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Mahjoob M, Cardy R, Penner M, Anagnostou E, Andrade BF, Crosbie J, Kelley E, Ayub M, Ayub M, Brian J, Iaboni A, Schachar R, Georgiades S, Nicolson R, Jones J, Kushki A. Predictors of health-related quality of life for children with neurodevelopmental conditions. Sci Rep 2024; 14:6377. [PMID: 38493236 PMCID: PMC10944519 DOI: 10.1038/s41598-024-56821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Neurodevelopmental conditions can be associated with decreased health-related quality of life; however, the predictors of these outcomes remain largely unknown. We characterized the predictors of health-related quality of life (HRQoL) in a sample of neurodiverse children and youth. We used a cross-sectional subsample from the Province of Ontario Neurodevelopmental Disorders Network (POND) consisting of those children and young people in the POND dataset with complete study data (total n = 615; 31% female; age: 11.28 years ± 2.84 years). Using a structural equation model, we investigated the effects of demographics (age, sex, socioeconomic status), core features (Social Communication Questionnaire, Toronto Obsessive Compulsive Scale, Strengths and Weaknesses of attention deficit/hyperactivity disorder (ADHD)-symptoms and Normal Behavior), co-occurring symptoms (Child Behaviour Checklist), and adaptive functioning (Adaptive Behaviour Assessment System) on HRQoL (KINDL). A total of 615 participants had complete data for this study (autism = 135, ADHD = 273, subthreshold ADHD = 7, obsessive-compulsive disorder (OCD) = 38, sub-threshold OCD = 1, neurotypical = 161). Of these participants, 190 (31%) identified as female, and 425 (69%) identified as male. The mean age was 11.28 years ± 2.84 years. Health-related quality of life was negatively associated with co-occurring symptoms (B = - 0.6, SE = 0.20, CI (- 0.95, - 0.19), p = 0.004)) and age (B = - 0.1, SE = 0.04, CI (- 0.19, - 0.01), p = 0.037). Fewer co-occurring symptoms were associated with higher socioeconomic status (B = - 0.5, SE = - 0.05, CI (- 0.58, - 0.37), p < 0.001). This study used a cross-sectional design. Given that one's experiences, needs, supports, and environment and thus HrQoL may change significantly over the lifespan and a longitudinal analysis of predictors is needed to capture these changes. Future studies with more diverse participant groups are needed. These results demonstrate the importance of behavioural and sociodemographic characteristics on health-related quality of life across neurodevelopmental conditions.
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Affiliation(s)
- Maryam Mahjoob
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Robyn Cardy
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Melanie Penner
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Brendan F Andrade
- Department of Psychiatry, Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children (SickKids), Toronto, Canada
| | | | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Muhammad Ayub
- Department of Psychology, Queen's University, Kingston, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Alana Iaboni
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children (SickKids), Toronto, Canada
| | - Stelios Georgiades
- Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, Canada
| | - Jessica Jones
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Azadeh Kushki
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.
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Ribeiro Junior CA, Vettore MV, Rebelo Vieira JM, de Queiroz Herkrath APC, de Queiroz Herkrath AC, Pereira JV, Herkrath FJ, Rebelo MAB. The role of dental pain and psychosocial factors on the relationship between dental caries and oral health-related quality of life in children. BMC Oral Health 2022; 22:340. [PMID: 35948932 PMCID: PMC9364536 DOI: 10.1186/s12903-022-02372-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/19/2022] [Indexed: 01/20/2023] Open
Abstract
Background To examine the role of dental pain, sense of coherence (SOC) and social support on the relationship between dental caries and oral health-related quality of life (OHRQoL) in children aged 12 years. Methods A cross-sectional study involving 400 schoolchildren selected from public schools in a socioeconomically disadvantaged region in the city of Manaus, Brazil was carried out. The predictors of OHRQoL were selected according to the Wilson and Cleary theoretical model, including number of decayed teeth and its clinical consequence (component D of the DMFT index and PUFA/pufa index), dental pain (symptom status), and SOC and social support (individual and environmental characteristics). Statistical analysis was conducted through structural equation modelling and multivariable negative binomial regression. The significance level established for all analyses was 5%. Results Number of dental caries was indirectly linked with OHRQoL (β = 0.19, 95% CI 0.11/0.29) through dental pain, SOC and social support. Clinical consequences of untreated caries directly predicted poor OHRQoL (β = 0.12, 95% CI 0.01/0.23). Dental pain, SOC and social support did not moderate the effect of dental caries measures on OHRQoL. Conclusion Our findings suggest the role of dental pain, SOC and social support as mediator factors on the link between dental caries and OHRQoL. Tackling dental caries along with psychosocial factors may attenuated the impact of oral health on OHRQoL in children.
