, to establish constructs that are truly useful.