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Three-year trajectories of global perceived quality of life for youth with chronic health conditions. Qual Life Res 2016; 25:3157-3171. [PMID: 27379406 PMCID: PMC5102979 DOI: 10.1007/s11136-016-1353-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2016] [Indexed: 11/30/2022]
Abstract
Purpose Objectives of this longitudinal study were to examine 3-year trajectories of global perceived quality of life (QOL) for youth with chronic health conditions, as obtained from youth and parent reports, and to identify personal and environmental factors associated with the trajectory groups for each perspective. Methods Youth with various chronic conditions aged 11–17 years and one of their parents were recruited from eight children’s treatment centers. Latent class growth analysis was used to investigate perceived QOL trajectories (separately for youth and parent perspectives) over a 3-year period (four data collection time points spaced 12 months apart). Multinomial logistic regression was employed to identify factors associated with these trajectories. Results A total of 439 youth and one of their parents participated at baseline, and 302 (69 %) of those youth/parent dyads completed all four data collection time points. Two QOL trajectories were identified for the youth analysis: ‘high and stable’ (85.7 %) and ‘moderate/low and stable’ (14.3 %), while three trajectories were found for the parent analysis: ‘high and stable’ (35.7 %), ‘moderate and stable’ (46.6 %), and ‘moderate/low and stable’ (17.7 %). Relative to the ‘high and stable’ groups, youth with more reported pain/other physical symptoms, emotional symptoms, and home/community barriers were more likely to be in the ‘moderate and stable’ or ‘moderate/low and stable’ groups. Also, youth with higher reported self-determination, spirituality, family social support, family functioning, school productivity/engagement, and school belongingness/safety were less likely to be in the ‘moderate and stable’ or ‘moderate/low and stable’ groups, compared to the ‘high and stable’ groups. Conclusion Findings suggest that youth with chronic conditions experience stable global perceived QOL across time, but that some individuals maintain stability at moderate to moderate/low levels which is related to ongoing personal and environmental influences. Potential benefits of universal strategies and programs to safeguard resilience for all youth and targeted interventions to optimize certain youths’ global perceived QOL are indicated. Electronic supplementary material The online version of this article (doi:10.1007/s11136-016-1353-z) contains supplementary material, which is available to authorized users.
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Eisenberg ME, Gower AL, McMorris BJ, Bucchianeri MM. Vulnerable Bullies: Perpetration of Peer Harassment Among Youths Across Sexual Orientation, Weight, and Disability Status. Am J Public Health 2015; 105:1784-91. [PMID: 26180987 DOI: 10.2105/ajph.2015.302704] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. METHODS Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122,180). We used the χ(2) test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. RESULTS Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. CONCLUSIONS Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate.
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Affiliation(s)
- Marla E Eisenberg
- Marla E. Eisenberg and Amy L. Gower are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Barbara J. McMorris is with the School of Nursing, University of Minnesota. Michaela M. Bucchianeri is with the Department of Psychological Science, Gustavus Adolphus College, Saint Peter, MN
| | - Amy L Gower
- Marla E. Eisenberg and Amy L. Gower are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Barbara J. McMorris is with the School of Nursing, University of Minnesota. Michaela M. Bucchianeri is with the Department of Psychological Science, Gustavus Adolphus College, Saint Peter, MN
| | - Barbara J McMorris
- Marla E. Eisenberg and Amy L. Gower are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Barbara J. McMorris is with the School of Nursing, University of Minnesota. Michaela M. Bucchianeri is with the Department of Psychological Science, Gustavus Adolphus College, Saint Peter, MN
| | - Michaela M Bucchianeri
- Marla E. Eisenberg and Amy L. Gower are with the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis. Barbara J. McMorris is with the School of Nursing, University of Minnesota. Michaela M. Bucchianeri is with the Department of Psychological Science, Gustavus Adolphus College, Saint Peter, MN
