Health-related Quality Of Life In Children Research Articles

Validity and Reliability of the Peds QLᵀᴹ 4.0 Generic Core Scale in Indonesian Version in Children with Chronic Kidney Disease Undergoing Hemodialysis in the Dialysis Unit of Cipto Mangunkusumo Hospital

Background: The Peds QLᵀᴹ 4.0 Generic Core Scales is a modular instrument for measuring health-related quality of life (HR-QoL) in children and adolescents aged 2 to 18 years. The Peds QLᵀᴹ 4.0 GCS consists of 23 items applicable to healthy school and community populations and populations of children with acute and chronic health conditions. The Pediatric Quality of Life Inventory (Peds QLᵀᴹ 4.0 Generic Core Scales) is a modular instrument designed to measure health-related quality of life (HR-QoL) in children and adolescents aged between two and thirteen years. It measures health-related quality of life (HR-QoL) in children and adolescents with progressive chronic kidney disease (CKD), regardless of the underlying etiology, due to the need for regular follow-up visits, strict medication regimens, and dietary intake. Purpose: This study aimed to evaluate the validity and reliability of the Peds QLᵀᴹ 4.0 GCS Indonesian version in children with CKD undergoing hemodialysis (HD) in the Dialysis Unit of Cipto Mangunkusumo Hospital. Methods: This type of research is analytical and observational in nature. The Peds QLᵀᴹ 4.0 GCS were administered to 30 children and 30 parents recruited from a pediatric dialysis unit. This study was conducted at a pediatric dialysis unit at Cipto Mangunkusumo Hospital Jakarta, Indonesia, in Mei-Juni 2024. Validity was tested using Pearson product moment, and reliability was tested using Cronbach's alpha. Results: A total of 30 children and 30 parents undergoing hemodialysis agreed to participate. The average age of the patients was 8–18 years old. Cronbach’s alpha coefficient for the total Peds QLᵀᴹ 4.0 GCS (α child self-report 0.918; α parent proxy report 0.928). Conclusion: The Indonesian versions of The Peds QLᵀᴹ 4.0 GCS were valid and reliable instruments to measure the HR-QoL of children with CKD on hemodialysis. The Peds QLᵀᴹ 4.0 GCS can be applied to provide relevant evidence that helps the function of quality of life among Indonesian patients on hemodialysis in evaluating health programs.

Assessment of health-related quality of life of children with idiopathic nephrotic syndrome and their caregivers in China

AimsThe primary aim of this study was to characterize the health-related quality of life (HRQoL) and identify the associated factors among children aged 2 to 18 in China diagnosed with idiopathic nephrotic syndrome (INS). Additionally, the study aimed to evaluate the HRQoL and caregiving burden of their caregivers and investigate the correlation between the HRQoL of the children and that of their caregivers.MethodsThis study recruited 181 children diagnosed with INS from Children’s Hospital, Zhejiang University School of Medicine in China. The proxy-reported PedsQL Generic Core Module (PedsQL™ 4.0 GCM) was used to measure the HRQoL of children, and the EuroQol five-dimensional questionnaire, five-level version (EQ-5D-5L) was applied to measure caregivers’ HRQoL. Differences in scale scores and total scores of PedsQL™ 4.0 GCM were assessed using t-tests and one-way ANOVA. Multivariate linear regression analysis was used to identify the factors associated with children’s HRQoL. Pearson correlation analysis evaluated the correlation between children’s HRQoL and caregiver’s HRQoL.ResultsHRQoL of Children with INS declines with increasing age, and children aged 5-18 had lower scores in physical functioning, emotional functioning, school functioning, psychosocial health summary score, and total PedsQL™ 4.0 GCM score compared to healthy children. Various factors, including the mother filling out the questionnaire, the father being unemployed, and the use of other medications except for steroids, were associated with worse HRQoL of children (p values < 0.05). Additionally, a correlation exists between children’s HRQoL and their caregivers’ HRQoL.ConclusionThis study evaluated the HRQoL of children aged 2-18 years diagnosed with INS in China, along with the HRQoL of their caregivers. Multiple factors potentially influence the HRQoL of children. A significant correlation was observed between the HRQoL of children and their caregivers, who frequently experienced varying levels of caregiving burden. Therefore, it is recommended that healthcare professionals prioritize optimizing HRQoL for children with INS and their caregivers.

