Parent-adolescent discrepancies in reports of health-related quality of life in adolescents with idiopathic scoliosis.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) can adversely affect health-related quality of life (HRQoL) and psychosocial functioning. Parents are integral to AIS management, but discrepancies between parent and adolescent perceptions of the adolescent's HRQoL may influence treatment outcomes. This study aimed to evaluate differences in HRQoL ratings between adolescents with AIS and their parents and to examine whether these discrepancies correlate with adolescents' psychological symptoms and adherence to exercise therapy. METHODS: In this cross-sectional study, 71 adolescent-parent dyads completed the Scoliosis Research Society-22 (SRS-22) questionnaire. Adolescents and parents also completed the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Exercise adherence was assessed two weeks after initiating home-based exercise. RESULTS: Parents rated adolescents' self-image and mental health significantly lower than the adolescents themselves (median self-image: 3.4 vs. 3.6, p < 0.001; median mental health: 3.8 vs. 4.2, p = 0.020). Larger parent-adolescent discrepancies in pain and mental health domain scores correlated with higher levels of adolescent psychological symptoms (p < 0.001). Greater discrepancy in functional appraisal predicted poorer exercise adherence (OR = 0.109, p = 0.015), whereas higher adolescent self-rated mental health predicted better adherence (OR = 3.523, p = 0.011). CONCLUSIONS: Significant discrepancies exist between parent and adolescent HRQoL assessments in AIS, particularly regarding self-image and mental health. These perceptual differences are associated with adolescent psychological distress and exercise adherence. Clinical management should incorporate dual-perspective evaluations to align perceptions, improve communication, and enhance treatment outcomes. WHAT IS KNOWN: • Parent-adolescent discrepancies in HRQoL have been documented in other pediatric chronic conditions, but they remain less explored in AIS. • Treatment adherence remains a major challenge in exercise therapy for AIS. WHAT IS NEW: • Focusing on adolescents with AIS receiving exercise therapy, this study identified a parental underestimation of adolescent self-image and mental health. • Greater discrepancies were associated with higher levels of psychological distress. • Discordance in functional appraisal predicted poorer exercise adherence, whereas better self-rated mental health predicted improved adherence, suggesting new targets for clinical intervention in AIS.