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McDougall J, Bedell G, Wright V. The youth report version of the Child and Adolescent Scale of Participation (CASP): assessment of psychometric properties and comparison with parent report. Child Care Health Dev 2013; 39:512-22. [PMID: 23763252 DOI: 10.1111/cch.12050] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The Child and Adolescent Scale of Participation (CASP) parent report is a brief and valid measure for use with children and youth with chronic conditions/disabilities that has been shown to have good coverage at the chapter level of the 'Activities and Participation' component of the International Classification of Functioning, Disability and Health. The purpose of this research was to assess the psychometric properties of a CASP youth self-report version, to further validate the parent report, and to compare parent and youth reports of youths' activity and participation. METHODS Baseline data from a longitudinal study examining predictors of changes in quality of life for youth with chronic conditions/disabilities were used. CASP data were collected on 409 youth aged 11-17 with various conditions/disabilities using youth and parent reports. Internal consistency and factor structure were examined for both versions using Cronbach's alpha and exploratory factor analyses. Inter-rater agreement and magnitude of differences between youth and parent report were evaluated using intraclass correlation coefficients and paired t-tests respectively. Gender, age and condition/disability group differences in youth report CASP scores were examined using independent t-tests or analyses of variance. RESULTS Strong internal consistency and internal structure validity was demonstrated for the CASP youth and parent report. The youth report factor structure was similar to the parent report in this and other studies. Youth reported their activity/participation to be significantly higher than did their parents. Significant differences in CASP scores were found among condition/disability groups. CONCLUSIONS Findings show that, from a psychometric standpoint, the youth version of the CASP is a promising new self-report measure of activity and participation. As youth perceive their activity and participation levels differently than their parents, it is important to collect data from both sources to obtain a more comprehensive understanding of this aspect of youths' lives.
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Affiliation(s)
- J McDougall
- Thames Valley Children's Centre, London, ON, Canada.
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McDougall J, Wright V, Nichols M, Miller L. Assessing the Psychometric Properties of Both a Global and a Domain-Specific Perceived Quality of Life Measure When Used with Youth Who Have Chronic Conditions. SOCIAL INDICATORS RESEARCH 2012; 114:1243-1257. [PMID: 25484486 PMCID: PMC4254371 DOI: 10.1007/s11205-012-0200-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 06/04/2023]
Abstract
The purpose of this paper was to assess the psychometric properties of the Students' Life Satisfaction Scale (SLSS) and the Brief Multidimensional Students' Life Satisfaction Scale (BMSLSS) when used with youth who have chronic conditions. Baseline data from a longitudinal study examining predictors of changes in perceived quality of life (PQOL) for youth with chronic conditions were used. SLSS and BMSLSS data were collected on over 400 youth aged 11-17 using youth self-report and parent proxy-report versions. Internal consistency, convergent validity, and factor structure were examined for both versions. Extent of agreement and magnitude of differences between youth and parent report were evaluated. Finally, gender, age, and condition group differences in youth report scores were examined for the SLSS and BMSLSS. Strong internal consistency was demonstrated for the youth and parent reports of both measures. As with normative samples, a single factor structure was found for youth and parent reports of the BMSLSS. However, both youth and parent reports of the SLSS had a two-factor structure: one consisting of five positively worded items, and the other, two negatively worded items. Youth reported their PQOL to be significantly higher than did their parents. Significant differences in PQOL scores for the youth report were not found by age, gender, or conditions. Findings show that, from a psychometric standpoint, the BMSLSS (both youth and parent report) is a promising measure of PQOL for use in population-based research with youth who have chronic conditions. The SLSS may need to be revised to exclude negative items when used with this population of youth.