Psychosocial factors mediate social inequalities in health-related quality of life among children and adolescents

BackgroundThe present analysis aimed to assess the mediating role of psychosocial and behavioural factors in socio-economic inequalities in health-related quality of life (HRQoL) among children and adolescents.MethodsCross-sectional data was drawn from the randomly selected SEROCoV-KIDS cohort study in Geneva, Switzerland. Associations of socio-economic conditions (parents’ highest education, household financial situation) with HRQoL, psychosocial (parent–child relationship, school difficulties, friends, extracurricular activities) and behavioural factors (screen time, physical activity, green spaces time, sleep duration), along with associations of psychosocial and behavioural factors with HRQoL, were evaluated with generalized estimating equations. Counterfactual mediation analyses were conducted to test pathways linking socio-economic conditions to HRQoL.ResultsOf 965 children and 816 adolescents, those with disadvantaged financial circumstances were more likely to have a poor HRQoL (adjusted Odds Ratio [aOR]: 3.80; 95% confidence interval [CI]: 1.96–7.36 and aOR: 3.66; 95%CI: 2.06–6.52, respectively). Psychosocial characteristics mediated 25% (95%CI: 5–70%) and 40% (95%CI: 18–63%) of financial disparities in HRQoL among children and adolescents, respectively. Health behaviours were weakly patterned by socio-economic conditions and did not contribute to financial differences in HRQoL.ConclusionsThese findings provide empirical evidence for mechanisms explaining socio-economic disparities in child HRQoL and could inform interventions aimed to tackle health inequalities.

Measuring health-related quality of life in a Chinese Mainland adolescent population: psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 and KIDSCREEN-10 index

BackgroundThe self-reported KIDSCREEN questionnaires are ideal for capturing children’s and adolescents’ health-related quality of life (HRQoL) and have gained worldwide popularity. Responding to demands for the concise nature of KIDSCREEN among Chinese Mainland researchers and practitioners, this study aimed to evaluate the psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 (KS-27) and KIDSCREEN-10 index (KS-10), which are short versions of the self-reported KIDSCREEN-52 (KS-52).MethodsThis study reanalyzed the validation dataset of the Mandarin Chinese self-reported KS-52. The dataset originated from a cross-sectional survey conducted in Weifang City, the Chinese Mainland, from October to November 2016. Adolescents aged 11–17 years (N = 4385) were surveyed, and sub-samples (N = 841) were retested. Statistical analyses were conducted on the feasibility, item and dimension properties, reliability, and validity of the Mandarin Chinese self-reported KS-27 and KS-10.ResultsIndirect evidence from the Small Group Pilot Survey indicated that the Mandarin Chinese self-reported KS-27 and KS-10 can be completed on average in less than 12.33 mins. Their response rate exceeded 90% regardless of the unit- and item (dimension)-level. The psychometric properties of items and dimensions were likewise found to be satisfactory. Internal consistency was robust with inter-item and item-total correlations (0.173–0.873, 0.422–0.786), Cronbach’s alpha (0.786–0.881), Guttman’s lambda-2 and - 6 (0.807–0.889, 0.829–0.896), and McDonald’s omega (0.725–0.886). Test–retest reliability at both item- and dimension-level was excellent, with intraclass correlation coefficients (ICCs) of (0.590–0.696, 0.785–0.842); standard error of measurements (SEMs) of (0.352–0.635, 0.949–1.949). Confirmatory factor analysis (CFA) confirmed their five- and one-dimensional structures, albeit with slight modifications. Moreover, the multi-group confirmatory factor analysis (MG-CFA) substantiated their configural and metric invariance across gender and grade groups. Convergent validity was robust, with stronger correlations observed with comparable dimensions of the Mandarin Chinese self-reported PedsQL™ 4.0, while discriminant validity was evident with low correlations observed with less comparable dimensions. The known-group validity was mainly supported by medium to large effect sizes concerning differences in socioeconomic status (η2 = 0.07–0.17, Cohen’s d = 0.55–1.03) and mental health status (η2 = 0.09–0.40, Cohen’s d = 0.73–1.83). The Mandarin Chinese self-reported KS-52 served as the criterion; the ICCs between the Mandarin Chinese self-reported KS-27 and KS-10 and their comparable dimensions were stronger, indicating robust criterion validity.ConclusionsThe Mandarin Chinese self-reported KS-27 and KS-10 demonstrated excellent psychometric properties, indicating their good potential for measuring HRQoL for children and adolescents in the Chinese Mainland.

