Health-related quality of life of children with physical disabilities: a longitudinal study

BMC Pediatrics

Liqin Xu³  Gillian King⁵  Marilyn Kertoy⁶  Dana Anaby¹  Steven Hanna⁴  Mary Law² 

[1] School of Physical and Occupational Therapy, McGill University, Montreal, Canada;School of Rehabilitation Science, McMaster University, Hamilton, Canada;Canadian Partnership Against Cancer, Toronto, Canada;Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada;Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada;School of Communication Sciences and Disorders, University of Western Ontario, London, Canada

关键词: Environmental barriers;    Longitudinal study;    Health-related quality of life;    Disability;   

Others  :  1143890
DOI  :  10.1186/1471-2431-14-26

 received in 2013-03-12, accepted in 2014-01-28,  发布年份 2014

【 摘 要 】

Background

Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent’s perceptions of child’s HRQoL across 18 months and 3) explore factors that predict these changes.

Methods

Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child’s factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors.

Results

CHQ scores of the study’s participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children’s behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time.

Conclusions

Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ.

【 授权许可】

   
2014 Law et al.; licensee BioMed Central Ltd.

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