Abstract
Living with a chronic disease in adolescence can have an impact on the perception of Health-related Quality of Life (HRQoL). Facing the increasing relevance of psychosocial dimensions and also considering the interaction with clinical variables, this study aimed to measure the impact of clinical and psychosocial factors (separated and combined) on adolescent’s reported HRQoL.A cross-sectional study was conducted in a clinical population of 135 adolescents with chronic diseases (n=70 boys), average age: 14±1.5 years old. Through a self-reported questionnaire, HRQoL (KIDSCREEN-10), socio-demographic, clinical variables (diagnostic; time of diagnosis; self-perceived pain; disease severity proxy; disease-related medication intake/use of special equipment), and psychosocial variables (psychosomatic health; resilience; self-regulation; social support) were assessed.Separately, clinical and psychosocial variables showed a significant impact in HRQoL, 27.9% and 62.4%, respectively. Once combined, the previously identified variables had a significant impact (64.2%), but a different contribution from clinical and psychosocial variables was revealed: when first entering the clinical variables (model 1) the variance only reaches 30%, and much more from psychosocial variables seems to explain the total (64.2%); inversely, when first integrating psychosocial variables (model 2), the clinical ones added a small significance to the model (0.6%).The present study underlined the association of clinical (“disease-related”) and psychosocial (“non-disease-related”) factors on HRQoL. Furthermore, it reinforced the need to focus more on psychosocial dimensions, highlighted the potential role of psychosomatic health, resilience, self-regulation and social support. It can be suggested that the identification of impaired psychosocial domains may help professionals to better plan, and achieve effective interventions of psychosocial care.
Highlights
In the last 40 years, advances in pediatric medicine have reduced the mortality rates of many fatal chronic diseases, increasing the survival of youths into adolescence and adulthood (Sattoe et al, 2015)
The adolescents were diagnosed with neurologic diseases, or allergic diseases, or diabetes mellitus, and the focus on these chronic diseases was based on the evidence of their high prevalence in adolescence (Barros, 2009)
A brief overlook of the results shows that, separately, both clinical and psychosocial variables have a significant association with the perception of health-related quality of life (HRQoL), showing high values of explained variance
Summary
In the last 40 years, advances in pediatric medicine have reduced the mortality rates of many fatal chronic diseases, increasing the survival of youths into adolescence and adulthood (Sattoe et al, 2015). Non-disease factors were considered determinants for HRQoL, namely anxiety/depression (Velasco, Martín, Díez, Pérez, & Amigo, 2012), gender (Williams et al, 2013; Zashikhina & Hagloff, 2014), age (Alba et al, 2013; Moreira et al, 2013; Zashikhina & Hagloff, 2014), socioeconomic status (Herzer et al, 2011; Zashikhina & Hagloff, 2014), quality of peer relationship (Rassart et al, 2012), social interaction/social support (Carona et al, 2014; Elsenbruch et al, 2013; Vanhalst et al, 2013) and parents’ support (Békési et al, 2011; Williams et al, 2013)
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