Starting Right, an evidence-based assessment of children in municipalities healthcare centers

Abstract During the last century, children’s health has evolved significantly, with mental health issues becoming a prominent public health concern. Childhood health problems profoundly impact quality of life (QoL), development, school functioning, and social interactions, affecting society broadly. In Norway, child and school health services offer free comprehensive care within the municipal primary health care system, prioritizing health promotion and prevention to address social health inequalities. The Norwegian Starting RightTM project recruits’ children aged 6 months to16 years and their parents, emphasizing early intervention and support to reduce health inequalities and promote well-being. In the Starting RightTM project, online proxy- and child-reported questionnaires are used to support public health nurses (PHNs) in assessing children’s health and development in routine follow- up. Parents and children receive an SMS text message asking them to answer an online questionnaire before attending their regular appointments in child or school health services. Validated instruments measure the development (ASQ, ASQ-SE), mental health (SDQ) and health-related quality of life (HRQoL), (KIDSCREEN -27). By mapping children and adolescents’ health and through discussions with PHNs, parents and children may be more involved in children’s health and development and may increase their Health Literacy. The primary objective of the proposed project is to develop child and school health services and improve children’s health and HRQoL. The ongoing project is the first to systematically assess development, health and HRQoL in children and adolescents in Norway through ordinary services, and to do so longitudinally. At present, &amp;gt;2000 children have been included. The large sample size combined with a broad multi- and interdisciplinary approach is unique from a national perspective. The upcoming workshop will showcase findings from this innovative study.

Evaluation of the Effect of Surgery on Psychosocial Function and Quality of Life in Children with Simple Congenital Ptosis and Their Parents.

Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Materials and. A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and parents answered the Spence Children's Anxiety Scale (SCAS) - Social Anxiety Domain, and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and three months after ptosis surgery. This study involved 45 children. Females comprised 57.8% (n=26). At enrolment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean MRD1 and mean inter-eye MRD1 difference of 4.070.62 mm and 0.290.46 mm respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p<0.001). A decrease in inter-eye MRD1 difference post-operatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p<0.001). Together with the presence of amblyopia (p<0.001), the inter-eye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p=0.021). Age, gender and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p<0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p<0.001). Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Factors influencing health-related quality of life of children with overweight and obesity in Kuala Lumpur, Malaysia

ABSTRACT Introduction: Overweight and obesity among children may have psychological consequences, with potentially lasting effects on health-related quality of life (HRQOL). The aims of this study were to compare HRQOL across weight status among children and to determine the factors influencing HRQOL among children with overweight and obesity. Methods: This cross-sectional study involved school children aged 9–16 years that were recruited from eight randomly selected primary and secondary schools in Kuala Lumpur. The validated Malay version of Pediatric Quality of Life Inventory (PedsQL) was used to measure HRQOL. Complex sample general linear model was used to determine the significant factors associated with HRQOL among children with overweight and obesity. Results: From 928 students, 41.2% (n = 375) of them had either overweight or obesity. Children with obesity reported lower overall HRQOL, physical functioning, social functioning, and psychosocial health summary, compared to normal weight children. In the final model, children with obesity had significantly lower HRQOL and physical functioning compared to children who were overweight, while those who lived with a single parent reported poorer HRQOL compared to children who lived with both parents. Children with history of being bullied had lower HRQOL and psychosocial health. Whereas those with lower self-esteem reported significantly lower scores in all three domains. Conclusion: Overweight and obesity have negative impacts on HRQOL of children. Among children with overweight and obesity, factors such as degree of obesity, family structure, history of being bullied, and self-esteem were found to be significantly associated with HRQOL. Therefore, assessing and managing HRQOL should be included as a part of the obesity prevention programme.