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Affiliation(s)
- Janette McDougall
- />Thames Valley Children’s Centre, 779 Base Line Road East, London, ON N6C 5Y6 Canada
| | - Virginia Wright
- />Bloorview Research Institute, 150 Kilgour Road, Toronto, ON M4G 1R8 Canada
| | - Megan Nichols
- />Thames Valley Children’s Centre, 779 Base Line Road East, London, ON N6C 5Y6 Canada
| | - Linda Miller
- />School of Graduate and Postdoctoral Studies, Western University, London, ON N6A 5B7 Canada
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Hack M, Schluchter M, Forrest CB, Taylor HG, Drotar D, Holmbeck G, Youngstrom E, Margevicius S, Andreias L. Self-reported adolescent health status of extremely low birth weight children born 1992-1995. Pediatrics 2012; 130:46-53. [PMID: 22665412 PMCID: PMC3382919 DOI: 10.1542/peds.2011-3402] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To compare the self-reported health of extremely low birth weight (ELBW, <1 kg) adolescents with that of normal birth weight (NBW) controls and the children's assessments of their general health at ages 8 versus 14 years. METHODS One hundred sixty-eight ELBW children and 115 NBW controls of similar gender and sociodemographic status completed the Child Health and Illness Profile-Adolescent Edition at age 14 years. It includes 6 domains: Satisfaction, Comfort, Resilience, Risk Avoidance, Achievement, and Disorders. At age 8 years, the children had completed the Child Health and Illness Profile-Child Edition. Results were compared between ELBW and NBW subjects adjusting for gender and sociodemographic status. RESULTS ELBW adolescents rated their health similar to that of NBW adolescents in the domains of Satisfaction, Comfort, Resilience, Achievement and Disorders but reported more Risk Avoidance (effect size [ES] 0.6, P < .001). In the subdomain of Resilience, they also noted less physical activity (ES -0.58, P < .001), and in the subdomain of Disorders, more long-term surgical (ES -0.49) and psychosocial disorders (ES -0.49; both P < .01). Both ELBW and NBW children reported a decrease in general health between ages 8 and 14 years, which did not differ significantly between groups. CONCLUSIONS ELBW adolescents report similar health and well-being compared with NBW controls but greater risk avoidance. Both ELBW and NBW children rate their general health to be poorer at age 14 than at age 8 years, possibly due to age-related developmental changes.
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Affiliation(s)
- Maureen Hack
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
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Chen HY, Cisler RA. Assessing Health-Related Quality of Life Among Children With Special Health Care Needs in the United States. CHILDRENS HEALTH CARE 2011. [DOI: 10.1080/02739615.2011.617239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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McDougall J, Wright V, Schmidt J, Miller L, Lowry K. Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions. Dev Neurorehabil 2010; 14:41-53. [PMID: 21034288 PMCID: PMC4245180 DOI: 10.3109/17518423.2010.521795] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 09/03/2010] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. METHOD This article will describe the study's aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used--and expanded upon--to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths' QoL. CONCLUSIONS Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals' perceptions of their QoL.
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Hopman WM, Berger C, Joseph L, Towheed T, Prior JC, Anastassiades T, Poliquin S, Zhou W, Adachi JD, Hanley DA, Papadimitropoulos EA, Tenenhouse A. Health-related quality of life in Canadian adolescents and young adults: normative data using the SF-36. Canadian Journal of Public Health 2010. [PMID: 20209739 DOI: 10.1007/bf03404342] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Normative data for the SF-36 measure of health-related quality of life (HRQOL) exist for those over 25 years of age, based on data from the population-based Canadian Multicentre Osteoporosis Study (CaMos). CaMos recently recruited a sample of young Canadians aged between 16 and 24 years. The purpose of this study was to develop normative SF-36 data for this age group. METHODS After direct standardization to the Canadian population, means, standard deviations (SD), 95% confidence intervals and percentage at floor and ceiling were produced for the eight domain and two summary scores of the SF-36. Domains are scored from 0 (poor) to 100 (excellent). Summary scores are standardized to a mean of 50, with scores over 50 representing better than average and below 50 poorer than average function. Separate analyses were completed for men and women, and for those 16-19 years and 20-24 years. RESULTS The 1,001 community-based participants consisted of 474 men and 527 women from nine CaMos centres across Canada. Mean Physical Component Summary scores were 53.9 (SD = 6.9) and 53.3 (SD = 5.7) for young men and women, respectively. The equivalent Mental Component Summary scores were 49.3 (SD = 9.7) and 48.8 (SD = 8.9). In general, men scored somewhat higher than women, and younger (16-19 years) women scored higher than older (20-24 years) women, although the differences were small. CONCLUSION HRQOL is good in this cohort of young Canadians. Both men and women scored somewhat better on physically than mentally oriented domains. In general, Canadian scores were similar to those of the US, while a comparable Swedish sample scored higher than both countries on most domains. Results underscore the importance of taking country, age and gender into consideration when using normative data.
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Affiliation(s)
- Wilma M Hopman
- Clinical Research Centre, Kingston General Hospital, Angada 4, Room 5-426, 76 Stuart Street, Kingston ON K7L 2V7.
