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Perez-Sousa MA, Olivares PR, Garcia-Hermoso A, Gusi N. Does anthropometric and fitness parameters mediate the effect of exercise on the HRQoL of overweight and obese children/adolescents? Qual Life Res 2018; 27:2305-2312. [PMID: 29948598 DOI: 10.1007/s11136-018-1893-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND There is sufficient evidence about the effects of physical exercise programs on health-related quality of life (HRQoL) in obese and overweight children. OBJECTIVES The purpose of this study was to observe the effects on physical fitness and HRQoL in overweight and obesity children and their parents and find out whether the effect of intervention on anthropometric and physical fitness parameters mediated the improvements found in the proxies' perception of participant quality of life. METHODS 151 overweight and obese children (106 intervention and 45 control) participated in a public exercise program. Anthropometrics characteristics, physical fitness, and HRQoL (EQ-5D-Y) were measured. Analysis of Covariance and effect size were performed to analyze the improvement. Mediation analyzed with bootstrap to observe whether anthropometric or physical fitness improvements mediate of the changes in the proxies' assessment of HRQoL. RESULTS Significant improvements were found in waist circumference, physical fitness, and HRQoL. The improvement of waist circumference showed a significant indirect effect on the change in the proxy perception of quality of life. CONCLUSION The reduction of waist circumference mediates the change on proxies' perception of quality of life and not by the improvement in physical fitness. TRIAL REGISTRATION ISRCTN97887613.
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Affiliation(s)
- Miguel A Perez-Sousa
- Faculty of Sport Sciences, University of Extremadura, Av/ Universidad s/n., 10007, Cáceres, Spain.
| | - Pedro R Olivares
- Instituto de actividad física y salud, Universidad Autonoma de Chile, Talca, Chile
| | - Antonio Garcia-Hermoso
- Facultad de Ciencias Médicas, Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Narcis Gusi
- Faculty of Sport Sciences, University of Extremadura, Av/ Universidad s/n., 10007, Cáceres, Spain
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Fiume A, Deveber G, Jang SH, Fuller C, Viner S, Friefeld S. Development and validation of the Pediatric Stroke Quality of Life Measure. Dev Med Child Neurol 2018; 60:587-595. [PMID: 29451699 DOI: 10.1111/dmcn.13684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/26/2022]
Abstract
AIM To develop and validate a disease-specific parent proxy and child quality of life (QoL) measure for patients aged 2 to 18 years surviving cerebral sinovenous thrombosis (CSVT) and arterial ischaemic stroke (AIS). METHOD Utilizing qualitative and quantitative methods, we developed a 75-item Pediatric Stroke Quality of Life Measure (PSQLM) questionnaire. We mailed the PSQLM and a standardized generic QoL measure, Pediatric Quality of Life Inventory (PedsQL), to 353 families. Stroke type, age at stroke, and neurological outcome on the Pediatric Stroke Outcome Measure were documented. We calculated the internal consistency, validity, and reliability of the PSQLM. RESULTS The response rate was 29%, yielding a sample of 101 patients (mean age 9y 9mo [SD 4.30]; 69 AIS [68.3%], 32 CSVT [31.7%]). The internal consistency of the PSQLM was high (Cronbach's α=0.94-0.97). Construct validity for the PSQLM was moderately strong (r=0.3-0.4; p<0.003) and, as expected, correlation with the PedsQL was moderate, suggesting the PSQLM operationalizes QoL distinct from the PedsQL. Test-retest reliability at 2 weeks was very good (intraclass correlation coefficient [ICC] 0.85-0.95; 95% confidence interval 0.83-0.97) and good agreement was established between parent and child report (ICC 0.63-0.76). INTERPRETATION The PSQLM demonstrates sound psychometric properties. Further research will seek to increase its clinical utility by reducing length and establishing responsiveness for descriptive and longitudinal evaluative assessment. WHAT THIS PAPER ADDS A pediatric stroke-specific quality of life (QoL) measurement tool for assessments based on perceptions of importance and satisfaction. Moderate-to-high reliability and validity established for a new clinical scale evaluating QoL among children with stroke. Perceived QoL measured using the Pediatric Stroke Quality of Life Measure appears lower in children with neurological impairment.
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Affiliation(s)
- Andrea Fiume
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Clinician Investigator Program, McMaster University, Hamilton, ON, Canada
| | - Gabrielle Deveber
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada
| | - Shu-Hyun Jang
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Colleen Fuller
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Shani Viner
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Sharon Friefeld
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Volger S, Landgraf JM, Mao M, Ge J, Northington R, Hays NP. Feasibility and Psychometric Properties of the Infant Toddler Quality of Life (ITQOL) Questionnaire in a Community-Based Sample of Healthy Infants in China. Matern Child Health J 2018; 22:702-712. [PMID: 29397496 PMCID: PMC5893691 DOI: 10.1007/s10995-018-2439-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective Evaluate the feasibility and psychometric properties of the Infant Toddler Quality of Life (ITQOL) questionnaire as a measure of health-related quality of life (HRQOL) in a sample of Chinese infants. Methods The linguistically validated Simplified Chinese version of the ITQOL was used in a multicenter, observational study of healthy, term infants (N = 427), age 6 weeks at enrollment, in China. At Days 1 and 48, parents/guardians completed the ITQOL, the Short Form Health Survey (SF-12v2) and the Infant Gastrointestinal Symptom Questionnaire (IGSQ). ITQOL feasibility, reliability, ceiling/floor effects, concurrent validity and discriminatory validity were evaluated. Results Feasibility of administering the ITQOL was supported by strong response rates (> 97%) with < 1% missing items for all scales except physical abilities. Reliability was acceptable (Cronbach's alpha > 0.70) for all scales except Day 1 General Health (0.67). Floor effects were minimal (< 2%), except Day 1 physical abilities (7%). Ceiling effects increased from Days 1 to 48 across all scales. Concurrent validity was demonstrated by correlations between ITQOL infant-focused scales and IGSQ score (r = -0.20 to - 0.34, p < 0.001) and between parent-focused scales and SF-12v2 mental health composite (MCS) scores (r = 0.29-0.46, p < 0.001). ITQOL scales discriminated between infant subgroups based on illness-related outcomes (sick visits, adverse events) and between parent subgroups based on SF-12v2 MCS scores. Conclusion The Simplified Chinese version of the ITQOL performed well in a community-based sample of Chinese infants, with evidence supporting the instrument's feasibility, reliability, and validity. These data support the ITQOL as a valuable tool to assess HRQOL in Chinese infants.
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Affiliation(s)
- Sheri Volger
- Clinical Research, Research and Development, Nestlé Nutrition, 3000 Horizon Drive, King of Prussia, PA 19406 USA
| | - Jeanne M. Landgraf
- HealthActCHQ, Inc. (HACHQ), 800 Boylston Street, 16th Floor, Boston, MA 02199 USA
| | - Meng Mao
- Chengdu Women’s and Children’s Central Hospital, Chengdu, China No. 1617, Riyue Avenue, Chengdu, 610091 Sichuan Province People’s Republic of China
| | - John Ge
- Wyeth Nutritional (China) Company Ltd., 30F, CITIC Square, 1168 Nanjing West Road, Shanghai, China
| | - Robert Northington
- Clinical Research, Research and Development, Nestlé Nutrition, 3000 Horizon Drive, King of Prussia, PA 19406 USA
| | - Nicholas P. Hays
- Clinical Research, Research and Development, Nestlé Nutrition, 3000 Horizon Drive, King of Prussia, PA 19406 USA
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Wolstenholme JL, Bargo D, Wang K, Harnden A, Räisänen U, Abel L. Preference-based measures to obtain health state utility values for use in economic evaluations with child-based populations: a review and UK-based focus group assessment of patient and parent choices. Qual Life Res 2018; 27:1769-1780. [PMID: 29564713 PMCID: PMC5997719 DOI: 10.1007/s11136-018-1831-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 12/02/2022]
Abstract
Background No current guidance is available in the UK on the choice of preference-based measure (PBM) that should be used in obtaining health-related quality of life from children. The aim of this study is to review the current usage of PBMs for obtaining health state utility values in child and adolescent populations, and to obtain information on patient and parent–proxy respondent preferences in completing PBMs in the UK. Methods A literature review was conducted to determine which instrument is most frequently used for child-based economic evaluations and whether child or proxy responses are used. Instruments were compared on dimensions, severity levels, elicitation and valuation methods, availability of value sets and validation studies, and the range of utility values generated. Additionally, a series of focus groups of parents and young people (11–20 years) were convened to determine patient and proxy preferences. Results Five PBMs suitable for child populations were identified, although only the Health Utilities Index 2 (HUI2) and Child Heath Utility 9D (CHU-9D) have UK value sets. 45 papers used PBMs in this population, but many used non-child-specific PBMs. Most respondents were parent proxies, even in adolescent populations. Reported missing data ranged from 0.5 to 49.3%. The focus groups reported their experiences with the EQ-5D-Y and CHU-9D. Both the young persons’ group and parent/proxy groups felt that the CHU-9D was more comprehensive but may be harder for a proxy to complete. Some younger children had difficulty understanding the CHU-9D questions, but the young persons’ group nonetheless preferred responding directly. Conclusion The use of PBMs in child populations is increasing, but many studies use PBMs that do not have appropriate value sets. Parent proxies are the most common respondents, but the focus group responses suggest it would be preferred, and may be more informative, for older children to self-report or for child–parent dyads to respond. Electronic supplementary material The online version of this article (10.1007/s11136-018-1831-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jane L Wolstenholme
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Danielle Bargo
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Kay Wang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anthony Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ulla Räisänen
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lucy Abel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Bloemeke J, Sommer R, Witt S, Dabs M, Badia FJ, Bullinger M, Quitmann J. Piloting and psychometric properties of a patient-reported outcome instrument for young people with achondroplasia based on the International Classification of Functioning Disability and Health: the Achondroplasia Personal Life Experience Scale (APLES). Disabil Rehabil 2018. [PMID: 29516753 DOI: 10.1080/09638288.2018.1447028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: This study describes the psychometric testing of the Achondroplasia Personal Life Experience Scale (APLES): a new disease- and functioning-specific health-related quality of life instrument for young people with achondroplasia, which was developed based on the International Classification of Functioning-Children and Youth Version. Method: The qualitative analysis of focus group statements from German patients and parents using the International Classification of Functioning-Children and Youth Version yielded 59 items, which after cognitive debriefing were included in a pilot-test. Psychometric performance was cross-culturally examined in a field- and re-test in Germany and Spain. Results: Cognitive debriefing and pilot-test results suggested to reduce the 59-APLES version to a 35-items version. Field-test data showed acceptable reliability and validity, which further improved after the APLES was shortened to 21 items. Conclusion: Developing a disease-specific instrument within the framework of the International Classification of Functioning allows the universal assessment and comparison of perceived health. Psychometric analysis showed that the APLES fulfills psychometric quality standards and provides a way to assess health-related quality of life from self- and observer report in young persons with achondroplasia. Further studies may use the instrument in clinical research and practice to understand perceived burden and to optimize care. Implications for Rehabilitation Health-related quality of life instruments are useful tools to include in clinical research and/or practice to evaluate treatment effects directly from the patient's perspective. Cross-culturally developed health-related quality of life measures that are based on the International Classification of Functioning Disability and Health provide the opportunity to assess the health status in a standardized language and to compare it across countries and health professions. All four components of the International Classification of Functioning Disability and Health - Child and Youth Version ("Body Functions & Structures", "Activities and Participation", "Environmental Factors", and "Personal Factors") have been shown to be relevant in assessing health-related quality of life and functioning in young achondroplasia patients. Results underline the important aspects associated with disproportionate short stature, emphasizing the benefits of a disease-specific instrument.
