Psychological adjustment and health related quality of life in children who have been diagnosed with acute lymphoblastic leukaemia

Abstract

Objectives: This study aimed to: a) investigate children's adjustment and Health Related Quality of Life (HRQL) in Acute Lymphoblastic Leukaemia (ALL) and b) identify factors associated with, and predicting, adjustment and HRQL in children with ALL. Wallander and Varni's (1992) model of child adjustment was used as a theoretical framework. Design: A cross-sectional, within-subjects, questionnaire survey design was used. Method: Forty-four parents and 28 children participated. Parents completed questionnaires assessing child's adjustment and HRQL. A parenting stress measure, to collect data on likely predictors, and a semi-structured interview was administered to parents. Children aged 5-12 years completed a questionnaire assessing HRQL. Results: ALL was associated with poor adjustment and poor HRQL. Demographic, treatment status, child and parent characteristics and life stress were associated with adjustment and/or HRQL. Child characteristics (i.e. distractability, hyperactivity, adaptability), gender and parent characteristics were significant predictors of adjustment. Number of siblings, parental isolation and treatment status significantly predicted child-rated HRQL, while child characteristics (Le. acceptability, mood, adaptability), treatment status, age at diagnosis and life stress predicted parent-rated HRQL. Conclusion: Results suggest child characteristics, parent characteristics and treatment status, in particular, are important predictors of adjustment and HRQL in ALL. The findings are discussed in relation to previous research, methodological weaknesses and the possible role of cross informant variance. Implications for clinical research, the development of theory and future research are outlined.