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Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model. Health Qual Life Outcomes 2010; 8:17. [PMID: 20128913 PMCID: PMC2829530 DOI: 10.1186/1477-7525-8-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 02/03/2010] [Indexed: 12/02/2022] Open
Abstract
Background We examined adolescents' differentiation of their self-reported physical and mental health status, the relative importance of these variables and five important life domains (satisfaction with family, friends, living environment, school and self) with respect to adolescents' global quality of life (QOL), and the extent to which the five life domains mediate the relationships between self-reported physical and mental health status and global QOL. Methods The data were obtained via a cross-sectional health survey of 8,225 adolescents in 49 schools in British Columbia, Canada. Structural equation modeling was applied to test the implied latent variable mediation model. The Pratt index (d) was used to evaluate variable importance. Results Relative to one another, self-reported mental health status was found to be more strongly associated with depressive symptoms, and self-reported physical health status more strongly associated with physical activity. Self-reported physical and mental health status and the five life domains explained 76% of the variance in global QOL. Relatively poorer mental health and physical health were significantly associated with lower satisfaction in each of the life domains. Global QOL was predominantly explained by three of the variables: mental health status (d = 30%), satisfaction with self (d = 42%), and satisfaction with family (d = 20%). Satisfaction with self and family were the predominant mediators of mental health and global QOL (45% total mediation), and of physical health and global QOL (68% total mediation). Conclusions This study provides support for the validity and relevance of differentiating self-reported physical and mental health status in adolescent health surveys. Self-reported mental health status and, to a lesser extent, self-reported physical health status were associated with significant differences in the adolescents' satisfaction with their family, friends, living environment, school experiences, self, and their global QOL. Questions about adolescents' self-reported physical and mental health status and their experiences with these life domains require more research attention so as to target appropriate supportive services, particularly for adolescents with mental or physical health challenges.
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Sawatzky R, Ratner PA, Johnson JL, Kopec JA, Zumbo BD. Sample Heterogeneity and the Measurement Structure of the Multidimensional Students' Life Satisfaction Scale. SOCIAL INDICATORS RESEARCH 2009; 94:273-296. [PMID: 27867252 PMCID: PMC5112029 DOI: 10.1007/s11205-008-9423-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Several measurement assumptions were examined with the goal of assessing the validity of the Multidimensional Students' Life Satisfaction Scale (MSLSS), a measure of adolescents' satisfaction with their family, friends, living environment, school, self, and general quality of life. The data were obtained via a cross-sectional survey of 8,225 adolescents in British Columbia, Canada. Confirmatory factor and factor mixture analyses of ordinal data were used to examine the measurement assumptions. The adolescents did not respond to all the MSLSS items in a psychometrically equivalent manner. A correlated five-factor model for an abridged version of the MSLSS resulted in good fit when all negatively worded items and several positively worded items (the least invariant) were excluded. The abridged 18-item version of the MSLSS provides a promising alternative for the measurement of five life domains that are pertinent to adolescents' quality of life.
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Affiliation(s)
- Richard Sawatzky
- Department of Nursing, Trinity Western University, 7600 Glover Road, Langley, BC V2Y 1Y1, Canada
| | - Pamela A Ratner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Joy L Johnson
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Jacek A Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Bruno D Zumbo
- ECPS, Measurement, Evaluation & Research Methodology, University of British Columbia, Vancouver, BC, Canada
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Warner-Czyz AD, Loy B, Roland PS, Tong L, Tobey EA. Parent versus child assessment of quality of life in children using cochlear implants. Int J Pediatr Otorhinolaryngol 2009; 73:1423-9. [PMID: 19674798 PMCID: PMC2891383 DOI: 10.1016/j.ijporl.2009.07.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/13/2009] [Accepted: 07/14/2009] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss. METHODS This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL(®), an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Pearson rank correlations were used to compare QoL with demographic variables. RESULTS Children using cochlear implants rated overall QoL significantly more positively than their parents (M(Difference)=4.22, p=.03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p=.42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age. CONCLUSIONS Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.