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Affiliation(s)
- Janika Bloemeke
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Rachel Sommer
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Stefanie Witt
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Michaela Dabs
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | | | - Monika Bullinger
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Julia Quitmann
- a Department of Medical Psychology , Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Dickerson JF, Feeny DH, Clarke GN, MacMillan AL, Lynch FL. Evidence on the longitudinal construct validity of major generic and utility measures of health-related quality of life in teens with depression. Qual Life Res 2018; 27:447-454. [PMID: 29149441 DOI: 10.1007/s11136-017-1728-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the longitudinal construct validity in the assessment of changes in depressive symptoms of widely used utility and generic HRQL instruments in teens. METHODS 392 teens enrolled in the study and completed HRQL and diagnostic measures as part of the baseline interview. HRQL measures included EuroQol (EQ-5D-3L), Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3), Quality of Well-Being Scale (QWB), Pediatric Quality of Life Inventory (PEDS-QL), RAND-36 (SF-6D), and Quality of Life in Depression Scale (QLDS). Youth completed follow-up interviews 12 weeks after baseline. Sixteen youth (4.1%) were lost to follow-up. We examined correlations between changes in HRQL instruments and the Children's Depression Rating Scale-Revised (CDRS-R) and assessed clinically meaningful change in multi-attribute utility HRQL measures using mean change (MC) and standardized response mean (SRM) among youth showing at least moderate (20%) improvement in depression symptomology. RESULTS Spearman's correlation coefficients demonstrated moderate correlation between changes in CDRS-R and the HUI2 (r = 0.38), HUI3 (r = 0.42), EQ-5D-3L (r = 0.36), SF-6D (r = 0.39), and PEDS-QL (r = 0.39) and strong correlation between changes in CDRS-R and QWB (r = 0.52) and QLDS (r = - 0.71). Effect size results are also reported. Among multi-attribute utility measures, all showed clinically meaningful improvements in the sample of youth with depression improvement (HUI2, MC = 0.20, SRM = 0.97; HUI3, MC = 0.32, SRM = 1.17; EQ-5D-3L, MC = 0.08, SRM = 0.51; QWB, MC = 0.11, SRM = 0.86; and SF-6D, MC = 0.12, SRM = 1.02). CONCLUSIONS Findings support the longitudinal construct validity of included HRQL instruments for the assessment of change in depression outcomes in teens. Results of this study can help inform researchers about viable instruments to include in economic evaluations for this population.
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Affiliation(s)
- John F Dickerson
- Center for Health Research - Kaiser Permanente, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
| | - David H Feeny
- Department of Economics, McMaster University, Hamilton, ON, Canada
- Health Utilities Incorporated, Dundas, ON, Canada
| | - Gregory N Clarke
- Center for Health Research - Kaiser Permanente, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - Alex L MacMillan
- ThinkShout, Inc, 433 NW 4th Ave, Suite 100, Portland, OR, 97209, USA
| | - Frances L Lynch
- Center for Health Research - Kaiser Permanente, 3800 N. Interstate Ave., Portland, OR, 97227, USA
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Verstraete J, Ramma L, Jelsma J. Influence of the child's perceived general health on the primary caregiver's health status. Health Qual Life Outcomes 2018; 16:8. [PMID: 29321017 PMCID: PMC5763523 DOI: 10.1186/s12955-018-0840-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In estimating the impact of an intervention, ignoring the effect of improving the health of one member of the caregiver/child dyad on the Health Related Quality of Life (HRQoL) of the other member may lead to an underestimation of the utility gained. This may be particularly true for infants/young children and their caregivers. The aim of this study was to quantify the interaction between the child's perceived general health as assessed by the newly developed Toddler and Infant Questionnaire (TANDI) on the reporting of the caregiver's own HRQoL as assessed by the EQ-5D-3 L. METHODS A sample of 187 caregivers participated. A total of 60 caregivers of acutely-ill (AI) and 60 caregivers of chronically-ill (CI) children were recruited from a children's hospital. The 67 caregivers of general population (GP) children were recruited at a pre-school. Each caregiver completed the proxy rating of their child's HRQoL on the TANDI (The TANDI is an experimental HRQoL instrument, modelled on the EQ-5D-Y proxy, for children aged 1-36 months), which comprises of six dimensions of health and a rating of general health on a Visual Analogue Scale (VAS). The caregiver completed the EQ-5D-3 L, a self-report measure of their own HRQoL. Forward stepwise regression models were developed with 1) the VAS score of the caregiver and 2) the VAS score of the child as dependent variables. The independent variables for the caregiver included dummy variables for the presence or absence of problems on the EQ-5D-3 L and the VAS score of the child. The independent variables for the child included dummy variables for each TANDI dimension and the VAS of the caregiver. RESULTS The TANDI results indicated that in five of the six dimensions AI children had more problems than the other two groups and the GP children were reported to have a significantly higher VAS than the other two groups. The child's VAS was significantly correlated with the caregiver's VAS in all groups, but most strongly in the AI group. The preference based scores (using the UK TTO tariff) were only correlated in the AI group. The inclusion of the child's VAS increased the variance accounted for 11% of the VAS score of the caregiver. Anxiety and depression was the only dimension which accounted for more variance (18%). Similarly the perceived health state, VAS of the caregiver accounted for 14% of the variance in the child's VAS, second only to problems with play (25%). CONCLUSION There does indeed appear to be a strong relationship between the VAS scores of the children and their caregivers. The perceived general health of the child influences the caregivers reporting of their general health, more than their own report of experiencing pain or discomfort or problems with mobility. Thus, improving the HRQoL of the very young child may improve the caregiver's HRQoL as well. Conversely, if the caregiver has a lower perceived HRQoL this may result in a decrement in the reported VAS of the child, independent of the presence or absence of problems in the different dimensions. This improvement is not currently captured by Cost Utility Analysis (CUA). It is recommended that future research investigates this effect with regards to CUA calculations.
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Affiliation(s)
- Janine Verstraete
- Department of Physiotherapy, Red Cross War Memorial Children’s Hospital, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Lebogang Ramma
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Jennifer Jelsma
- Faculty of Health and Rehabilitation Sciences, Anzio Road, Observatory, Cape Town, 7925 South Africa
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Santos T, de Matos MG, Simões C, Leal I, do Céu Machado M. (Health-related) quality of life and psychosocial factors in adolescents with chronic disease: a systematic literature review. Int J Adolesc Med Health 2017; 31:ijamh-2017-0037. [PMID: 29168956 DOI: 10.1515/ijamh-2017-0037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 05/10/2017] [Indexed: 11/15/2022]
Abstract
Background Research on living with a chronic disease (CD) in adolescence is increasing. However, studies on the relevance of psychosocial factors are still needed. The present review, focuses on the impact of living with a CD in adolescence on on quality of life (QoL), health-related quality of life (HRQoL) and psychosocial factors. Methods A literature review of articles identified through PubMed, PsycINFO and PsycARTICLES (these last two ones comprise the Ebsco Host platform) and original peer-reviewed research papers, published between 2010 and 2015, with no restrictions regarding the format/source of interventions, randomized controlled trials (RCTs) or types of comparisons were included. Results Eighteen papers met the inclusion criteria and contradictory results were found: the majority showed a significantly higher risk of impairment on QoL/HRQoL and psychosocial factors, whereas others reported a significantly lower risk of impairment (highlighting possible protective factors), or no significant differences. Heterogeneity in the assessment procedures and substantial difficulties in considering adolescence as a single and independent age group, were also noted. Conclusion The higher risk of impairment and the heterogeneity observed between cohorts, reinforce the need to work towards consensual procedures, which allow for more accurate comparisons among studies. Additionally, it conveys the challenge to find more effective interventions. Furthermore, it is highly suggested to routinely assess HRQoL/psychosocial factors within an individualized framework, to considerer adolescents as a single/independent group, to emphasize potential protective factors, and, to increase youth's participation in their own adaptation process and in health promotion in general. These are possible future directions that could enable multidisciplinary responses to improve HRQoL and psychosocial care in adolescents with a CD.