Health-related quality of life in children and adolescents born very preterm and its correlates: a cross-sectional study

ObjectiveWe aimed to assess health-related quality of life (HRQOL) in a cohort of very preterm born children and adolescents (aged 5–16), and to compare it with their fullterm born siblings...

Health-related quality of life of toddlers during and after cancer treatment

BackgroundThere is a knowledge gap regarding health-related quality of life (HRQOL) in childhood cancer patients below 2 years of age. The aim of this study was therefore to compare HRQOL of young children during and after treatment for cancer, to healthy controls, and to investigate effects of biopsychosocial factors. ProcedureThe study is based on data from an online monitoring program. Parent-proxy reports of HRQOL in 205 children aged 12–24 months were compared to 108 healthy children. The parents filled out the TNO-AZL Preschool Quality of Life questionnaire for young children, which consists of 12 subscales, in addition to a parental distress thermometer. ResultsParticipants undergoing treatment had less favorable HRQOL than children after treatment for eight of the subscales. They also had less favorable HRQOL than healthy children for seven scales, while the only significant difference between children off treatment and healthy controls was for motor functioning. For ten subscales, there were significant relationships between biopsychosocial variables and HRQOL outcomes. Parental distress and treatment with immunotherapy were the variables most frequently associated with lower HRQOL. ConclusionsParental distress should be considered when monitoring young childhood cancer patients. Treatment with immunotherapy is likely to be a marker of disease severity and might represent other underlying factors affecting HRQOL. The association between immunotherapy and HRQOL therefore needs more research. While there was a significant difference depending on treatment status, it cannot be concluded that this represents an improvement in HRQOL after end of treatment.

Maladaptive eating behaviors and health-related quality of life in Spanish children

In children, assessing health-related quality of life (HRQoL) and identifying the factors that can influence it are essential to understanding their overall health and well-being. Although eating disorders in children have been associated with reduced HRQoL, the impact of maladaptive eating behaviors, such as external eating, emotional eating and restrained eating, on children's HRQoL has not yet been prospectively explored. Therefore, the aim of this study was to determine whether external, emotional and restrained eating at baseline was associated with HRQoL in children after 14.65 months (95% CI: 14.57–14.73) of follow-up. The study involved 690 boys and 681 girls aged between 8 and 10 years, recruited from primary schools in Catalonia (Spain). To assess the relationship between external, emotional and restrained eating behaviors at baseline and HRQoL at follow-up, the Dutch Eating Behavior and KIDSCREEN-10 questionnaires were used, respectively. After adjusting for sex, age, intervention allocation group, school, maternal education, zBMI and physical activity, external and emotional eating behaviors at baseline were negatively associated with HRQoL at follow-up (p < 0.01). These associations were attenuated after final adjustment for HRQoL at baseline. Furthermore, a composite score of maladaptive eating behaviors at baseline was created by summing the individual scores for emotional, restrained and external eating behaviors. This composite score showed a significant inverse association with HRQoL at follow-up, even after adjusting for baseline HRQoL (p = 0.024). In conclusion, external and emotional eating behaviors seems to negatively affect HRQoL prospectively in Spanish children. The composite score of maladaptive eating behaviors showed a stronger inverse association with HRQoL than each eating behavior individually. Trial registration numberISRCTN registry: ISRCTN68403446; Date of registration, August 01, 2014 ′Retrospectively registered'.