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Affiliation(s)
- Andrea D. Warner-Czyz
- The University of Texas at Dallas, Callier Advanced Hearing Research Center, 1966 Inwood Road, Dallas, Texas 75235,The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9003,Dallas Cochlear Implant Program, Dallas, Texas 75235
| | - Betty Loy
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9003,Dallas Cochlear Implant Program, Dallas, Texas 75235
| | - Peter S. Roland
- The University of Texas at Dallas, Callier Advanced Hearing Research Center, 1966 Inwood Road, Dallas, Texas 75235,The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9003,Dallas Cochlear Implant Program, Dallas, Texas 75235
| | - Liyue Tong
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9003
| | - Emily A. Tobey
- The University of Texas at Dallas, Callier Advanced Hearing Research Center, 1966 Inwood Road, Dallas, Texas 75235,The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9003,Dallas Cochlear Implant Program, Dallas, Texas 75235
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McDougall J, Tsonis M. Quality of life in survivors of childhood cancer: a systematic review of the literature (2001-2008). Support Care Cancer 2009; 17:1231-46. [PMID: 19488790 DOI: 10.1007/s00520-009-0660-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 05/13/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this paper was to provide a comprehensive, contemporary systematic review of studies that have examined the quality of life (QOL) of survivors of childhood cancer in order to extend upon the findings of earlier reviews. MATERIALS AND METHODS A review was conducted that used the databases MEDLINE, PubMed, PsycINFO, and CINAHL. Articles were included that were published in English between 2001 and 2008 and used quantitative measures and statistical tests to compare health-related quality of life (HRQL) or QOL of childhood cancer survivors with population norms or matched comparison groups. RESULTS Thirteen studies were identified. Findings were contradictory across studies, yet by and large, reflected those of past reviews. In general, survivors' scores on subscales representing physical, psychological, and social domains of HRQL/QOL were similar to comparisons, with the greatest differences being in physical well-being. Key personal and environmental factors were negatively correlated with the three domains across studies for survivors including: older age at diagnosis, longer time since diagnosis, certain cancer and treatment types, female gender, and a number of socioeconomic factors. CONCLUSIONS Lack of comparability across studies remains a problem due to wide variation in study focus and designs. Conceptual and methodological issues include: use of numerous HRQOL and QOL measures, lack of distinction between conceptualization and measurement of HRQL and QOL, lack of initial qualitative input from survivors about QOL, little examination of the influence of environmental factors on QOL, little attention to survivors' satisfaction with life quality, use of small heterogeneous samples, and need for population-based longitudinal studies.
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Affiliation(s)
- Janette McDougall
- Thames Valley Children's Centre, 779 Base Line Road East, London, Ontario, Canada.
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Simon AE, Chan KS, Forrest CB. Assessment of children's health-related quality of life in the United States with a multidimensional index. Pediatrics 2008; 121:e118-26. [PMID: 18056290 DOI: 10.1542/peds.2007-0480] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Using nationally representative data, we examined biological, medical system, and sociodemographic factors that are associated with health-related quality of life as measured by a multidimensional index that accounts for a wide range of child health domains. METHODS Children aged > or = 6 years (N = 69,031) were drawn from the 2003/2004 National Survey of Children's Health. A random 25% sample was used to create a 12-item index of health-related quality of life with a range of 0 to 100, based on the conceptual framework of the Child Health and Illness Profile. Bivariate and multivariable regression analyses were conducted to identify the unadjusted and independent associations of key biological, medical system, and sociodemographic variables with health-related quality of life. RESULTS The index mean was 72.3 (SD: 14.5), median value was 73.7, and range was 11.1 to 99.9. Only 0.2% of children had a score at the ceiling. In multivariable regression analysis, the following variables were independently associated with lower health-related quality of life: biological factors (greater disease burden, severe asthma, and overweight status); medical system factors (unmet medical needs, lack of a regular health care provider, Medicaid insurance, or being uninsured previously during the year); and sociodemographic factors (older age groups, lower family education, single-mother family, having a smoker in the household, black race, and poverty). CONCLUSIONS Health-related quality of life in the United States is poorest for children and youth in lower socioeconomic status groups, those with access barriers, adolescents compared with children, and individuals with medical conditions. A multidimensional health-related quality-of-life index is an alternative to conventional measures (eg, mortality) for national monitoring of child health.