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Affiliation(s)
- Teresa Santos
- William James Center of Research, ISPA-Instituto Universitário, Ciências Psicológicas, Sociais e da Vida, Rua Jardim do Tabaco, no 34, 1149-041 Lisboa, Portugal, Phone: +351 218811700; Mobile: +351 966142393.,FMH, Faculdade de Motricidade Humana (Projecto Aventura Social-Social Adventure Team)/Universidade de Lisboa, Lisboa, Portugal.,ISAMB, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Margarida Gaspar de Matos
- FMH, Faculdade de Motricidade Humana (Projecto Aventura Social-Social Adventure Team)/Universidade de Lisboa, Lisboa, Portugal.,ISAMB, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,William James Center for Research, ISPA - Instituto Universitário, Lisboa, Portugal
| | - Celeste Simões
- FMH, Faculdade de Motricidade Humana (Projecto Aventura Social-Social Adventure Team)/Universidade de Lisboa, Lisboa, Portugal.,ISAMB, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Leal
- William James Center for Research, ISPA - Instituto Universitário, Lisboa, Portugal
| | - Maria do Céu Machado
- FM, Faculdade de Medicina/Universidade de Lisboa, Lisboa, Portugal.,Departamento de Pediatria do Hospital de Santa Maria, CAML, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
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59
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Greenley RN, Reed-Knight B, Wojtowicz AA, Plevinsky JM, Lewis JD, Kahn SA. A bitter pill to swallow: Medication adherence barriers in adolescents and young adults with inflammatory bowel diseases. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2017.1383911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Rachel Neff Greenley
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL
| | - Bonney Reed-Knight
- Gastroenterology, Hepatology, Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University, Atlanta, GA
- GI Care for Kids, Atlanta, GA
| | - Andrea A. Wojtowicz
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL
| | - Jill M. Plevinsky
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL
| | - Jeffery D. Lewis
- GI Care for Kids, Atlanta, GA
- Children’s Healthcare of Atlanta, Atlanta, GA
| | - Stacy A. Kahn
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
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Wei Y, Speechley KN, Zou G, Campbell C. The relationship between quality of life and health-related quality of life in young males with Duchenne muscular dystrophy. Dev Med Child Neurol 2017; 59:1152-1157. [PMID: 28963725 DOI: 10.1111/dmcn.13574] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 11/27/2022]
Abstract
AIM This study investigated the relationship between quality of life (QoL) and health-related quality of life (HRQoL) and assessed factors other than health that contribute to differences in QoL in young males with Duchenne muscular dystrophy (DMD). METHOD In this cross-sectional study, QoL and HRQoL measures were completed by 98 parents and 85 children. The Quality of My Life (QoML) questionnaire measured QoL and HRQoL as single-items, and the Pediatric Quality of Life 4.0 Generic Core (PedsQL) questionnaire was used as a multidimensional measure of HRQoL. Simple regression was used to examine the relationship between single-item measures of HRQoL and QoL. Multivariable regression was used to investigate factors that may contribute to difference in QoL and HRQoL. RESULTS While ratings of QoL and HRQoL were significantly correlated with one another, HRQoL only accounted for 21% and 44% of the variability in QoL by child- and parent-reports respectively. None of the factors measured contributed ratings of the child's QoL to be much higher than HRQoL. INTERPRETATION QoL and HRQoL are related but distinct constructs as rated by children with DMD and their parents. Further research is needed to elucidate factors outside HRQoL that contribute to QoL. WHAT THIS PAPER ADDS Quality of life (QoL) and health-related quality of life are distinct concepts rated by young males with Duchenne muscular dystrophy (DMD) and their parents. Factors outside of 'health' contribute to overall QoL in the paediatric population with DMD. This article's abstract has been translated into Spanish and Portuguese. Follow the links from the abstract to view the translations.
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Affiliation(s)
- Yi Wei
- Department of Pediatrics, Western University, London, ON, Canada
| | - Kathy Nixon Speechley
- Department of Pediatrics, Western University, London, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Guangyong Zou
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Craig Campbell
- Department of Pediatrics, Western University, London, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
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Cycling Through Cancer: Exploring Childhood Cancer Survivors' Experiences of Well- and Ill-Being. Adapt Phys Activ Q 2017; 34:345-361. [PMID: 28942675 DOI: 10.1123/apaq.2016-0011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The benefits of informal physical activity during recovery from childhood cancer have rarely been investigated. This study adopted a multiple case study approach to explore the impact of recreational cycling on childhood cancer survivors' experiences of well- and ill-being. Three semistructured interviews were conducted over a 3-month period with four survivors to explore their experiences of physical, psychological, and social well- and ill-being. Within-case analysis followed by cross-case analysis identified three themes that captured their well- and ill-being experiences with recreational cycling and cancer: (a) cultivating feelings and emotions, (b) experiencing physical changes, and (c) encountering positive and negative social interactions. The results from this study show that recreational cycling may be a useful adjunct to conventional treatments for the self-management of multiple domains of well- and ill-being during recovery from childhood cancer.
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Ferro MA, Avery L, Fayed N, Streiner DL, Cunningham CE, Boyle MH, Lach L, Glidden G, Rosenbaum PL, Ronen GM. Child- and parent-reported quality of life trajectories in children with epilepsy: A prospective cohort study. Epilepsia 2017; 58:1277-1286. [PMID: 28485850 DOI: 10.1111/epi.13774] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the developmental trajectories of quality of life (QoL) in a large cohort of children with epilepsy, and to assess the relative contribution of clinical, psychosocial, and sociodemographic variables on QoL trajectories. METHODS Five assessments during a 28-month prospective cohort study were used to model trajectories of QoL. Participants were recruited with their parents from six Canadian tertiary centers. A convenience sample of 506 children aged 8-14 years with epilepsy and without intellectual disability or autism spectrum disorder were enrolled. A total of 894 children were eligible and 330 refused participation. Participating children were, on average, 11.4 years of age, and 49% were female. Nearly one third (32%) had partial seizures. At baseline, 479 and 503 child- and parent-reported questionnaires were completed. In total, 354 children (74%) and 366 parents (73%) completed the 28-month follow-up. QoL was measured using the child- and parent-reported version of the Childhood Epilepsy QoL scale (CHEQOL-25). RESULTS Child-reported QoL was fitted best by a six-class model and parent-reported QoL by a five-class model. In both models, trajectories remained either stable or improved over 28 months. Of these children, 62% rated their QoL as high or moderately high, defined as at least one standard deviation above the average CHEQOL-25 score. Greater family, classmate, and peer social support, fewer symptoms of child and parent depression, and higher receptive vocabulary were identified as the most robust predictors of better QoL (all p < 0.001). SIGNIFICANCE Most children with epilepsy and their parents reported relatively good QoL in this first joint self- and proxy-reported trajectory study. Findings confirm the heterogeneous QoL outcomes for children with epilepsy and the primary importance of psychosocial factors rather than seizure and AED-specific factors in influencing QoL. These predictors that are potentially amenable to change should now be the focus of specific intervention studies.
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa Avery
- Avery Information Services, Orillia, Ontario, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Charles E Cunningham
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Ontario, Canada
| | - Gina Glidden
- School of Social Work, McGill University, Montreal, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Qadeer RA, Ferro MA. Child–parent agreement on health-related quality of life in children with newly diagnosed chronic health conditions: a longitudinal study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2017. [DOI: 10.1080/02673843.2017.1297242] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Rana A. Qadeer
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Mark A. Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Edmonds EW, Bastrom TP, Roocroft JH, Calandra-Young VA, Pennock AT. The Pediatric/Adolescent Shoulder Survey (PASS): A Reliable Youth Questionnaire With Discriminant Validity and Responsiveness to Change. Orthop J Sports Med 2017; 5:2325967117698466. [PMID: 28451609 PMCID: PMC5400147 DOI: 10.1177/2325967117698466] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Health-related quality of life tools for shoulder pathology in adults have been developed, such as the Disabilities of the Arm, Shoulder, and Hand (DASH) or QuickDASH. However, some content is not applicable to or readily grasped by a younger population. PURPOSE To evaluate the psychometric properties of a new 13-item pediatric/adolescent shoulder survey (PASS). STUDY DESIGN Cohort study (diagnosis); Level of evidence, 2. METHODS An initial development cohort of children was given the PASS, QuickDASH, and single assessment numeric evaluation (SANE) in a prospective fashion. Internal reliability and concurrent validity were evaluated. Subsequent to this, the PASS, along with the QuickDASH, was incorporated into routine clinical evaluation of shoulder injuries. The secondary cohort was established via a retrospective review of patients (age <18 years) evaluated in our sports clinics for shoulder complaints. Discriminant validity and floor/ceiling effects were evaluated. A subset of patients with scores available both pre- and within 6 months postoperatively was analyzed to assess responsiveness to treatment. RESULTS Overall internal reliability of the shoulder survey was good in the development cohort of 127 patients, with Cronbach α = 0.86. Total score averaged 59.7% ± 17.9% in this cohort (range, 18.75%-100%). Significant correlations between all surveys were observed (r = 0.51-0.79, P < .05). A total of 127 surveys were available for the secondary cohort. The QuickDASH demonstrated significant differences between sexes with regard to scores (P < .05). Both tools were able to discriminate between patients with acute injuries and diminished clinical examinations (P < .05). A significant correlation was observed between duration of symptoms and scores on the PASS. The subset of 25 patients with pre- and postoperative data showed significant change in total score and the symptoms/limitations domain of the PASS, with significant correlation with length of time since surgery. CONCLUSION This 13-question pediatric/adolescent-focused shoulder survey shows excellent psychometric properties, good discriminant ability, and early evidence of responsiveness to change, especially when compared with an adult-formatted questionnaire.