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Affiliation(s)
- Cilio Antonio Ribeiro Junior
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Campus Kristiansand, Universitetsveien 25, 4630, Kristiansand, Norway.
| | - Janete Maria Rebelo Vieira
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Ana Paula Corrêa de Queiroz Herkrath
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Adriana Corrêa de Queiroz Herkrath
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Juliana Vianna Pereira
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Fernando José Herkrath
- Instituto Leônidas e Maria Deane, Fundacão Oswaldo Cruz, Rua Teresina, 476, Adrianópolis, Manaus, AM, CEP: 69027-070, Brazil
| | - Maria Augusta Bessa Rebelo
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
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Nabavi Nouri M, Puka K, Palmar K, Speechley KN. Impact of number of anti-seizure medications on long-term health-related quality of life in children with epilepsy: A prospective cohort study. Seizure 2022; 99:120-126. [PMID: 35636159 DOI: 10.1016/j.seizure.2022.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/01/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Health-related quality of life (HRQL) is compromised in children with epilepsy. We aimed to determine whether children diagnosed with epilepsy between ages 4-12 years who are exposed to a higher number of anti-seizure medication (ASM) over the first 2 years, have poorer HRQL 10 years after diagnosis. METHODS Data were obtained from 195 children enrolled in the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES) in Canada. HRQL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) completed by parents at baseline through to 10 years after diagnosis. The total number of ASM were reported by physicians four times in the first two years after diagnosis. Multivariable block-wise linear regression was used to assess the impact of ASM (categorized as none, one, or more than one), as well as clinical and family factors on children's HRQL 10 years after diagnosis. RESULTS Children had a mean age of 7.9 ± 2.3 years at diagnosis and 92 (47%) were female. Mean QOLCE at baseline and 10 years was 72.04±14 and 78.7±16,respectively. Clinically meaningful improvement in HRQL from the 2 to 10-year follow-up was detected in 35% of children, reported similarly across all ASM treatment categories (p = .38). The number of ASM prescribed in the first two years was associated with HRQL at the 10-year follow-up, however this association was not significant when adjusting for clinical characteristics, family factors, and HRQL at the two-year follow-up (p = .75). Our data showed that HRQL at 2 years was the only variable associated with better HRQL scores at 10 years (p = <.001). CONCLUSION In children with new onset epilepsy, exposure to a higher number of ASM, when accounting for clinical and family factors as well as HRQL at 2 years, is not independently associated with lower long-term HRQL. Early HRQL was found to be a good indicator of long-term HRQL, despite the number of ASMs prescribed.
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Affiliation(s)
- Maryam Nabavi Nouri
- Department of Pediatrics, Schulich school of Dentistry and Medicine, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada.
| | - Klajdi Puka
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada; Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Katie Palmar
- Department of Clinical Geriatrics, NVS, Karolinska Institute, Stockholm, Sweden
| | - Kathy N Speechley
- Department of Pediatrics, Schulich school of Dentistry and Medicine, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada; Epidemiology and Biostatistics, Western University, London, ON, Canada
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Rozensztrauch A, Kołtuniuk A. The Quality of Life of Children with Epilepsy and the Impact of the Disease on the Family Functioning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042277. [PMID: 35206465 PMCID: PMC8871959 DOI: 10.3390/ijerph19042277] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022]
Abstract
Epilepsy is a neurological chronic disease, which negatively affects physical, psychological and social functioning of children and their families. The main objective of this study was to assess the quality of life (QoL) in children with diagnosed epilepsy and the impact of a child’s disease on the functioning of the family. Method: A cross-sectional survey involved a total of 103 legal guardians of children with diagnosed epilepsy. QoL was measured by PedsQL 4.0, with appropriate forms for specific age groups, the impact of a child’s condition on the functioning of the family was measured by PedsQL 2.0 Family Impact Module, and the authors’ own questionnaire was used to collect sociodemographic and medical data. Results: Subjects reported a decreased level of family daily activities (total score: 32.4 out of 100, SD = 26.5) and relationships (total score: 55.63 out of 100, SD = 24.03). QoL in children aged 5–7 years is lower by an average of 11.956 points as compared with children aged 2–4 years. Comorbidities had a significant impact (p < 0.05) on QoL in all domains. The overall QoL has reported a low score of 46.42 out of 100, respectively (SD ± 20.95), with the highest mean scores reported for the social functioning (total score: 49.4, SD = 27.3) and the physical functioning (total score: 49.4, SD = 28.4) and with the lowest mean score reported for the work/school functioning (total score: 42.3, SD = 27.8). Conclusions: Child’s epilepsy shows a considerable negative impact on the QoL of children and family functioning.
