3
|
Fischer KI, Barthel D, Otto C, Ravens-Sieberer U, Thyen U, Klein M, Walter O, Rose M, Nolte S. Minimal Associations Between Clinical Data and Children's Self-Reported Health-Related Quality of Life in Children With Chronic Conditions-A Cross-Sectional Study. Front Pediatr 2019; 7:17. [PMID: 30805321 PMCID: PMC6370724 DOI: 10.3389/fped.2019.00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/15/2019] [Indexed: 12/31/2022] Open
Abstract
Introduction: The improvement-or at least maintenance-of health-related quality of life (HRQoL) in children and adolescents is one of the main aims of chronic disease care. This study examines HRQoL of children and adolescents with three different chronic conditions (i.e., diabetes mellitus, asthma, juvenile arthritis) using the computer-adaptive test Kids-CAT, comprising five HRQoL domains: physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. Further, associations between HRQoL and distinct clinical data and medical assessments are investigated to explore how much variability of the five domains can be explained by these variables. Methods: Cross-sectional data of the Kids-CAT study was analyzed. The Kids-CAT was used in two outpatient clinics in northern Germany gathering data on self-reported HRQoL in n = 309 children and adolescents aged 7-17 years. Additionally, general patient information, clinical data, and pediatrician-reported medical assessments were measured. Multiple regression analyses were conducted to explore associations between HRQoL and selected variables (i.e., disease duration, co-morbidity, disease control, overall health status). Results: Overall, self-reported HRQoL in all five domains were comparable to data of an age- and sex-matched reference population. Results of regression analyses indicated that the investigated variables only minimally explain variance in the five Kids-CAT domains. Sociodemographic, clinical data, and medical assessments explained 18.4% of the variance in physical well-being, 10.7% in psychological well-being, and < 10% of the variance in parent relations, social support and peers, and school well-being. Conclusion: Sociodemographic data, disease duration, co-morbidity, and medical assessments, such as disease control or pediatrician-assessed overall health status show low association with HRQoL of children and adolescents with chronic conditions. Data on self-reported HRQoL delivers valuable information on children's well-being and can improve healthcare professionals' understanding of the subjective well-being of their young patients. The implementation of tools like the Kids-CAT can facilitate the identification of potential problem areas, which should enable healthcare professionals to better address specific healthcare needs. Clinical Trial Registration: identifier: DRKS00006326 (retrospectively registered); Date of registry: August 1st, 2014.
Collapse
Affiliation(s)
- Kathrin I Fischer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany
| | - Dana Barthel
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Otto
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ute Thyen
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Lübeck, Germany
| | - Marcus Klein
- Department of General Pediatrics, Christian-Albrechts-Universität, Kiel, Germany
| | - Otto Walter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany
| | - Matthias Rose
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sandra Nolte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany.,Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
8
|
Varni JW, Bendo CB, Shulman RJ, Self MM, Nurko S, Franciosi JP, Saps M, Saeed S, Zacur GM, Vaughan Dark C, Pohl JF. Interpretability of the PedsQL™ Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in Pediatric Patients With Functional and Organic Gastrointestinal Diseases. J Pediatr Psychol 2015; 40:591-601. [PMID: 25682210 PMCID: PMC4469917 DOI: 10.1093/jpepsy/jsv005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The present study investigates the clinical interpretability of the Pediatric Quality of Life Inventory™ (PedsQL™) Gastrointestinal Symptoms Scales and Worry Scales in pediatric patients with functional gastrointestinal disorders or organic gastrointestinal diseases in comparison with healthy controls. METHODS The PedsQL™ Gastrointestinal Scales were completed by 587 patients with gastrointestinal disorders/diseases and 685 parents, and 513 healthy children and 337 parents. Minimal important difference (MID) scores were derived from the standard error of measurement (SEM). Cut-points were derived based on one and two standard deviations (SDs) from the healthy reference means. RESULTS The percentages of patients below the scales' cut-points were significantly greater than the healthy controls (most p values ≤ .001). Scale scores 2 SDs from the healthy reference means were within the range of scores for pediatric patients with a gastrointestinal disorder. MID values were generated using the SEM. CONCLUSIONS The findings support the clinical interpretability of the new PedsQL™ Gastrointestinal Symptoms Scales and Worry Scales.
Collapse
Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Cristiane B Bendo
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Robert J Shulman
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Mariella M Self
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Samuel Nurko
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - James P Franciosi
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Miguel Saps
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Shehzad Saeed
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - George M Zacur
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - Chelsea Vaughan Dark
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| | - John F Pohl
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Department of Psychiatry and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Psychology, Texas A&M University, and Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah
| |
Collapse
|