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Affiliation(s)
- Eric W. Edmonds
- Rady Children’s Hospital, San Diego, California, USA
- University of California–San Diego, San Diego, California, USA
| | | | | | | | - Andrew T. Pennock
- Rady Children’s Hospital, San Diego, California, USA
- University of California–San Diego, San Diego, California, USA
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Baiardini I, Fasola S, Montalbano L, Cilluffo G, Malizia V, Ferrante G, Braido F, La Grutta S. RHINASTHMA-Children: A new quality of life tool for patients with respiratory allergy. Pediatr Allergy Immunol 2017; 28:102-105. [PMID: 27732756 DOI: 10.1111/pai.12667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ilaria Baiardini
- DIMI, Allergy & Respiratory Diseases Clinic, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Salvatore Fasola
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.,Department of Economic, Business and Statistical Sciences, University of Palermo, Palermo, Italy
| | - Laura Montalbano
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.,Department of Psychology, University of Palermo, Palermo, Italy
| | - Giovanna Cilluffo
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.,Department of Economic, Business and Statistical Sciences, University of Palermo, Palermo, Italy
| | - Velia Malizia
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuliana Ferrante
- Department of Science for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Fulvio Braido
- DIMI, Allergy & Respiratory Diseases Clinic, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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Quitmann J, Rohenkohl A, Sommer R, Bullinger M, Silva N. Explaining parent-child (dis)agreement in generic and short stature-specific health-related quality of life reports: do family and social relationships matter? Health Qual Life Outcomes 2016; 14:150. [PMID: 27769269 PMCID: PMC5075198 DOI: 10.1186/s12955-016-0553-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the context of health-related quality of life (HrQoL) assessment in pediatric short stature, the present study aimed to examine the levels of agreement/disagreement between parents' and children's reports of generic and condition-specific HrQoL, and to identify socio-demographic, clinical and psychosocial variables associated with the extent and direction of parent-child discrepancies. METHODS This study was part of the retest phase of the QoLISSY project, which was a multicenter study conducted simultaneously in France, Germany, Spain, Sweden and UK. The sample comprised 137 dyads of children/adolescents between 8 and 18 years of age, diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS), and one of their parents. The participants completed child- and parent-reported questionnaires on generic (KIDSCREEN-10 Index) and condition-specific HrQoL (QoLISSY Core Module). Children/adolescents also reported on social support (Oslo 3-items Social Support Scale) and parents assessed the parent-child relationships (Parental Role subscale of the Social Adjustment Scale) and burden of short stature on parents (QoLISSY- additional module). RESULTS The parent-child agreement on reported HrQoL was strong (intraclass correlation coefficients between .59 and .80). The rates of parent-child discrepancies were 61.5 % for generic and 35.2 % for condition-specific HrQoL, with the parents being more prone to report lower generic (42.3 %) and condition-specific HrQoL (23.7 %) than their children. The extent of discrepancies was better explained by family and social relationships than by clinical and socio-demographic variables: poorer parent-child relationships and better children's social support were associated with larger discrepancies in generic HrQoL, while more parental burden was associated with larger discrepancies in condition-specific HrQoL reports. Regarding the direction of discrepancies, higher parental burden was significantly associated with parents' underrating, and better children's social support was significantly associated with parents' overrating of condition-specific HrQoL. CONCLUSIONS Routine assessment of pediatric HrQoL in healthcare and research contexts should include child- and parent-reported data as complementary sources of information, and also consider the family and social context.
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Affiliation(s)
- Julia Quitmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany.
| | - Anja Rohenkohl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Rachel Sommer
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany
| | - Neuza Silva
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52 D, 20246, Hamburg, Germany.,Cognitive and Behavioural Center for Research and Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Rua do Colégio Novo, 3001-802, Coimbra, Portugal
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Leal RB, Gomes MC, Granville-Garcia AF, Goes PSA, de Menezes VA. Development of a questionnaire for measuring health-related quality of life among children and adolescents with mouth breathing. Am J Rhinol Allergy 2016; 29:e212-5. [PMID: 26637572 DOI: 10.2500/ajra.2015.29.4258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mouth breathing can exert an influence on quality of life and should be evaluated within a multidimensional context. However, there is no specific questionnaire to measure the impact of mouth breathing on quality of life. OBJECTIVE To develop and validate a questionnaire for measuring the impact of mouth breathing on quality of life among children and adolescents. METHODS Thirty-six items were evaluated by six health care professionals, one parent and one child with mouth breathing. After a qualitative evaluation, a modified set of 32 items was developed. The modified Mouth Breather Quality of Life (MBQoL) questionnaire was submitted to a pretest with a sample of 30 children and adolescents diagnosed with mouth breathing to evaluate comprehension, the order of the items, and the form of administration. The MBQoL questionnaire was then administered to 60 children and adolescents (30 mouth breathers and 30 nose breathers) for the evaluation of construct validity, internal consistency, and reproducibility. All the participants answered the questionnaire, and 50% of each group answered the questionnaire a second time after a 1-week interval (test-retest). RESULTS Higher MBQoL scores (which indicated poorer quality of life) were significantly associated with mouth breathing. The Cronbach α coefficient for the items of the questionnaire was 0.88, and the Spearman correlation coefficient for test-retest reliability demonstrated that the questionnaire was reproducible (r = 0.993; p < 0.01). CONCLUSION Through this validation study, the MBQoL questionnaire demonstrated a good performance in the evaluation of the quality of life of children and adolescents with mouth breathing and may be a useful tool in clinical studies as well as public health programs. However, further studies are needed to establish its applicability in other populations with respiration disorders.
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Affiliation(s)
- Rossana B Leal
- Department of Dentistry, Caruaru Higher Education Association, Caruaru, Pernambuco, Brazil
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Dalton ED, Hammen CL, Brennan PA, Najman JM. Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood. Psychol Health 2016; 31:1255-71. [PMID: 27329508 DOI: 10.1080/08870446.2016.1204448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health. DESIGN The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384). MAIN OUTCOME MEASURES The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood. RESULTS The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood. CONCLUSIONS Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.
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Affiliation(s)
- Elizabeth D Dalton
- a Department of Psychology , University of California , Los Angeles , CA , USA
| | - Constance L Hammen
- a Department of Psychology , University of California , Los Angeles , CA , USA
| | | | - Jake M Najman
- c Department of Sociology, School of Population Health , University of Queensland , Brisbane , Australia
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Hemmingsson H, Ólafsdóttir LB, Egilson ST. Agreements and disagreements between children and their parents in health-related assessments. Disabil Rehabil 2016; 39:1059-1072. [PMID: 27291406 DOI: 10.1080/09638288.2016.1189603] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. METHOD The Uni-Search and five additional databases were searched. Children's health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. RESULTS Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their children's difficulties in emotional functioning and pain. There were no consistencies in differences between children's and parent's ratings on levels of agreement with respect to the children's health issue, age or gender. CONCLUSIONS Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. Implications for Rehabilitation In general, parents consider their children to have more difficulties - or more extensive difficulties - than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the child´s health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the children's emotional functioning and pain. Clinicians should prioritize obtaining children's views on subjective aspects such as emotional issues as well as on pain.
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Affiliation(s)
- Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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An item-level response shift study on the change of health state with the rating of asthma-specific quality of life: a report from the PROMIS(®) Pediatric Asthma Study. Qual Life Res 2016; 25:1349-59. [PMID: 27061424 DOI: 10.1007/s11136-016-1290-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine item-level response shift associated with the change in asthma-related health state (i.e., change in asthma control status and global rating of change (GRC) in breathing problems). METHODS Study sample comprised 238 asthmatic children who were between 8 and 17.9 years and completed the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) symptoms, emotion function, and activity limitation domains at baseline and a follow-up assessment. Structural equation modeling was implemented to assess item-level response shift associated with the change in asthma-related health state with the adjustment for the influence of confounding variables. The magnitude of item-level response shift and its influence on the change of domain scores was estimated using Cohen's effect sizes. RESULTS We found no instances of item-level response shift. However, two items were identified with measurement bias related to GRC due to breathing problems. Specifically, asthmatic children with better/about the same GRC due to breathing problems reported lower scores for one item in the emotional domain at follow-up compared to those with deteriorated GRC due to breathing problems. In addition, asthmatic children with better/about the same GRC due to breathing problems reported better scores for another item in the symptom domain at baseline compared to those with deteriorated GRC due to breathing problems. The impact of measurement bias was small and did not bias the change of domain scores over time. CONCLUSIONS No item-level response shift, but two instances of measurement bias, appears in asthmatic children. However, the impact of these measurement issues is negligible.
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Similuk MN, Wang A, Lenardo MJ, Erby LH. Life with a Primary Immune Deficiency: a Systematic Synthesis of the Literature and Proposed Research Agenda. J Clin Immunol 2016; 36:123-33. [PMID: 26873708 PMCID: PMC11090044 DOI: 10.1007/s10875-016-0241-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 01/31/2016] [Indexed: 12/28/2022]
Abstract
PURPOSE The clinical immunology literature is punctuated with research on psychosocial dimensions of illness. Studies investigating the lived experiences and stated needs of patients with primary immune deficiencies and their families are essential to improving clinical management and determining the research questions that matter to patients and other stakeholders. Yet, to move the field forward, a systematic review of literature and proposed agenda is needed. METHODS A systematic review was conducted via PubMed and Scopus to include original research on psychological, social, or behavioral aspects of primary immune deficiencies published between 1999 and 2015. A Title/Abstract keyword search was conducted, 317 candidate article abstracts were manually reviewed, and forward/backward reference searches were completed. RESULTS Twenty-nine studies met inclusion criteria. These illuminate the complex psychological, social, and emotional experiences of primary immune deficiency. Themes included the potential for negative psychosocial impact from disease; adaptation over time; the multi-dimensional assessments of quality of life; familial impact; the important roles of hope, developing a sense of control, social support; and addressing anxiety/depression in our patients and their families. Methodological considerations and areas for improvement are discussed. CONCLUSION We propose the research agenda focus on study creativity and rigor, with improved engagement with existing literature and critical study design (e.g., methodology with adequate statistical power, careful variable selection, etc.). This review highlights opportunities to advance psychosocial research and bring a brighter future to clinicians, researchers, and families affected by primary immune deficiency.