Health-related quality of life of children and adolescents with sickle cell disease: An evolutionary concept analysis

The concept of Health-Related Quality of life (HRQOL) of children and adolescents with Sickle cell disease (SCD) is not clearly understood due to the lack of available studies. This review aimed to elucidate various attributes and related concepts of HRQOL in children and adolescents with SCD using Rodgers' (2000) concept analysis framework. A systematic search was performed to identify studies reporting the attributes, antecedents, consequences, surrogate terms, and related concepts of HRQOL in children and adolescents with SCD. The review included 75 articles, including 70 quantitative, two mixed-methods, and three qualitative studies. These were categorized into attributes, antecedents, consequences, surrogate terms, related concepts, and an exemplar of HRQOL in children and adolescents with SCD. The review identified nine important attributes. It includes multidimensional and dynamic concepts, acknowledging the illness, maintaining emotional balance and self-control, coping with the disease, pain management, stigma and discrimination, treatment burden, palliative care and personal resilience. The antecedents were knowledge and attitude toward the disease, self-efficacy, social support, spirituality and spiritual well-being, disease severity, access to healthcare, environmental factors, and financial considerations. The consequences were independence in personal life, improved physical health outcomes, psychological well-being, family and caregiver well-being, improved family, social and peer relationships and social interactions, improved school performance, and improved overall HRQOL and long-term outcomes. This analysis provides an overview of HRQOL concepts related to children and adolescents with SCD, guiding further research into nursing care and clinical practice.

Development and testing of a videogame intervention for symptom management among 8–18 years old children with cancer: a study protocol

IntroductionEvidence shows that cancer treatment-related symptoms could be managed effectively in 8–18 years old children through Digital Health Interventions (DHIs), consequently improving their health-related quality of life (HRQOL). However, limited...

Taste and smell are associated with dietary intake, eating behavior, nutritional status, and health-related quality of life in children with cancer

Background & aimsSmell and taste changes are frequently reported bothersome treatment symptoms during treatment for childhood cancer and assumed to influence outcomes such as food intake. Since nutritional status of children with cancer is already vulnerable, any detrimental effects on food intake should be prevented. Therefore, understanding the exact relationship between chemosensory changes and dietary intake, eating behavior, and other domains such as health-related quality of life (HRQoL), is important for improving outcomes. MethodsIn this longitudinal study, we followed 87 childhood cancer patients treated for hematological, solid, or brain malignancies. Smell (odor threshold and odor identification) and taste function (total taste score) were objectively investigated using commercial Sniffin’ Sticks and Taste Strips respectively, and by self-report. Dietary intake was measured using a 3-day food dairy. For nutritional status, BMI expressed as standard deviation scores was derived from medical records. Eating behavior and HRQoL were assessed by the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and PedsQL 4.0 Generic Core Scales, respectively. Measurements were taken approximately 6 weeks (T0), 3 months (T1), 6 months after starting chemotherapy (T2), and 3 months after termination of chemotherapy or maintenance phase for children with acute lymphoblastic leukemia (ALL) (T3). Dietary intake, eating behavior, nutritional status, and HRQoL were modelled over time using mixed model analysis. Associations between smell and taste (objective and self-report), as well as patient characteries were studied. ResultsEnergy intake significantly increased during the study period, with a higher age, BMI, and total taste scores associated to this increase. Boys had higher energy intake compared to girls. Eating behavior scores significantly declined, indicating less eating problems. Age, pre-diagnosis eating behavior, self-reported smell changes, and tube feeding were associated to eating behavior. BMI significantly increased, with a higher BMI at diagnosis to be related to a higher BMI during the study period. A lower BMI was found in children receiving tube feeding and self-reported taste changes. HRQoL improved during the study period, with lower HRQoL in children receiving tube feeding and self-reported taste changes. ConclusionBoth objective and subjective measures of taste and smell influence dietary intake, eating behavior, nutritional status, and HRQoL. Individual dietary advice and coping strategies are warranted to prevent detrimental effects of chemosensory changes on food intake and clinical outcomes in children with cancer.