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Affiliation(s)
- Anna Rozensztrauch
- Department of Nursing and Obstetrics, Division of Family and Pediatric Nursing, Wroclaw Medical University, Poland 1, 51-618 Wrocław, Poland
- Correspondence:
| | - Aleksandra Kołtuniuk
- Department of Nursing and Obstetrics, Division of Internal Medicine Nursing, Wroclaw Medical University, Poland 1, 51-618 Wrocław, Poland;
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Liu J, Evans R, Wang Y, Hu B, Tong Y, Li S, Tian Z, Li J, Zhang C, He L, Zheng J. Development and Evaluation of the Quality of Life Scale for Children With Visual Impairments in China. Front Pediatr 2022; 10:739296. [PMID: 35386258 PMCID: PMC8979288 DOI: 10.3389/fped.2022.739296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Visual impairments related to non-correctable vision loss, including blindness and low vision, have been consistently shown to lower a person's health-related quality of life. This study assessed the reliability, validity, and discrimination of the Quality of Life Scale for Children with Visual Impairments (QOLS-CVI) in China. METHODS The Pediatric Quality of Life Inventory™ 4.0 and World Health Organization Quality of Life-Disability Scale for physical disability were selected to define conceptual frameworks and item libraries based on relevant existing studies. According to two rounds of expert consultations and group discussions, some items were modified, and the draft scale was developed. Two item selection processes based on classical test theory and item response theory were used to conduct a preliminary survey and a formal survey in special schools in Shanxi and Hebei Provinces. Finally, the reliability and validity of the quality of life scale for visually impaired children in China were verified. RESULTS The final QOLS-CVI consisted of 38 items, 10 subdomains, and 6 domains. Reliability was verified by Cronbach's alpha coefficient, split-half reliability, and test-retest reliability (Cronbach's alpha for the full scale, 0.841; split-half reliability, 0.629; and test-retest reliability, 0.888). The validity results showed that the multidimensional scale met expectations: exploratory factor analysis and confirmatory factor analysis indicated good fitting models for children with visual impairments. CONCLUSIONS The QOLS-CVI was determined to be reliable and valid and to have strong feasibility and effectiveness. This scale can be used as an evaluation tool to study the QOL and social-participation ability of children with visual impairments.
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Affiliation(s)
- Jie Liu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Richard Evans
- College of Engineering, Design and Physical Sciences, Brunel University London, London, United Kingdom
| | - Yanjun Wang
- Service Center of Shanxi Medical and Health Institutions, Taiyuan, China
| | - Beibei Hu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yan Tong
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Shaoqiong Li
- Center for Information, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiqiang Tian
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jing Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Cuihua Zhang
- Physiatry Department, Hospital of Traditional Chinese Medicine, Taiyuan, China
| | - Lu He
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jianzhong Zheng
- School of Public Health, Shanxi Medical University, Taiyuan, China
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Oen K, Tian J, Loughin TM, Shiff NJ, Tucker LB, Huber AM, Berard RA, Levy DM, Rumsey DG, Tse SM, Chan M, Feldman BM, Duffy CM, Guzman J. Causal pathways to health-related quality of life in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort. Rheumatology (Oxford) 2021; 60:4691-4702. [PMID: 33506861 DOI: 10.1093/rheumatology/keab079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/04/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Structural equation modelling was applied to data from the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) cohort to help elucidate causal pathways to decreased health-related quality of life (HRQoL) in children with JIA. METHODS Based on published literature and clinical plausibility, a priori models were constructed with explicit root causes (disease activity, treatment intensity) and mediators (pain, disease symptoms, functional impairments) leading to HRQoL [measured by the Quality of my Life (QoML) scale and the Juvenile Arthritis Quality of Life Questionnaire (JAQQ)] at five disease stages: (i) diagnosis, (ii) 3-9 months after diagnosis, (iii) flare, (iv) remission on medications, (v) remission off medications. Following structural equation modelling, a posteriori models were selected based on data fit and clinical plausibility. RESULTS We included 561, 887, 137, 186 and 182 patients at each stage, respectively. In a posteriori models for active disease stages, paths from disease activity led through pain, functional impairments, and disease symptoms, directly or through restrictions in participation, to decreased QoML scores. Treatment intensity had detrimental effects through psychosocial domains; while treatment side effects had a lesser role. Pathways were similar for QoML and JAQQ, but JAQQ models provided greater specificity. Models for remission stages were not supported by the data. CONCLUSION Our findings support disease activity and treatment intensity as being root causes of decreased HRQoL in children with JIA, with pain, functional impairments, and participation restrictions being mediators for disease activity; they support psychosocial effects and side effects as being mediators for treatment intensity.