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Affiliation(s)
- Morgan N Similuk
- National Institute of Allergy and Infectious Disease, NIH, 10 Center Drive, Building 10, Room 12C103, Bethesda, MD, USA.
| | - Angela Wang
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, 21702, USA
| | - Michael J Lenardo
- National Institute of Allergy and Infectious Disease, NIH, 10 Center Drive, Building 10, Room 12C103, Bethesda, MD, USA
| | - Lori H Erby
- National Human Genome Research Institute, NIH, Bethesda, MD, USA
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Huhtala M, Korja R, Rautava L, Lehtonen L, Haataja L, Lapinleimu H, Rautava P. Health-related quality of life in very low birth weight children at nearly eight years of age. Acta Paediatr 2016; 105:53-9. [PMID: 26461964 DOI: 10.1111/apa.13241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/17/2015] [Accepted: 10/08/2015] [Indexed: 11/28/2022]
Abstract
AIM This study examined the impact of prematurity-related morbidity on the health-related quality of life (HRQoL) of premature children at eight years of age, compared to term born controls of same age. METHODS We focused on 155 premature, very low birth weight (VLBW) infants weighing up to 1500 g who were born from 2001 to 2006 in Turku University Hospital, Finland, and compared them with 129 full-term controls. Cognitive development and length was assessed at five years of age and the children self-reported 17 dimensions of HRQoL at eight years of age. The VLBW group was subdivided into healthy children and those with prematurity-related morbidities. RESULTS Our findings showed that 64.5% of the VLBW children did not have prematurity-related morbidities. The HRQoL of the healthy preterm VLBW children was very good and did not differ significantly from the controls. However, the VLBW children with one or more morbidities had significantly lower scores in nine of the 17 HRQoL dimensions than the children in the control group. CONCLUSION The majority of the VLBW children survived without prematurity-related morbidities, and their HRQoL was very good and similar to the control children. The main goal of neonatal care for preterm infants should be to prevent long-term morbidities.
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Affiliation(s)
- Mira Huhtala
- Department of Public Health; University of Turku and Turku University Hospital; Turku Finland
- Department of Pediatrics; University of Turku and Turku University Hospital; Turku Finland
| | - Riikka Korja
- Department of Psychology; University of Turku and Turku University Hospital; Turku Finland
| | - Liisi Rautava
- Department of Pediatric Surgery; University of Turku and Turku University Hospital; Turku Finland
| | - Liisa Lehtonen
- Department of Pediatrics; University of Turku and Turku University Hospital; Turku Finland
| | - Leena Haataja
- Department of Pediatric Neurology; University of Turku and Turku University Hospital; Turku Finland
| | - Helena Lapinleimu
- Department of Pediatrics; University of Turku and Turku University Hospital; Turku Finland
| | - Päivi Rautava
- Department of Public Health; University of Turku and Turku University Hospital; Turku Finland
- Turku Clinical Research Centre; University of Turku and Turku University Hospital; Turku Finland
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Herdman M, Hoyle CK, Coles V, Carroll S, Devlin N. Assessing Patient-Reported Outcomes in Pediatric Populations With Vaccine-Preventable Infectious Diseases: A Systematic Review of the Literature (the PROCHID Study). VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:109-119. [PMID: 26797243 DOI: 10.1016/j.jval.2015.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 08/01/2015] [Accepted: 10/03/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the use of patient-reported outcomes (PROs) in pediatric populations with vaccine-preventable infectious diseases in high-income Western countries. METHODS Systematic review of PRO use in populations younger than 18 years with any of 17 infectious diseases for which vaccines are available or in development. The search was limited to studies performed in Europe, North America, Australia, and New Zealand and published between January 1, 1990, and July 31, 2013. Searches were conducted in Scopus and PsycINFO, and reference lists were manually searched. Results are reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Of 6410 titles and abstracts and 174 full-text articles reviewed, 17 full-text articles were included for data extraction. The largest number of PRO studies was carried out in patients with anogenital warts and rotavirus gastroenteritis. No PRO studies were identified for nine conditions. A total of 24 PRO measures (12 generic and 12 disease-specific) were used in the studies reviewed. Most of the instruments used were of high quality. Proxy responses were occasionally obtained when self-report would have been feasible. No validated disease-specific instruments for children with any of the conditions studied were found. CONCLUSIONS The paucity of studies and PRO instruments to assess pediatric health status in vaccine-preventable infectious diseases, and the lack of a standardized approach to measurement, makes it difficult to capture the impact of disease and the benefit of vaccination and could potentially hinder decision making. Guidelines from relevant bodies to steer research in this area would be useful.
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Abstract
INTRODUCTION Sports activities are part of multidisciplinary treatments in people with hemophilia. AIM The objective of this study was to assess the incidence of sports activities in the quality of life as perceived by children with hemophilia. METHODS A total of 53 children with hemophilia aged 7 to 13 years and 51 children without hemophilia were evaluated. The perception of quality of life, clinical variables, and the frequency of sports activities were registered. The joint condition of patients with hemophilia was measured with the Spanish version of the Haemophilia Joint Health Score. RESULTS There were no significant differences in the perception of quality of life between children with hemophilia and children without hemophilia. Sports activities in people with hemophilia promoted a greater health satisfaction. CONCLUSIONS Sports activity in children with hemophilia is associated with an improved quality of life and joint health. It is also associated with improved psychosocial wellness.
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Wallander JL, Koot HM. Quality of life in children: A critical examination of concepts, approaches, issues, and future directions. Clin Psychol Rev 2015; 45:131-43. [PMID: 26911191 DOI: 10.1016/j.cpr.2015.11.007] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
The quality of children's life is important both as an investment in the future of our society and because children constitute an important group of themselves and deserve to experience well-being presently. Quality of life (QOL) has been conceptualized and studied in children for several decades, but with disparate approaches that have rarely been discussed jointly with application to children in general. Here we describe and critically examine the three main approaches to children's QOL: health-related QOL (HRQOL), social indicators, and subjective well-being (SWB). Although this is not a review of instruments per se, we illustrate these approaches by describing their most prominent measures. Issues and opportunities in research on children's QOL are then discussed related to conceptual clarity, content specification, range of experience, subjective and objective perspectives, development in childhood, reporting source, and malleability of QOL. Finally, directions for advancing children's QOL are considered. We highlight the benefits of focusing on social indicators and SWB, rather than HRQOL, when representing this concept for children in general, the need for applying more sophisticated research strategies, and using QOL as a universal indicator of success whenever we intend to advance the well-being of children through intervention, programs, and policy.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, United States.
| | - Hans M Koot
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
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77
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Wei Y, Speechley K, Campbell C. Health-Related Quality of Life in Children with Duchenne Muscular Dystrophy: A Review. J Neuromuscul Dis 2015; 2:313-324. [PMID: 27858736 PMCID: PMC5240578 DOI: 10.3233/jnd-150071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In pediatric chronic illness, improving health-related quality of life (HRQOL) has become one of the most important goals of disease management. Duchenne muscular dystrophy (DMD) is a debilitating, progressive and chronic neuromuscular disorder affecting boys. The purpose of this review is to provide an overview of published research on HRQOL in the pediatric DMD population, describe the instruments used and summarize the study findings. The databases searched were Medline, Embase and PsycInfo. The literature search yielded 167 articles, of which 19 were included in this review. The studies were published between 2005 and 2013 across nine countries. Thirteen different generic and disease-specific measures were used, the most common being the Pediatric Quality of Life 4.0 Generic Core module. HRQOL in boys with DMD is worse than that of healthy peers and children with other chronic illnesses, especially in the physical domains. Boys who are at a more severe stage of the disease reported worse physical HRQOL but not necessarily psychosocial HRQOL than boys at a less severe stage. Traditional clinical outcome measures correlated well only with physical HRQOL. Parents’ proxy-reports of their sons’ HRQOL and the boys’ self-reports had poor concordance. More research is needed to assess trends in HRQOL over time and to elucidate factors that affect HRQOL.
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Affiliation(s)
- Yi Wei
- Department of Pediatrics and Epidemiology and Biostatistics, Western University
| | - Kathy Speechley
- Department of Pediatrics and Epidemiology and Biostatistics, Western University
| | - Craig Campbell
- Department of Pediatrics and Epidemiology and Biostatistics, Western University
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Abstract
PURPOSE To understand the vision-related quality of life (QoL) of schoolchildren with uncorrected refractive error (URE). METHODS A snapshot qualitative research design and homogeneous sampling strategy was adopted. Thirty-one, 27, and 22 eye care practitioners, children, and teachers participated in four, three, and two focus group discussions, respectively. The participants were recruited from various parts of Chennai, India. The discussions were audio recorded, transcribed, coded, and analyzed. RESULTS Eight themes emerged: complaints and symptoms of children with URE, vision-related activity limitation, coping strategies, psychological impact, social impact, the perceived difference after first time refractive correction, reasons for refractive error remaining uncorrected, and the significant amount of refractive error. CONCLUSIONS The study gives a holistic view of the vision-related QoL of children with URE by demonstrating the difficulties and problems that they face in their day-to-day life and also by describing the perceived difference in QoL after wearing refractive correction.