Quality of Life of Children After Completion of Surgical Treatment for Anorectal Malformation: A Single-centre Cross-sectional Study in South-Western Uganda

BackgroundAnorectal malformations (ARMs) range from abnormalities such as imperforate anus to complex forms such as cloaca and are often associated with other anomalies and residual functional stooling problems. The present study aimed to evaluate the quality of life (QoL) of children after surgical treatment for ARMs at Mbarara Regional Referral Hospital (MRRH) in South-Western Uganda. MethodsIn this cross-sectional study, we enrolled children who had completed surgical treatment for ARMs between 2014 and 2021 at MRRH. A 23-item PedsQL 4.0 inventory was used to evaluate health-related QoL in children using a multidimensional parent proxy reporting for children aged 3 years to 7 years and child self-reporting for children aged 8–17 years. Regression analysis was used to determine the association between sociodemographic and clinical variables and QoL. Crude and adjusted coefficients and their corresponding 95% confidence intervals (CI) were calculated. The significance level was set to a p-value <0.05. ResultsA total of 88 participants (F:M ratio = 1.15:1) aged 3 years–18 years with a median age of 4.5 years (IQR 3–7) were enrolled. The median age at diagnosis of ARM and preliminary diverting colostomy was 3 days (range: 2–30 days) and 3 days (range: 2–60 days) respectively. Rectovestibular fistulas, 47 (53.4%), were the most prevalent subtype of ARMs, and 5.7% of children had associated anomalies. Over one-third of the participants (38.6%) had definitive surgery after 3 years of age, and PSARP was the most common procedure. The average PedsQL score was 94 out of a maximum score of 100. The mean physical functioning score was 96.7 in males and 98.9 in females. The overall mean emotional functioning score was 91 ± 2. The mean social functioning score was 92 ± 3.0. The mean school functioning score was 95.7 in males and 98.5 in females. Associated anomalies and reoperation significantly predicted poor QoL. ConclusionThe overall QoL of the participants was good. Increasing years after completion of surgery was significantly associated with good QoL scores in all dormains. Associated anomalies and reoperation were associated with poor QoL, while years after definitive surgery was associated with good QoL. There is a need for increased awareness and utilization of QoL assessments as an outcome measure after definitive surgery for ARM. Level of evidence4. Type of studyCross sectional clinical study.

Quality of life, capability well-being, financial strain and physical activity in the short- and medium-term COVID-19 post-lockdown phases in the UK: a repeated cross-sectional study.

The COVID-19 lockdowns had negative effects on children's and adults' mental and physical health. There is, however, a paucity of research that explores differences in health-related quality of life (HRQL) and well-being over time after the COVID-19 lockdowns had been lifted. Furlough during lockdowns, increases in unemployment, and the emerging cost-of-living crisis all put pressure on family finances, which could have a detrimental effect on HRQL and well-being. This study, part of the wider Active-6 study, explored how HRQL, capability well-being and family financial strain changed after the lockdowns, the relationship between these outcomes, and whether physical activity had any mediating effect on differences in HRQL and capability well-being. Cross-sectional data were collected in May-December 2021 (Wave 1) and January-July 2022 (Wave 2). Children (aged 10-11) and their parent/carer were recruited from 23 to 27 schools in each wave, respectively, and completed validated questionnaires measuring HRQL (adults - EQ-5D-5L, children - CHU9D), capability well-being (adults - ICECAP-A) and family financial strain (adults - Family Economic Strain Scale, FESS). Children also completed questions on capability well-being. Weekday minutes of moderate-to-vigorous physical activity (MVPA) were measured using accelerometers. Mixed-effects regression models, adjusted for gender, age group (adults only), IMD and highest household education, were used to explore differences in HRQL and capability well-being between waves. In addition, the moderating effect of financial strain and the mediating effect of MVPA on HRQL and capability well-being were explored. Active-6 recruited 393 parent-child pairs in Wave 1 and 436 in Wave 2. There were no differences in HRQL (EQ-5D, CHU9D) and capability well-being (ICECAP-A) scores between waves, but financial strain was worse in Wave 2 compared to Wave 1 (FESS score difference 1.14 adjusted 95% CI 0.15 to 2.12). Increased financial strain was associated with lower (worse) EQ-5D-5L, CHU9D and ICECAP-A scores. There was no evidence of a mediating effect of MVPA. Pre-COVID-19 data on HRQL were not collected, so analysis was limited to post-lockdown only. Participating parents were predominantly female and participation was lower among lower socio-economic groups, limiting our ability to explore inequalities. Intervention planning to increase physical activity and health and well-being during the COVID-19 recovery should consider the financial strain families are experiencing and the negative implications of financial strain on HRQL. There were no differences in HRQL and capability well-being in children and adults after lockdowns lifted in 2021 and a year later in 2022. The results indicate increasing financial strain, which could reflect the UK's 'cost of living crisis'. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.