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Abstract
BACKGROUND The authors examined self-perceived health and psychosocial health in 10-15 year old children and the relationship between children's self-perceived health and a set of psychosocial health status measurements. METHODS Data were collected from middle school students (n = 548; age range, 10-15 years of age; mean, 12.2 years; SD, 1.2 years) using randomly selected classes from four schools in different school districts in Szeged, Hungary. The self-administered questionnaires contained items on sociodemographics; school achievement; height and weight (body mass index); self-perceived health and fitness; health behaviors; and anger and psychosomatic health. The self-perceived health variable was dichotomized and expressed with poor/fair or good/excellent perceptions of one's own health. RESULTS Most of the children evaluated their own health as excellent or good. Logistic regression analyses revealed that poor academic achievement, socioeconomic status self-assessment, smoking, alcohol use, sports activity, self-perceived fitness, and high levels of anger and psychosomatic symptoms were associated with an increased likelihood of reported poor/fair perceptions of health. CONCLUSIONS Findings reflect that psychosocial factors are important influences of self-perceived health in an early adolescent population.
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Affiliation(s)
- Bettina F Piko
- Department of Psychiatry, Division of Behavioral Sciences, University of Szeged, Szeged, Hungary.
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Howell EM, Trenholm C. The effect of new insurance coverage on the health status of low-income children in Santa Clara County. Health Serv Res 2007; 42:867-89. [PMID: 17362222 PMCID: PMC1890688 DOI: 10.1111/j.1475-6773.2006.00625.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine whether providing health insurance coverage to undocumented children affects the health of those children. DATA SOURCES/STUDY SETTING The data come from a survey of 1235 parents of enrollees in the new insurance program ("Healthy Kids") in Santa Clara County, California. The survey was conducted from August 2003 to July 2004. STUDY DESIGN Cross-sectional study using a group of children insured for one year as the study group (N=626) and a group of newly insured children as the comparison group (N=609). Regression analysis is used to adjust for differences in the groups according to a range of characteristics. DATA COLLECTION Parents were interviewed by telephone in either English or Spanish (most responded in Spanish). The response rate was 89 percent. PRINCIPAL FINDINGS The study group-who were children continuously insured by Healthy Kids for one year-were significantly less likely to be in fair/poor health and to have functional impairments than the comparison group of newly insured children (15.9 percent versus 28.5 percent and 4.5 percent versus 8.4 percent, respectively). Impacts were largest among children who enrolled for a specific medical reason (such as an illness or injury); indeed, the impact on functional limitations was evident only for this subgroup. The study group also had fewer missed school days than the comparison group, but the difference was significant only among children who did not enroll for a medical reason. CONCLUSIONS Health insurance coverage of undocumented children in Santa Clara County was associated with significant improvements in children's health status. The size of this association could be overstated, since the comparison sample included some children who enrolled because of an illness or other temporary health problem that would have improved even without insurance coverage. However, even after limiting the study sample to children who did not enroll for a medical reason, a significant association remained between children's reported health and their health coverage. We thus cautiously conclude that Healthy Kids had a favorable impact on children's health.
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Affiliation(s)
- Embry M Howell
- The Urban Institute, 2100 M St., N.W. Washington, DC 20037, USA
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Olson LM, Radecki L, Frintner MP, Weiss KB, Korfmacher J, Siegel RM. At what age can children report dependably on their asthma health status? Pediatrics 2007; 119:e93-102. [PMID: 17200264 DOI: 10.1542/peds.2005-3211] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined psychometric properties and feasibility issues surrounding child-reported asthma health status data. METHODS In separate interviews, parents and children completed 3 visits. Child questionnaires were interviewer administered. The primary instrument was the Children's Health Survey for Asthma-Child Version, used to compute 3 scales (physical health, activities, and emotional health). The following were assessed: reliability (internal consistency and test-retest reliability), validity (general health status, symptom burden, and lung function), and feasibility (completion time, missing data, and inconsistent responses). RESULTS A total of 414 parent-child pairs completed the study (mean child age: 11.5 years). Reliability estimates for the activities and emotional health scales were > .70 in all but 1 age category; 5 of 9 age groups had acceptable internal consistency ratings (> or = .70) for the physical health scale. Cronbach's alpha tended to increase with child age. In general, test-retest correlations between forms and intraclass correlation coefficients were strong for all ages but tended to increase with child age. Correlations between forms ranged from .57 (7-year-old subjects, physical health) to .96 (14-year-old subjects, activities). Intraclass correlation coefficients ranged from .76 (13-year-old subjects, emotional health) to .94 (15-16-year-old subjects, physical health). Children with less symptom burden reported higher mean Children's Health Survey for Asthma-Child Version scores (indicating better health status) for each scale, at significant levels for nearly all age groups. Children's Health Survey for Asthma-Child Version completion times decreased from 12.9 minutes at age 7 to 6.9 minutes at age 13. CONCLUSIONS This research indicates that children with asthma as young as 7 may be dependable and valuable reporters of their health. Data quality tends to improve with age.