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Kreslins A, Robertson AE, Melville C. The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2015; 9:22. [PMID: 26120361 PMCID: PMC4482189 DOI: 10.1186/s13034-015-0054-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/08/2015] [Indexed: 12/28/2022] Open
Abstract
Anxiety is a common problem in children and adolescents with autism spectrum disorder (ASD). This meta-analysis aimed to systematically evaluate the evidence for the use of psychosocial interventions to manage anxiety in this population. Cognitive behavioural therapy (CBT) was the primary intervention modality studied. A comprehensive systematic search and study selection process was conducted. Separate statistical analyses were carried out for clinician-, parent-, and self-reported outcome measures. Sensitivity analyses were conducted by removing any outlying studies and any studies that did not use a CBT intervention. A subgroup analysis was performed to compare individual and group delivery of treatment. Ten randomised control trials involving a total of 470 participants were included. The overall SMD was d = 1.05 (95 % CI 0.45, 1.65; z = 3.45, p = 0.0006) for clinician- reported outcome measures; d = 1.00 (95%CI 0.21, 1.80; z = 2.47, p = 0.01) for parent-reported outcome measures; and d = 0.65 (95%CI -0.10, 1.07; z = 1.63, p = 0.10) for self-reported outcome measures. Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment. However, the results of self-reported outcome measures failed to reach significance. The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment. The main limitations of this review were the small number of included studies as well as the clinical and methodological variability between studies.
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Affiliation(s)
- Ance Kreslins
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
| | - Ashley E. Robertson
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
| | - Craig Melville
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
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Regnault A, Burlina A, Cunningham A, Bettiol E, Moreau-Stucker F, Benmedjahed K, Bosch AM. Development and psychometric validation of measures to assess the impact of phenylketonuria and its dietary treatment on patients' and parents' quality of life: the phenylketonuria - quality of life (PKU-QOL) questionnaires. Orphanet J Rare Dis 2015; 10:59. [PMID: 25958326 PMCID: PMC4449597 DOI: 10.1186/s13023-015-0261-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/30/2015] [Indexed: 11/25/2022] Open
Abstract
Background The aim of our study was to develop and validate the first set of PKU-specific Health-related Quality of Life (HRQoL) questionnaires that: 1) were developed for patients with PKU and their parents, 2) cover the physical, emotional, and social impacts of PKU and its treatment on patients’ lives, 3) are age specific (Child PKU-QOL, Adolescent PKU-QOL, Adult PKU-QOL), 4) enable the evaluation of the HRQoL of children by their parents (Parent PKU-QOL), and 5) have been cross-culturally adapted for use in seven countries (i.e. France, Germany, Italy, The Netherlands, Spain, Turkey and the UK). Methods The PKU-QOL questionnaires were developed according to reference methods including patients’, parents’ and healthcare professionals’ interviews; testing in a pilot study (qualitative step in six countries), and linguistic validation of the finalised pilot versions in Turkish. For finalisation and psychometric validation, the pilot versions were included in a multicentre, prospective, non-interventional, observational study conducted in 34 sites in France, Germany, Italy, The Netherlands, Spain, Turkey and the UK. Iterative multi-trait analyses were conducted. Psychometric properties were assessed (concurrent and clinical validity, internal consistency reliability and test-retest reliability). Results Data from 559 subjects (306 patients, 253 parents) were analysed. After finalisation, the PKU-QOL questionnaires included 40 items (Child PKU-QOL), 58 items (Adolescent PKU-QOL), 65 items (Adult PKU-QOL) and 54 items (Parent PKU-QOL), distributed in four modules: PKU symptoms, PKU in general, administration of Phe-free protein supplements and dietary protein restriction. The measurement properties of the Adolescent, Adult and Parent PKU-QOL questionnaires were overall fairly satisfactory, but weaker for the Child questionnaire. Conclusions The four PKU-QOL questionnaires developed for different ages (Child PKU-QOL, Adolescent PKU-QOL, Adult PKU-QOL), and for parents of children with PKU (Parent PKU-QOL) are valid and reliable instruments for assessing the multifaceted impact of PKU on patients of different age groups (children, adolescents and adults) and their parents, and are available for use in seven countries. They are very promising tools to explore how patients’ perceptions evolve with age, to increase knowledge of the impact of PKU on patients and parents in different countries, and to help monitor the effect of therapeutic strategies. Electronic supplementary material The online version of this article (doi:10.1186/s13023-015-0261-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antoine Regnault
- Mapi, Health Economics & Outcomes Research and Strategic Market Access, 27 rue de la Villette, Lyon, France.
| | - Alberto Burlina
- Division of Metabolic Diseases, Department of Paediatrics, University Hospital of Padova, Padova, Italy.
| | - Amy Cunningham
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, Louisiana, USA.
| | - Esther Bettiol
- Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | | | - Khadra Benmedjahed
- Mapi, Health Economics & Outcomes Research and Strategic Market Access, 27 rue de la Villette, Lyon, France.
| | - Annet M Bosch
- Department of Pediatrics, Division of Metabolic Disorders, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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QUAlity of Life Assessment in Spina bifida for Adults (QUALAS-A): development and international validation of a novel health-related quality of life instrument. Qual Life Res 2015; 24:2355-64. [DOI: 10.1007/s11136-015-0988-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
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82
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Gutierrez-Colina AM, Eaton CK, Lee JL, LaMotte J, Blount RL. Health-related quality of life and psychosocial functioning in children with Tourette syndrome: parent-child agreement and comparison to healthy norms. J Child Neurol 2015; 30:326-32. [PMID: 24963072 DOI: 10.1177/0883073814538507] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to evaluate the degree of agreement between parent proxy- and child self-report on measures of child psychosocial functioning and health-related quality of life in children with Tourette syndrome. Participants included 28 children with Tourette syndrome and their parents. All participants provided ratings of children's level of quality of life and psychosocial functioning. Results revealed strong, positive relationships between child self- and parent proxy-reports on all quality of life and psychosocial functioning domains. Parents perceived significantly higher levels of depression compared to their children, whereas children reported significantly lower Physical quality of life compared to their parents. Results suggest that assessment of quality of life and psychosocial functioning should include multiple reporters whenever feasible. Caution should be used when exclusively relying on parent proxy-reports of quality of life and psychosocial functioning, as these reports may not accurately reflect children's difficulties or perceptions of their functioning.
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Affiliation(s)
| | - Cyd K Eaton
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Jennifer L Lee
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Julia LaMotte
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ronald L Blount
- Department of Psychology, University of Georgia, Athens, GA, USA
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Stevanovic D, Atilola O, Balhara YPS, Avicenna M, Kandemir H, Vostanis P, Knez R, Petrov P. The Relationships Between Alcohol/Drug Use and Quality of Life Among Adolescents: An International, Cross-Sectional Study. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015. [DOI: 10.1080/1067828x.2013.773864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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84
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Silva N, Crespo C, Carona C, Bullinger M, Canavarro MC. Why the (dis)agreement? Family context and child-parent perspectives on health-related quality of life and psychological problems in paediatric asthma. Child Care Health Dev 2015; 41:112-21. [PMID: 24797724 DOI: 10.1111/cch.12147] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children's health-related quality of life (HrQoL) and psychological problems are important outcomes to consider in clinical decision making in paediatric asthma. However, children's and parents' reports often differ. The present study aimed to examine the levels of agreement/disagreement between children's and parents' reports of HrQoL and psychological problems and to identify socio-demographic, clinical and family variables associated with the extent and direction of (dis)agreement. METHODS The sample comprised 279 dyads of Portuguese children with asthma who were between 8 and 18 years of age (M = 12.13; SD = 2.56) and one of their parents. The participants completed self- and proxy-reported questionnaires on paediatric generic HrQoL (KIDSCREEN-10), chronic-generic HrQoL (DISABKIDS-37) and psychological problems (Strengths and Difficulties Questionnaire). Children's and parents' perceptions of family relationships were measured with the Family Environment Scale and the caregiving burden was assessed using the Revised Burden Measure. RESULTS The child-parent agreement on reported HrQoL and psychological problems was poor to moderate (intraclass correlation coefficients between 0.32 and 0.47). The rates of child-parent discrepancies ranged between 52.7% (psychological problems) and 68.8% (generic HrQoL), with 50.5% and 31.5% of the parents reporting worse generic and chronic-generic HrQoL, respectively, and 33.3% reporting more psychological problems than their children. The extent and direction of disagreement were better explained by family factors than by socio-demographic and clinical variables: a greater caregiving burden was associated with increased discrepancies in both directions and children's and parents' perceptions of less positive family relationships were associated with discrepancies in different directions. CONCLUSIONS Routine assessment of paediatric HrQoL and psychological problems in healthcare and research contexts should include self- and parent-reported data as complementary sources of information, and also consider the family context. The additional cost of conducting a more in-depth assessment of paediatric adaptation outcomes can be offset through more efficient allocation of health resources.