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Affiliation(s)
- Kiem Oen
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba
| | - Jiahao Tian
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia
| | - Thomas M Loughin
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia
| | - Natalie J Shiff
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Lori B Tucker
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam M Huber
- Division of Pediatric Rheumatology, IWK Health Centre and Dalhousie University, Halifax, Nova Scotia
| | - Roberta A Berard
- Pediatric Rheumatology, Children's Hospital, London Health Sciences Centre, London
| | - Deborah M Levy
- Division of Rheumatology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario
| | - Dax G Rumsey
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Shirley M Tse
- Division of Rheumatology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario
| | - Mercedes Chan
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian M Feldman
- Division of Rheumatology, The Hospital for Sick Children and Departments of Pediatrics, Medicine, and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto
| | - Ciaran M Duffy
- Children's Hospital of Eastern Ontario and Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jaime Guzman
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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Hassen TA, Chojenta C, Egan N, Loxton D. The association between birth weight and proxy-reported health-related quality of life among children aged 5 - 10 years old: A linked data analysis. BMC Pediatr 2021; 21:408. [PMID: 34530773 PMCID: PMC8444413 DOI: 10.1186/s12887-021-02882-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Birth weight has a substantial effect on children’s cognitive development, physical capability, and emotional development, which in turn impact on Health-Related Quality of Life (HRQoL). Generally, evidence indicates that children born with low birth weight tend to have poorer proxy-reported HRQoL, particularly at school age. However, there is limited evidence on whether variation in HRQoL exists across the entire range of possible birth weights. This study aimed to examine the association between birth weight and proxy-reported HRQoL among children aged 5–10 years old. Methods Data from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health were linked with state-based Perinatal Data Collections and the Mothers and their Children’s Health study for 1,589 mothers and 2,092 children aged 5 − 10 years old. Generalized estimating equations were used to model the association between birth weight and proxy-reported HRQoL measured by the Pediatric Quality of Life Inventory 4.0. Results are presented as odds ratios with 95 % confidence intervals. Results In this study, 15.61 % of children were at risk of impaired proxy-reported HRQoL. Each 100-gram increase in birth weight was associated with a 3 % reduction in the odds of impaired HRQoL (AOR = 0.97; 95 % CI: 0.94, 0.99). However, there was only limited evidence of an effect within the normal birth weight range (AOR = 0.97; 95 % CI: 0.94, 1.01). Conclusions The findings indicate that increased birth weight was protective against impaired HRQoL, although there was limited evidence of variability within the normal birth weight range. This study contributes to the existing literature by not only emphasizing the impact of low birth weight on children’s health and health-related outcomes but also by focusing on the variability within the normal birth weight range, particularly in a setting where low birth weight is less prevalent.
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Affiliation(s)
- Tahir Ahmed Hassen
- School of nursing and midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia. .,Centre For Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia. .,Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
| | - Catherine Chojenta
- Centre For Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia.,Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Nicholas Egan
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
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Firouzbakht M, Hajian-Tilaki K, Moslemi D. Analysis of quality of life in breast cancer survivors using structural equation modelling: the role of spirituality, social support and psychological well-being. Int Health 2021; 12:354-363. [PMID: 31927594 PMCID: PMC7322199 DOI: 10.1093/inthealth/ihz108] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/29/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To explore and characterize the inter-relationship between psychological well-being, spirituality, social support, comorbidity, demographic and lifestyle factors and quality of life (QoL). METHODS This cross-sectional study was conducted with 305 breast cancer survivors in northern Iran in 2017. The demographic and socio-economic data and physical activity were measured with a standard questionnaire. The standard European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 QoL scale, a system-of-belief inventory questionnaire, the social support scale, the short form of the Hospital Anxiety and Depression Scale and the fatigue severity scale (FSS) were used in data collection. In structural equation modelling analysis, we used the maximum likelihood procedure to estimate the direct and indirect effects of relevant factors on QoL. RESULTS The median age (quartile 1 [Q1], quartile 3 [Q3]) of patients was 50 y (43, 55). The psychological factors designated by anxiety, depression and FSS had a negative significant direct effect on QoL (β=-0.62). Spirituality has a positive direct effect (β=0.089) but a negligible indirect effect (β=0.020) on QoL, while the direct association of social support was almost negligible. CONCLUSIONS The findings emphasized the unifying structure of the determinants of QoL and the mediating negative association of psychological factors with QoL. Thus the supportive education efforts should focus on improving psychological well-being along with standard treatment in breast cancer survivors.