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Affiliation(s)
- Lynn M Olson
- Department of Research, American Academy of Pediatrics, 141 Northwest Point Blvd, Elk Grove Village, IL 60007, USA.
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Varni JW, Burwinkle TM, Seid M. The PedsQLTM 4.0 as a School Population Health Measure: Feasibility, Reliability, and Validity. Qual Life Res 2006; 15:203-15. [PMID: 16468077 DOI: 10.1007/s11136-005-1388-z] [Citation(s) in RCA: 298] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2005] [Indexed: 11/25/2022]
Abstract
BACKGROUND The application of health-related quality of life (HRQOL) as a school population health measure may facilitate risk assessment and resource allocation, the tracking of student health at the school and district level, the identification of health disparities among schoolchildren, and the determination of health outcomes from interventions and policy decisions at the school, district, and county level. OBJECTIVE To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a school population health measure for children and adolescents. DESIGN Survey conducted in 304 classes at 18 elementary schools, 4 middle schools, and 3 high schools within a large metropolitan school district. METHODS The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8-18 and 4227 parents of children ages 5-18. RESULTS The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha = 0.89 child, 0.92, parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was related to indicators of socioeconomic status (SES) at the school and district level. The PedsQL School Functioning Scale was significantly correlated with standardized achievement scores based on the Stanford 9. CONCLUSION The results demonstrate the feasibility, reliability and validity of the PedsQL 4.0 Generic Core Scales as a school population health measure. The implications of measuring HRQOL in schoolchildren at the school, district, and county level for identifying and ameliorating health disparities are discussed.
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Affiliation(s)
- James W Varni
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, Texas 77843-3137, USA.
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Huber M. Health-related quality of life of Austrian children and adolescents with cochlear implants. Int J Pediatr Otorhinolaryngol 2005; 69:1089-101. [PMID: 15946746 DOI: 10.1016/j.ijporl.2005.02.018] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2004] [Revised: 02/07/2005] [Accepted: 02/17/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVE As shown by many studies, deaf children benefit considerably by cochlear implants (CI), concerning oral language and integration in mainstream schools. This had lead to the general view of a good quality of life of these children. Unfortunately so far nearly no studies on quality of life, and specially no studies on health-related quality of life (HRQoL) of children with cochlear implants, have been published. The present study with the objective for first, initial information on health-related quality of life of Austrian pupils with cochlear implants is a first step to fill this gap. METHODS Forty-four Austrian pupils, out of 65 candidates, age 8-16, with a hearing experience of at least 3 years with implants, and their parents were surveyed in the CI Center, Salzburg (cross sectional study). Basic medical and audiological data were available for all pupils. Because of reading comprehension difficulties 15 pupils were excluded. Parents and children were surveyed with the KINDLr, a generic instrument for health-related quality of life of children and adolescents. Main outcome measures were the HRQoL-total scores (mean, transformed to 100, standard deviation). In addition, 95% confidence intervals, effect sizes, t scores (one- and two-sided t-tests), rank order correlations and coefficients of determination were calculated. RESULTS The HRQoL-total score of the children with CI (n=18), age 8-12 was below the standard for hearing children (P<0.001). It differed from the total score of the parent rating (P<0.0001). The difference between the parent ratings of non-excluded and of excluded children (n=12) was not significant. The total score of the adolescents (n=11), age 13-16 was within the norm, with no significant difference between adolescent and parents. The total scores correlate with parent-child agreement in the ratings, with outcomes of audiological speech tests, length of time of deafness, and age at implantation. CONCLUSIONS Children with CI experience a lower health-related quality of life, compared to hearing children, with a low parent-child agreement. The findings of this study point to a normal subjective health of adolescents with CI.
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Affiliation(s)
- Maria Huber
- Cochlear Implant Center, Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, St. Johanns-Spital, Landeskliniken Salzburg, Austria. m.huber2salk.at
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