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Affiliation(s)
- N Silva
- Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
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85
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Murray CB, Holmbeck GN, Ros AM, Flores DM, Mir SA, Varni JW. A longitudinal examination of health-related quality of life in children and adolescents with spina bifida. J Pediatr Psychol 2014; 40:419-30. [PMID: 25434043 DOI: 10.1093/jpepsy/jsu098] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 10/19/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The current study examined (1) spina bifida (SB) youths' health-related quality of life (HRQOL) compared with nonclinical and chronic health condition (CHC) samples, (2) parent-child agreement regarding HRQOL, and (3) prospective changes in HRQOL. METHODS Child and parent-proxy reports of Pediatric Quality of Life were collected at two time waves (Time 1: N = 134, ages 8-15 years; Time 2: N = 109, ages 10-17 years) as part of a larger longitudinal study. RESULTS SB youth had statistically and clinically reduced physical HRQOL compared with the nonclinical and CHC samples at both time points. There were significant discrepancies between youth and parent-proxy reports of HRQOL; youth reported higher levels of physical and social HRQOL than parents. The majority of parent- and child-reported HRQOL domains remained stable, yet youth-reported social HRQOL increased over time. CONCLUSIONS Youth with SB are at risk for poor HRQOL. Examining modifiable condition and social-environmental predictors of youth HRQOL will be important in informing future interventions.
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Affiliation(s)
- Caitlin B Murray
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Grayson N Holmbeck
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Anna M Ros
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Donna M Flores
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - Sophie A Mir
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
| | - James W Varni
- Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University Psychology Department, Loyola University Chicago, Department of Pediatrics, College of Medicine, Texas A&M University, and Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University
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86
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Health-Related Quality of Life in Patients with MPS II. J Genet Couns 2014; 24:635-44. [PMID: 25395377 DOI: 10.1007/s10897-014-9791-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
Mucopolysaccharidosis type II (MPS II), also known as Hunter syndrome, is a chronic and progressive X-linked lysosomal disease that mainly affects males. The National MPS Society (2013) reports that MPS II affects 1 in 100,000 to 1 in 150,000 males worldwide. Two distinct forms of the disease are based on age of onset and clinical course: attenuated and severe. MPS II affects many organ systems including the nervous, cardiovascular, gastrointestinal and respiratory systems. Clinical manifestations can include progressive hearing loss, mental impairment, and enlarged liver and spleen. This study focuses on the health-related quality of life of individuals (HRQOL) with MPS II as measured by the parent and self-report versions of the Pediatric Quality of Life Inventory (PedsQL™). Both parents of patients with MPS II as well as patients themselves reported lower scores on all domains of the PedsQL™ (physical, emotional, social and school functioning) indicating that children with MPS II have an overall lower HRQOL when compared to a healthy sample. When compared with patients with other chronic illnesses (cancer, MSUD, galactosemia,), the MPS II sample had significantly lower scores on a number of PedsQL™ scales, suggesting an overall lower HRQOL. No significant relationships were found using scores from parent or self report PedsQL™ measures and length of time on ERT.
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87
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Gandhi PK, Thompson LA, Tuli SY, Revicki DA, Shenkman E, Huang IC. Developing item banks for measuring pediatric generic health-related quality of life: an application of the International Classification of Functioning, Disability and Health for Children and Youth and item response theory. PLoS One 2014; 9:e107771. [PMID: 25268926 PMCID: PMC4182329 DOI: 10.1371/journal.pone.0107771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 08/14/2014] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to develop item banks by linking items from three pediatric health-related quality of life (HRQoL) instruments using a mixed methodology. Secondary data were collected from 469 parents of children aged 8-16 years. The International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY) served as a framework to compare the concepts of items from three HRQoL instruments. The structural validity of the individual domains was examined using confirmatory factor analyses. Samejima's Graded Response Model was used to calibrate items from different instruments. The known-groups validity of each domain was examined using the status of children with special health care needs (CSHCN). Concepts represented by the items in the three instruments were linked to 24 different second-level categories of the ICF-CY. Eight item banks representing eight unidimensional domains were created based on the linkage of the concepts measured by the items of the three instruments to the ICF-CY. The HRQoL results of CSHCN in seven out of eight domains (except personality) were significantly lower compared with children without special health care needs (p<0.05). This study demonstrates a useful approach to compare the item concepts from the three instruments and to generate item banks for a pediatric population.
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Affiliation(s)
- Pranav K. Gandhi
- Department of Pharmacy Practice, School of Pharmacy, South College, Knoxville, TN, United States of America
| | - Lindsay A. Thompson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Sanjeev Y. Tuli
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | | | - Elizabeth Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, United States of America
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, United States of America
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
- * E-mail:
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Abstract
The goal was to present the factor structure of subjective quality of life in adolescents, investigated by means of four questionnaires: the Youth Quality of Life-Research Version (YQOL-R), the Quality of Life Profile-Adolescent Version (QOLP-AV), the KIDSCREEN-52 Questionnaire, and the Quality of Life Questionnaire for Children and Adolescents (QLQ-CA). Two exploratory factor analyses conducted on the results obtained from two samples of adolescents: healthy, N = 252 (144 girls, 108 boys), and chronically ill, suffering from several illnesses, N = 189 (118 girls, 71 boys). Both factor analyses revealed four-factor solutions, each explaining about 60% of the total variance. The factor structure for the healthy group approximately reproduced the structures of the four questionnaires: Developmental quality of life (23%), Health and Well-being (16%), Relational quality of life (14%), and Ego strength (8%). The factor structure for the chronically ill group was similar for three factors: Developmental quality of life (22%), Harmony between the self and the environment (14%), and Coping and Support (12%), but different for another one: Health-related quality of life (10%). The discussion focuses on the specific nature of four aspects of quality of life observed in the healthy sample and their similarities to and differences from the factors in the chronic patients' sample.
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Affiliation(s)
- Maria Oleś
- 1 Institute of Psychology, The John Paul II Catholic University of Lublin, Poland
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89
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Health-related quality of life in children with disorders of sex development (DSD). Eur J Pediatr 2014; 173:893-903. [PMID: 24469231 DOI: 10.1007/s00431-014-2264-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/31/2013] [Accepted: 01/07/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Disorders of sex development (DSD) are rare genetic conditions resulting in atypical development of the sex organs. While some evidence is available on psychosexual outcomes, much less is known about the quality of life in this population, especially in children. Health-related quality of life (HRQOL) is a widely accepted endpoint for assessment and evaluation of interventions and medical care. Within the German DSD Network study, 86 children aged 8-12 years with several subtypes of DSD were recruited from Germany, Austria and Switzerland. Demographic, medical and psychosocial variables were collected through interviews of the attending physicians, the children and the parents. HRQOL was the primary outcome. It was assessed by the KINDL-R Questionnaire [2001]. Psychosexual determinants included gender identity/gender dysphoria, gender role behaviour, the child's knowledge about the condition and number/timing of genital surgery. A significant reduction of HRQOL was reported in children's self-report (p < 0.001), in particular in the area of self-esteem (p < 0.001), physical well-being (p < 0.01) and school functioning (p < 0.05). Girls with congenital adrenal hyperplasia who experienced gender dysphoria reported lower HRQOL scores compared to the study group at large. Atypical gender role behaviour was not associated with HRQOL. CONCLUSION Psychosocial support of children with DSD and their families appears to be necessary in at least some cases and must be accessible for all patients.
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90
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Hayward J, Millar L, Petersen S, Swinburn B, Lewis AJ. When ignorance is bliss: weight perception, body mass index and quality of life in adolescents. Int J Obes (Lond) 2014; 38:1328-34. [PMID: 24824556 PMCID: PMC4189380 DOI: 10.1038/ijo.2014.78] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 04/14/2014] [Accepted: 04/30/2014] [Indexed: 11/11/2022]
Abstract
Background/Objectives: Body weight is negatively associated with adolescent Health-Related Quality of Life (HRQoL). Despite this well-established relationship, some adolescents with obesity do not display the expected HRQoL decreases. This study hypothesised weight perception as a moderator of the association between weight status and adolescent HRQoL. Subjects/Methods: Subjects were secondary school students from an obesity prevention project in the Barwon South-West region of Victoria, Australia, entitled It's Your Move (N=3040). Measures included standardised body mass index (BMI-z; World Health Organization growth standards), weight perception and HRQoL, measured by the Paediatric Quality of Life Inventory. Linear regression and average marginal effect analyses were conducted on cross-sectional baseline data to determine the significance of any interaction between weight perception and measured weight status in shaping adolescent HRQoL. Results: The BMI-z/perceived weight status interaction was significantly associated with adolescent HRQoL outcomes. Adolescents with BMI z-scores in the overweight/obesity range who perceived themselves as overweight had lower HRQoL than those who perceived themselves as ‘about right.' Conversely, adolescents with BMI scores in the lower end of the normal range or in the thinness range who perceived themselves as underweight had lower HRQoL than those with ‘about right' perceptions. Conclusions: This was the first study to report third-variable impacts of a body-perception variable on the relationship between adolescent weight status and HRQoL. Adolescents' weight perceptions significantly moderated the relationship between overweight/obesity and reduced HRQoL. Adolescents who were outside the normal weight range and misperceived their objectively measured weight status enjoyed a higher HRQoL than adolescents whose weight perception was concordant with their actual weight status. These findings suggest that practitioners may need to exercise caution when educating adolescents about their weight status, as such ‘reality checks' may negatively impact on adolescent HRQoL. It is suggested that more research be conducted to examine this potential effect.