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Affiliation(s)
- Mojgan Firouzbakht
- Social Determinants of Health Research Center, Health Research Institute, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
| | - Karimollah Hajian-Tilaki
- Department of Biostatistics and Epidemiology, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
| | - Dariush Moslemi
- Department of Radiotherapy, School of Paramedical Sciences, Ghang-Afrouz St. Babol University of Medical Sciences, Babol, Iran
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Riechmann J, Willems LM, Boor R, Kieslich M, Knake S, Langner C, Neubauer BA, Oberman B, Philippi H, Reese JP, Rochel M, Schubert-Bast S, Seeger J, Seipelt P, Stephani U, Rosenow F, Hamer HM, Strzelczyk A. Quality of life and correlating factors in children, adolescents with epilepsy, and their caregivers: A cross-sectional multicenter study from Germany. Seizure 2019; 69:92-98. [PMID: 31004927 DOI: 10.1016/j.seizure.2019.03.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/30/2019] [Accepted: 03/24/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To identify factors correlating with poorer quality of life (QoL) in children and adolescents with epilepsy and regarding QoL and depression of their caregivers in Germany. METHOD A cross-sectional multicenter study on QoL and depression was performed in two representative German states (Hessen and Schleswig-Holstein). Variance analysis, linear regression, and bivariate correlation were used to identify correlating factors for poorer QoL and symptoms of depression. RESULTS Data from 489 children and adolescents (mean age 10.4 ± 4.2 years, range 0.5-17.8; 54.0% male) and their caregivers were collected. We identified missing seizure freedom (p = 0.046), concomitant diseases (p = 0.007), hospitalization (p = 0.049), recent status epilepticus (p = 0.035), living in a nursing home or with foster parents (p = 0.049), and relevant degree of disability (p = 0.007) to correlate with poorer QoL in children and adolescents with epilepsy. Poorer QoL of caregivers was associated with longer disease duration (p = 0.004), non-idiopathic (mainly structural-metabolic) epilepsy (p = 0.003), ongoing seizures (p = 0.003), concomitant diseases (p = 0.003), relevant disability (p = 0.003), or status epilepticus (p = 0.003) as well as with unemployment of the primary caretaker (p = 0.010). Symptoms of depression of caregivers were associated with non-idiopathic epilepsy (p = 0.003), concomitant diseases (p = 0.003), missing seizure freedom (p = 0.007), status epilepticus (p = 0.004), or a relevant disability (p = 0.004) of their ward. A poorer QoL value of the children and adolescents correlated with a poorer QoL value of the caregivers (p < 0.001). CONCLUSIONS Epilepsy shows a considerable impact on QoL and symptoms of depression. Early and effective therapy should focus on reduction of seizure frequency and the probability for developing status epilepticus. Furthermore, comprehensive care should pay attention at comorbidities, consequences of disability and dependency on others.
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Affiliation(s)
- Janna Riechmann
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; Department of Pediatrics, Philipps-University Marburg, Marburg (Lahn), Germany
| | - Laurent M Willems
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Rainer Boor
- Department of Pediatric Neurology and Northern German Epilepsy Centre for Children and Adolescents, Christian-Albrechts-University, Kiel, Germany
| | - Matthias Kieslich
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Susanne Knake
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | | | - Bernd A Neubauer
- Department of Pediatric Neurology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Bettina Oberman
- Center for Social Pediatrics Frankfurt Höchst, Frankfurt am Main, Germany
| | - Heike Philippi
- Center for Social Pediatrics and Epilepsy Outpatient Clinic Frankfurt Mitte, Frankfurt am Main, Germany
| | - Jens P Reese
- Coordinating Center for Clinical Trials, Philipps-University Marburg, Marburg (Lahn), Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | | | - Susanne Schubert-Bast
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; Department of Neuropediatrics, Goethe-University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Jürgen Seeger
- Center for Social Pediatrics and Epilepsy Outpatient Clinic Frankfurt Mitte, Frankfurt am Main, Germany
| | - Peter Seipelt
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; Department of Pediatrics, Philipps-University Marburg, Marburg (Lahn), Germany
| | - Ulrich Stephani
- Department of Pediatric Neurology and Northern German Epilepsy Centre for Children and Adolescents, Christian-Albrechts-University, Kiel, Germany
| | - Felix Rosenow
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Hajo M Hamer
- Epilepsy Center Erlangen, Friedrich-Alexander University, Erlangen, Germany
| | - Adam Strzelczyk
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
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10
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Germain N, Aballéa S, Toumi M. Measuring the health-related quality of life in young children: how far have we come? JOURNAL OF MARKET ACCESS & HEALTH POLICY 2019; 7:1618661. [PMID: 31156762 PMCID: PMC6534256 DOI: 10.1080/20016689.2019.1618661] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/19/2019] [Accepted: 05/10/2019] [Indexed: 05/07/2023]
Abstract
The importance of understanding the impact of disease and treatment on children's Health-Related Quality of Life (HRQoL) has given rise to an increasing use of child self-report and observer or proxy instruments. In this article, we review the status quo and challenges of HRQoL measurement specific to children under five. A number of HRQoL questionnaires exist for use with children and/or proxies, and both guidelines and reviews have been published on paediatric HRQoL. However, none address the challenges of measurement for children under five, for whom proxy measures should be used. In reality, there is significant heterogeneity in the cut-off age for self-report questionnaires. Recommendations are that proxies should be used for observable concepts, but not for concepts that require interpretation. Some research has been undertaken on dimensions/concepts in paediatric HRQoL questionnaires. However, no HRQoL models have been developed specifically for children, and heterogeneity in questionnaire dimensions underlines that there is no clear grasp of what HRQoL means in paediatric populations. There is a need to carry out research in order to develop theoretical models of HRQoL that are specific to children at different developmental stages, in order to evaluate and support new and existing measures for paediatric HRQoL and their use in clinical practice as well as clinical trials.