Health-Related Quality of Life of Adolescents With Non-transfusion-Dependent Thalassemia in Basrah, Iraq.

Thalassemia is a chronic inherited disease with the potential for serious clinical and psychological effects. In the case of thalassemia, a cure is not currently accessible, and lifelong treatment is required. Health-related quality of life (HRQoL) is considered a crucial health outcome. This study aims to assess the HRQoL of children and adolescents with non-transfusion-dependent thalassemia (NTDT) and compare it with that of beta-thalassemia major (β-TM) and healthy subjects. This case-control study included 88 patients with NTDT and 153 age- and gender-matched healthy children and adolescents. In addition, we included 70 registered patients with β-TM. We used the short-form health survey questionnaire to assess HRQoL. Of the 88 patients, 41 were diagnosed with alpha-thalassemia intermedia (α-TI; hemoglobin H disease), and 47 were with beta-thalassemia intermedia (β-TI). HRQoL domains were significantly higher in healthy children and adolescents compared to NTDT patients (P<0.001); the role emotion domain was the most affected in NTDT patients (51.92 ± 3.37), followed by general health (52.72 ± 3.05) and role physical (53.59 ± 3.13). α-TI patients had significantly higher HRQoL domains than patients with β-TI. The study also indicated that NTDT patients had significantly better QoL scores compared to β-TM patients (P<0.001) across all domains. NTDT patients have a lower HRQoL compared to healthy controls. However, their HRQoL scores are significantly better than those of patients with β-TM. Among NTDT patients, those with α-TI have significantly better HRQoL scores compared to patients with β-TI.

An analysis of health-related quality of life in children and adolescents after parotidectomy based on patient-reported outcomes.

To assess health-related quality of life (HRQoL) and its influencing factors in these pediatric patients undergoing parotidectomy. This was a cross-sectional study that included 37 children and adolescents (≤ 19years) with parotid gland tumors who were treated in Sichuan Cancer Hospital between January 2006 and November 2021. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). The Wilcoxon rank sum test was used to analyze the factors influencing patients' HRQoL. 37 children and adolescents were included in the study, including 22 cases of benign tumors and 15 cases of malignant tumors. All patients underwent surgery, and some patients with malignant tumors received radiotherapy or chemotherapy. Malignancy, permanent facial palsy, and Frey syndrome were associated with worse HRQoL in children and adolescents with parotid gland tumors. Radiotherapy and no cervical lymph node dissection were associated with worse HRQoL in pediatric patients with malignancy. The surgical approach of parotid is not a factor influencing HRQoL. Factors associated with HRQoL in children and adolescents with parotid gland tumors include pathological types, permanent facial palsy, and Frey syndrome. In addition, factors affecting patients with malignancy include lateral lymph node dissection and radiotherapy.

Risk and protective factors associated with health-related quality of life in children and adolescents with ADHD in Germany - Findings from the consortium project INTEGRATE-ADHD.