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Affiliation(s)
- J Hayward
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - L Millar
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - S Petersen
- 1] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Geelong, Victoria, Australia [2] Child and Adolescent Psychiatry, Clinical Sciences, Umeå University, Umeå, Sweden
| | - B Swinburn
- 1] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Geelong, Victoria, Australia [2] School of Population Health, University of Auckland, Auckland, New Zealand
| | - A J Lewis
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Lawitschka A, Güclü ED, Varni JW, Putz M, Wolff D, Pavletic S, Greinix H, Peters C, Felder-Puig R. Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study. Bone Marrow Transplant 2014; 49:1093-7. [DOI: 10.1038/bmt.2014.96] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/02/2014] [Accepted: 03/05/2014] [Indexed: 01/11/2023]
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Kenzik KM, Tuli SY, Revicki DA, Shenkman EA, Huang IC. Comparison of 4 Pediatric Health-Related Quality-of-Life Instruments: A Study on a Medicaid Population. Med Decis Making 2014; 34:590-602. [PMID: 24739533 DOI: 10.1177/0272989x14529846] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 03/07/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have compared multiple health-related quality-of-life (HRQOL) instruments simultaneously for pediatric populations. This study aimed to test psychometric properties of 4 legacy pediatric HRQOL instruments: the Child Health and Illness Profile (CHIP), the KIDSCREEN-52, the KINDL, and the Pediatric Quality of Life Inventory (PedsQL). METHODS This study used data from 908 parents whose children (ages 2-19 years) were enrolled in Florida Medicaid. Parents were asked via telephone interview to complete each instrument appropriate to the age of their children. Structural, convergent/discriminant, and known-group validities were investigated. We examined structural validity using confirmatory factor analyses. We examined convergent/discriminant validity by comparing Spearman rank correlation coefficients of homogeneous (physical functioning and physical well-being) versus heterogeneous (physical and psychological functioning) domains of the instruments. We assessed known-groups validity by examining the extent to which HRQOL differed by the status of children with special health needs (CSHCN). RESULTS Domain scores of the 4 instruments were not normally distributed, and ceiling effects were significant in most domains. The KIDSCREEN-52 demonstrates the best structural validity, followed by the CHIP, KINDL, and PedsQL. The PedsQL and the KIDSCREEN-52 show better convergent/discriminant validity than the other instruments. Known-groups validity in discriminating CSHCN versus no needs was the best for the PedsQL, followed by the KIDSCREEN-52, the CHIP, and the KINDL. CONCLUSION No one instrument was fully satisfactory in all psychometric properties. Strategies are recommended for future comparison of item content and measurement properties across different HRQOL instruments for research and clinical use.
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Affiliation(s)
- Kelly M Kenzik
- Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, AL, USA (KMK)
| | - Sanjeev Y Tuli
- Division of General Pediatrics, Department of Pediatrics, University of Florida, Gainesville, FL, USA (SYT)
| | - Dennis A Revicki
- Center for Health Outcomes Research, Evidera, Bethesda, MD, USA (DAR)
| | - Elizabeth A Shenkman
- Institute for Child Health Policy, Department of Health Outcomes & Policy, University of Florida, Gainesville, FL, USA (EAS, I-CH)
| | - I-Chan Huang
- Institute for Child Health Policy, Department of Health Outcomes & Policy, University of Florida, Gainesville, FL, USA (EAS, I-CH)
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93
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Heart rate variability reflects the natural history of physiological development in healthy children and is not associated with quality of life. PLoS One 2014; 9:e91036. [PMID: 24625571 PMCID: PMC3953202 DOI: 10.1371/journal.pone.0091036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/10/2014] [Indexed: 01/13/2023] Open
Abstract
Background Quality of life (QoL), being the sum expression of diverse influencing factors, is not easy to determine. A clinically relevant option would be to identify and measure quality of life on the basis of physiological parameters which correlate plausibly and statistically with psychometrically measured QoL. Analysis of heart rate variability (HRV) offers readily measurable physiological parameters which could be of use here. A correlation of HRV with both course of disease and QoL has been reported in patients with chronic illness. Various psychometric instruments have been developed for use in paediatric oncology. The aim of this study was to obtain data on HRV and QoL and their correlations, initially in healthy children. Methods Holter ECG and quality of life were examined in 160 children and adolescents (72 male) aged between 8 and 18 years. QoL was determined with the established questionnaire PEDQoL. Standard parameters of HRV from the frequency domain were calculated and correlated with QoL domains using Spearman (nonparametric) correlation analysis. Results Minor but significant associations were revealed only with regard to the PEDQoL domain “autonomy” on the one hand and heart rate and HRV (e.g. MRR, MRRn, MRRd, HRV_ULF, SDNN) parameters which evidently reflect distinct physiological functions on the other. Conclusions In healthy children and adolescents we have a first indication that there is a correlation between parameters of HRV and QoL. However, to a greater extent, HRV reflects associated physiological processes of the autonomic nervous system. A higher correlation is more likely to be found in chronically ill children.
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94
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The level of agreement between child self-reports and parent proxy-reports of health-related quality of life in boys with Duchenne muscular dystrophy. Qual Life Res 2014; 23:1945-52. [PMID: 24566887 DOI: 10.1007/s11136-014-0642-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the level of agreement between child self-reports and parent proxy-reports of the health-related quality of life (HRQoL) in boys with Duchenne muscular dystrophy (DMD) using both classical test theory (CTT) and Rasch analysis. METHODS A total of 63 boys with DMD and their parents completed the pediatric quality of life inventory version 4.0 child self-report and parent proxy-report of HRQoL, respectively. The data were analyzed using both the CTT (scale-score level) and Rasch analysis (item-level). RESULTS The intraclass correlation coefficient (ICC, scale-score level) between children and parents showed good to moderate agreement, although parents consistently underestimated their child HRQoL. In Rasch analysis (item-level), 1 out of 8 items was significantly different between children and parents in the physical health scale. Also, 3 out of 15 items were significantly different between those two groups in the psychosocial health scale. CONCLUSIONS By applying both scale-score and item-level analyses, our study seeks to broaden the understanding of the discrepancy of the ratings between child self-reports and parent proxy-reports. The findings could provide further information about the decision-making process when selecting therapy and care programs.
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95
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Das Konzept der Lebensqualität in der Medizin – Entwicklung und heutiger Stellenwert. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2014; 108:97-103. [DOI: 10.1016/j.zefq.2014.02.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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96
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Cheng P, Gutierrez-Colina AM, Loiselle KA, Strieper M, Frias P, Gooden K, Blount RL. Health Related Quality of Life and Social Support in Pediatric Patients with Pacemakers. J Clin Psychol Med Settings 2013; 21:92-102. [DOI: 10.1007/s10880-013-9381-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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97
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Children’s Quality of Life in Europe: National Wealth and Familial Socioeconomic Position Explain Variations in Mental Health and Wellbeing—A Multilevel Analysis in 27 EU Countries. ACTA ACUST UNITED AC 2013. [DOI: 10.1155/2013/419530] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sizeable variations in quality of life (QoL) and wellbeing according to socioeconomic status and national wealth have been observed. The assessment of children’s wellbeing may vary, depending on whether a parental or a child perspective is taken. Still, both perspectives provide important and valid information on children’s wellbeing. The Flash Eurobarometer no. 246 which was conducted for the European Commission assesses parents’ reports on their children’s health and wellbeing in 27 EU member states. Overall, 12,783 parents of 6–17-year-old children in the 27 EU states participated in telephone interviews. Parents reported children’s QoL and wellbeing using the KIDSCREEN-10 measure, as well as their occupational status and education level. Within a multilevel analysis, the KIDSCREEN-10 was regressed on parental occupation and education level. Random intercepts and slopes were regressed on gross domestic product per capita and income inequality. Low QoL was reported in 11.6% of cases, whereby cross-national variation accounted for 13% of the total variance in QoL. Children from countries with higher national wealth and lower income inequality were at lower risk for low QoL and wellbeing. Higher age of the child, a medium or low parental occupational status, and low parental educational status were associated with a higher risk for low QoL and wellbeing.
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98
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Jacoby A, Baker GA, Crossley J, Schachter S. Tools for assessing quality of life in epilepsy patients. Expert Rev Neurother 2013; 13:1355-69. [PMID: 24215282 DOI: 10.1586/14737175.2013.850032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this review, we attempt to bring the reader up to date with recent developments in the area of assessment of quality of life (QOL) of patients with epilepsy, in both the research and clinical contexts. We present evidence from recent publications on the major and most commonly used QOL instruments for both adults and children with epilepsy, including both strengths and limitations. We discuss both generic measures and ones that have been developed specifically for use in the epilepsy population. We draw attention to some of the broader issues that render the QOL assessment endeavor a somewhat complex one - in particular, that epilepsy is not a single condition, with a common clinical trajectory; and that QOL measures as currently configured almost universally focus on its negative impacts, largely neglecting the possibility of those affected being able to retain reasonable social adjustment and life satisfaction. Finally, we suggest that further work needs to focus on plugging the current evidence gaps in relation to psychometric and cross-cultural applicability issues; and on the value of QOL instruments in the clinical care setting. We conclude by highlighting a number of issues from the QOL literature that will, in our view, be the focus of increasing research interest in the next few years.
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Affiliation(s)
- Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, L69 3GB, UK
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Potvin MC, Snider L, Prelock PA, Wood-Dauphinee S, Kehayia E. Health-related quality of life in children with high-functioning autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 19:14-9. [DOI: 10.1177/1362361313509730] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism ( n = 30) and peers ( n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves ( p < .001) or their parents ( p < .001), although disagreement (intra-class coefficient = −.075) between children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child’s perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child’s life that promote or hinder their sense of well-being.
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100
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Ekim A, Ocakci AF. Perceptions of parents and children regarding asthma management responsibilities. J SPEC PEDIATR NURS 2013; 18:289-96. [PMID: 24094124 DOI: 10.1111/jspn.12037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine perceptions of children and parents regarding shared responsibilities for asthma management. DESIGN AND METHODS The study included 72 children with asthma who were between the ages of 7 and 12 years and their parents. Asthma management responsibilities were assessed by the "Asthma Responsibility Questionnaire." RESULTS Disagreements occurred between parents and children on assuming responsibility. Children reported higher asthma management responsibility scores than reported by parents for them. PRACTICE IMPLICATIONS It is important that nurses provide education and counseling to both children and their families to ensure that children take responsibility for disease management.
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Affiliation(s)
- Ayfer Ekim
- Department of Pediatric Nursing, Faculty of Health Sciences, Marmara University, Turkey
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