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Affiliation(s)
- Nicola Germain
- Health Economics and Outcomes Research, Creativ-Ceutical, Paris, France
- CONTACT Nicola Germain Health Economics and Outcomes ResearchCreativ-Ceutical, 215 rue du Faubourg St Honoré, Paris75008, France
| | - Samuel Aballéa
- Health Economics and Outcomes Research, Creativ-Ceutical, Paris, France
| | - Mondher Toumi
- Public Health Research Unit, Aix-Marseille University, Marseille, France
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11
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Kim Y, Park HR. [Structural Equation Model of Health-Related Quality of Life in School Age Children with Asthma]. J Korean Acad Nurs 2018. [PMID: 29535288 DOI: 10.4040/jkan.2018.48.1.96] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary. METHODS Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. RESULTS Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%. CONCLUSION Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.
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Affiliation(s)
- Yunsoo Kim
- Seoul Women's College of Nursing, Seoul, Korea
| | - Ho Ran Park
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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12
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Rodday AM, Terrin N, Leslie LK, Graham RJ, Parsons SK. Understanding the Relationship Between Child Health-Related Quality of Life and Parent Emotional Functioning in Pediatric Hematopoietic Stem Cell Transplant. J Pediatr Psychol 2018; 42:804-814. [PMID: 28369555 DOI: 10.1093/jpepsy/jsx047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 01/09/2017] [Indexed: 11/12/2022] Open
Abstract
Objective Explore interrelationships between domains of child health-related quality of life (HRQL) and parent emotional functioning using parent-proxy and child report in the context of hematopoietic stem cell transplant (HSCT). Methods Data on 258 parent-child dyads were used from two longitudinal studies. Domains of HRQL included physical, emotional, and role functioning, and HSCT-related worry. We used structural equation modeling to model the outcome of parent emotional functioning using primary and alternative conceptual models. Results Parent-proxy raters reported lower child HRQL than child raters. Structural equation models demonstrated relationships between child emotional functioning, child HSCT-related worry, and parent emotional functioning, with some differences by raters. Conclusions Relationships between child HRQL and parent emotional functioning within the context of HSCT are complex. To optimize the child's health outcomes, providing psychosocial support for children and their families may be necessary, especially for those experiencing distress or facing treatment complications.
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Affiliation(s)
- Angie Mae Rodday
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.,Department of Medicine, Tufts University
| | - Norma Terrin
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.,Department of Medicine, Tufts University
| | - Laurel K Leslie
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.,American Board of Pediatrics, Chapel Hill, NC
| | - Robert J Graham
- Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital.,Department of Anesthesia, Harvard Medical School
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.,Department of Medicine, Tufts University
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13
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Frew JW, Davidson M, Murrell DF. Disease-specific health related quality of life patient reported outcome measures in Genodermatoses: a systematic review and critical evaluation. Orphanet J Rare Dis 2017; 12:189. [PMID: 29284525 PMCID: PMC5747090 DOI: 10.1186/s13023-017-0739-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/07/2017] [Indexed: 12/30/2022] Open
Abstract
Background Health Related Quality of Life (HR-QoL) Patient reported outcome measures (PROMs) have high utility in evaluation of new interventions in genodermatoses, however inconsistent standards of development and validation have hampered widespread acceptance and adoption. Objectives To identify all published HR-QoL PROMs in genodermatoses and critically evaluate their development and measurement properties. Methods This systematic review was registered with PROSPERO (CRD42016053301). Ovid Medline, Embase and PsycINFO databases were utilised for literature review using predefined inclusion and exclusion criteria. PROM development was assessed using the COSMIN Checklist and measurement properties were assessed against quality criteria for measurement properties of health standard questionnaires. Results 15 HRQoL PROMs in genodermatoses were identified. Major areas of deficiency in development were internal consistency, reliability and structural validity. No PROM satisfied measurement property standards for agreement, responsiveness or floor and ceiling effects. Four PROMs included Minimal Important Change scores for interpretability. Issues regarding the generalisability of the evaluated PROMs in culturally diverse and paediatric populations remain unresolved. Conclusions The overall standards of development and measurement properties in PROMs in genodermatoses is fair, despite no single instrument meeting all requirements. None are perfectly validated according to COSMIN criteria but seven of the fifteen PROMs may be appropriate pending further validation. The development of culturally appropriate and child-specific variants of PROMs should be a priority in order to increase the utility of patient based outcome measures in genodermatoses in various patient populations. Electronic supplementary material The online version of this article (10.1186/s13023-017-0739-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John W Frew
- Department of Dermatology, Liverpool Hospital, Sydney, Australia. .,Faculty of Medicine, UNSW, Sydney, Australia.