The health-related quality of life (HRQoL) of individuals living with Attention-deficit/hyperactivity disorder (ADHD) is known to be impaired. Identifying factors that influence HRQoL can provide important information for the development of prevention and intervention programmes for affected children and adolescents. The aim of the present study was to investigate health care-related and psychosocial risk and protective factors for HRQoL in children and adolescents with an administrative ADHD diagnosis. In the consortium project INTEGRATE-ADHD, n = 4,809 parents of children and adolescents aged 7 to 17 years participated in an online survey between October 2021 and August 2022 and answered questions regarding HRQoL (KIDSCREEN-27), health care utilisation, and psychosocial risk and protective factors. Multiple linear regression analyses were conducted to assess the association between these factors and the five HRQoL dimensions of the KIDSCREEN-27. Findings indicate that parental psychopathology and parental burden were risk factors for lower HRQoL in children and adolescents with ADHD. Further, a positive association was found between the five HRQoL dimensions and the psychosocial factors family climate and social support, indicating that these are protective factors. The results highlight the importance of prevention and intervention programmes for individuals with ADHD that consider parental mental health and aim to strengthen resources such as the availability of good family climate and social support.

Comparative analysis of health-related quality of life between children with bladder and bowel dysfunction versus lower urinary tract dysfunction and healthy controls.

This study aimed to compare health-related quality of life (HRQoL) between children with bladder and bowel dysfunction (BBD) and lower urinary tract dysfunction (LUTD) alone and healthy controls based on self-report forms and parent-proxy report forms. In this retrospective study, clinical records were reviewed. Children with LUTD, with or without bowel dysfunction, and healthy children were included in this study. The dysfunctional voiding scoring system and Rome IV Diagnostic Criteria were used to assess lower urinary tract symptoms. The Rome IV Diagnostic Criteria was also used to evaluate bowel symptoms. The Pediatric Quality of Life Inventory 4.0 (PedsQL) questionnaire was administered to investigate pediatric HRQoL. Of the total 252 children (mean age, 7.3±2.1 years) who participated in this study, 78 were classified into the BBD group and 174 into the LUTD group. Compared with the control group, the BBD group had significantly lower total PedsQL scores (p<0.001) and psychosocial healthy summary scores (p<0.001). The BBD group had significantly lower emotional functioning scores than the LUTD group (p=0.023). Children with BBD who presented with fecal incontinence (FI) had a significantly lower social functioning score than those without FI (p=0.023). Children with BBD who present with FI are at higher risk of decreased psychosocial HRQoL, and they require special emotional support. These findings underscore the need for effective treatment and follow-up to improve the HRQoL of children with BBD who presented with FI.

Are diet quality and dietary acid load associated with health-related quality of life in children and adolescents with celiac disease?

Purpose This study aims to examine the dietary compliance of children and adolescents with celiac disease (CD) and their diet quality (DQ) and dietary acid load (DAL) and to determine the relationship of these dietary parameters with health-related quality of life (HRQoL). Design/methodology/approach Ninety-one children and adolescents with CD and 144 healthy peers were included in this cross-sectional study. Anthropometric measurements were conducted by researchers. DQ and DAL were calculated from participants’ 24-h dietary recall records. HRQoL was assessed using the Pediatric Quality of Life Inventory, and compliance with a gluten-free diet (GFD) was obtained using the GFD score. Data was collected through a face-to-face questionnaire. Findings Of celiac patients, 53.1% were strictly compatible with the GFD, and 35.8% were non-compliant with the diet. The DQ scores of participants with CD were higher than their healthy peers, and the DAL scores were lower (p &lt; 0.01). Finally, no relationship was found between the DQ and DAL with HRQoL scores in celiac patients (p &gt; 0.05). However, better dietary compliance with the GFD was associated with improved HRQoL (p &lt; 0.05). Practical implications While DQ and DAL had no association with HRQoL, better dietary compliance improved the HRQoL of celiac patients. This may help develop solutions to the problems experienced by celiac patients, thereby improving the management of CD. Originality/value To the best of the authors’ knowledge, this study is the first to investigate the association of DQ and DAL with HRQoL in children with CD.