| | | | - Dedee F Murrell
- Faculty of Medicine, UNSW, Sydney, Australia.,Department of Dermatology St George Hospital, Sydney, Australia
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14
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Ojelabi AO, Graham Y, Haighton C, Ling J. A systematic review of the application of Wilson and Cleary health-related quality of life model in chronic diseases. Health Qual Life Outcomes 2017; 15:241. [PMID: 29228977 PMCID: PMC5725920 DOI: 10.1186/s12955-017-0818-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/30/2017] [Indexed: 02/08/2023] Open
Abstract
Background A conceptual model approach to clarify the elements of health-related quality of life (HRQL), their determinants and causal pathways is needed to aid researchers, health practitioners and policy makers in their bid to improve HRQL outcomes in patients. The aim of this systematic review was to appraise empirical evidence on the performance of the Wilson and Cleary Model of HRQL. Methods We conducted a search of MEDLINE, Science Direct, PsyARTICLES and CINAHL databases to identify articles that used Wilson and Cleary model to examine HRQL in chronic diseases. A narrative synthesis was employed in the review of the articles. Results Evidence supports linkages between adjacent concepts and between non-adjacent concepts of the Wilson and Cleary model indicating that in practice there is a need to examine relationships among constructs - or to consider interventions in terms of - both with and without mediators. Symptoms status has the highest magnitude of relative impact on health-related quality of life. Conclusion The Wilson and Cleary model demonstrated good features suitable for evaluating health-related quality of life in chronic diseases.
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Affiliation(s)
- Adedokun Oluwafemi Ojelabi
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK. .,University of Ibadan, Ibadan, Nigeria.
| | - Yitka Graham
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Northumbria, UK.,Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Jonathan Ling
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
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15
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Villalonga-Olives E, Kawachi I, Almansa J, von Steinbüchel N. Longitudinal changes in health related quality of life in children with migrant backgrounds. PLoS One 2017; 12:e0170891. [PMID: 28151986 PMCID: PMC5289509 DOI: 10.1371/journal.pone.0170891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 01/12/2017] [Indexed: 11/18/2022] Open
Abstract
Background Little is known about longitudinal changes in the Health Related Quality of Life (HRQoL) among children with migrant backgrounds. Methods The sample comprised 350 children with predominantly migrant backgrounds enrolled in 7 kindergartens in Frankfurt and Darmstadt, Germany. At baseline, the participants’ mean age was 4.4 years (SD 0.9). Data collection started in May 2009. Two waves of data were collected one year apart (94% response rate). HRQoL was evaluated with the Kiddy-KINDL. The other variables under study were sex, age, socioeconomic status, country of origin, developmental status (WET) and individual behavior (VBV). Data were collected from the children, parents and teachers. Structural equation modeling (SEM) was used to assess the Wilson and Cleary theoretical framework on changes in HRQoL and Generalized Estimated Equations (GEE) to model the longitudinal trend in HRQoL. Results Overall HRQoL remained stable between baseline and follow-up. SEM model fit was χ2 = 8.51; df = 5; p = 0.13; SRMR = 0.02 RMSEA = 0.06 and indicated that there were differences in kindergarten activities (p<0.05). The GEE model elucidated that the differences in HRQoL between the baseline and follow-up varied according to kindergarten activities that the children were assigned to (music, art, or no activities) (p<0.05), but that there were no differences in terms of country of origin. On average, girls reported better HRQoL. Conclusion Overall HRQoL scores remained stable over follow-up in a sample of migrant children and there were no differences in terms of origin. However, there was heterogeneity in the results depending on the kindergarten activities that the children were assigned to.
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Affiliation(s)
- Ester Villalonga-Olives
- Institute of Medical Psychology and Medical Sociology, Georg-August-University Göttingen, Göttingen, Germany
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- * E-mail:
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Josue Almansa
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, Georg-August-University Göttingen, Göttingen, Germany
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16
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Lah Tomulic K, Mestrovic J, Zuvic M, Rubelj K, Peter B, Bilic Cace I, Verbic A. Neonatal risk mortality scores as predictors for health-related quality of life of infants treated in NICU: a prospective cross-sectional study. Qual Life Res 2016; 26:1361-1369. [PMID: 27848129 DOI: 10.1007/s11136-016-1457-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the relationship of Apgar scores, gestational age and neonatal risk mortality scores to health-related quality of life (HRQoL) for infants at the age of 8 months treated after birth in neonatal intensive care unit (NICU). METHODS All surviving infants treated in two-third level NICUs in Rijeka, Croatia (from August 2013 to August 2014) were included in this prospective, cross-sectional study. For all neonates, the Score for Neonatal Acute Physiology (SNAP), SNAP with Perinatal Extension (SNAP-PE) and their simplified modifications (SNAP II and SNAP-PE II) were calculated. At the corrected age of 8 months, the Pediatric Quality of Life Questionnaire (PedsQL)-infant scale-was completed by parents of surviving infants. Multiple regression analysis was performed in order to assess the value of neonatal risk mortality scores, Apgar scores and gestational age as possible predictors of HRQoL, measured by questionnaire score. RESULTS A strong correlation has been found between SNAP and 5-min Apgar scores to HRQoL. A positive correlation was also found between gestational age and HRQoL. CONCLUSION SNAP and 5-min Apgar scores are important outcome indicators, can aid clinicians' and parents' decision making on the benefits and burdens of acute medical interventions and help determine quantities of medical treatment. Educated medical staff, effective and efficient medical treatment and a high quality of care which prevent adverse events in the first minute of life should be a priority in efforts to improve the future quality of life.
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Affiliation(s)
- K Lah Tomulic
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Rijeka, Istarska 43, 51000, Rijeka, Croatia. .,Faculty of Medicine, University of Rijeka, Brace Brancheta 20/1, 51000, Rijeka, Croatia.
| | - J Mestrovic
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Split, Spinciceva 1, 21000, Split, Croatia.,Faculty of Medicine, University of Split, Soltanska 2, 21000, Split, Croatia
| | - M Zuvic
- Department of Biotechnology, University of Rijeka, Radmile Matejcic 2, 51000, Rijeka, Croatia
| | - K Rubelj
- Faculty of Medicine, University of Rijeka, Brace Brancheta 20/1, 51000, Rijeka, Croatia
| | - B Peter
- Neonatal Intensive Care Unit, Department of Gynecology and Obstetrics, University Hospital Centre Rijeka, Kresimirova 42, 51000, Rijeka, Croatia
| | - I Bilic Cace
- Faculty of Medicine, University of Rijeka, Brace Brancheta 20/1, 51000, Rijeka, Croatia.,Neonatal Intensive Care Unit, Department of Gynecology and Obstetrics, University Hospital Centre Rijeka, Kresimirova 42, 51000, Rijeka, Croatia
| | - A Verbic
- Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Rijeka, Istarska 43, 51000, Rijeka, Croatia
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Hassanzadeh J, Asadi-Lari M, Baghbanian A, Ghaem H, Kassani A, Rezaianzadeh A. Association between social capital, health-related quality of life, and mental health: a structural-equation modeling approach. Croat Med J 2016; 57:58-65. [PMID: 26935615 PMCID: PMC4800324 DOI: 10.3325/cmj.2016.57.58] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, health-related quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76% (95% confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health.
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Affiliation(s)
| | | | | | | | - Aziz Kassani
- Aziz Kassani, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran,
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18
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Goldhagen J, Fafard M, Komatz K, Eason T, Livingood WC. Community-based pediatric palliative care for health related quality of life, hospital utilization and costs lessons learned from a pilot study. BMC Palliat Care 2016; 15:73. [PMID: 27487770 PMCID: PMC4971636 DOI: 10.1186/s12904-016-0138-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/22/2016] [Indexed: 11/12/2022] Open
Abstract
Background Children with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve their quality of life and lead to reduced costs of hospital care. This study's purpose was to analyze and report unpublished evaluation study results from 2007 that demonstrate the potential for CBPPC on Health Related Quality of Life (HRQoL) and hospital utilization and costs in light of the increasing national focus on the care of children with complex-medical conditions, including the Affordable Care Act's emphasis on patient-centered outcomes. Methods A multi-method research design used primary data collected from caregivers to determine the Program's potential impact on HRQoL, and administrative data to assess the Program's potential impact on hospital utilization and costs. Caregivers (n=53) of children enrolled in the Northeast Florida CBPPC program (Community PedsCare) through the years 2002-2007 were recruited for the Health Related Quality of Life (HRQoL) study. Children (n=48) enrolled in the Program through years 2000-2006 were included in the utilization and cost study. Results HRQoL was generally high, and hospital charges per child declined by $1203 for total hospital services (p=.34) and $1047 for diagnostic charges per quarter (p=0.13). Hospital length of stay decreased from 2.92 days per quarter to 1.22 days per quarter (p<.05). Conclusion The decrease in hospital utilization and costs and the high HRQoL results indicate that CBPPC has the potential to influence important outcomes for the quality of care available for children with complex-medical conditions and their caregivers. Electronic supplementary material The online version of this article (doi:10.1186/s12904-016-0138-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jeffrey Goldhagen
- Division of Community and Societal Pediatrics, Department of Pediatrics, UF College of Medicine - Jacksonville, 841 Prudential Drive, Suite 1330 m, Jacksonville, FL, 32207, USA
| | - Mark Fafard
- Baptist Health Research Institute, Baptist Health System, 836 Prudential Drive, Pavilion 6th Floor, Jacksonville, FL, 32207, USA.
| | - Kelly Komatz
- Division of Community and Societal Pediatrics, Department of Pediatrics, UF College of Medicine - Jacksonville, 841 Prudential Drive, Suite 1330 m, Jacksonville, FL, 32207, USA
| | - Terry Eason
- Community PedsCare, Community Hospice of Northeast Florida, 4266 Sunbeam Rd., Jacksonville, FL, 32257, USA
| | - William C Livingood
- Center for Health Equity and Quality Research, UF College of Medicine-Jacksonville, 580 W. 8th St., Tower II, Room 6015, Jacksonville, FL, 32209, USA
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