Life In School-age Children Research Articles

Perception of quality of life in school-age children born before 32weeks of gestational age.

In our population of preterm school-aged childrenwith grades 2-3 BPD, worseperceived quality of lifewas reported compared tothose with no BPD or grade 1 BPD. Preterm children who developed asthma symptoms during the follow-up period also reported lowerperceived quality of life. No differences in QoL were observed between patients with no BPD and those with grade 1 BPD, or between thoseborn before and after 28weeks ofgestation.These findings highlightthe importance of assessing the QoLin preterm patients with BPD, particularly those with grade 2-3 BPD or asthma symptoms, as early assessment can help identify patients who may benefit from targeted interventions to improve quality of lifeand long-term outcomes. • Survival rates of extremely preterm infants have increased significantly in recent years, but respiratory morbidity, particularly bronchopulmonary dysplasia, remains a common problem. The impact of BPD on the quality of life of preterm infants, particularly at school age, is still debated. BPD is associated with an increased risk of asthma and abnormal lung function, but its effect on QoL is not fully understood. • Preterm infants with grade 2-3 BPD have a significantly worse perception of QoL at school age, especially in the domain of "social activities". This finding emphasises the need for long-term follow-up and possible interventions to improve QoL, especially in terms of social integration. Asthma symptoms during childhood also contribute to poorer QoL perceptions, highlighting the importance of early diagnosis and effective treatment.

The Correlation Between Family Support with The Quality of Life of School-Age Children with Thalassemia

Introduction: Thalassemia is a severe disease affecting many school-aged children, characterized by symptoms such as weakness and paleness due to low hemoglobin levels. These children often require routine blood transfusions, which can lead to several side effects impacting their quality of life. Generally, the quality of life for school-aged children with thalassemia is lower than that of their healthy peers. Family support is one factor that can influence the quality of life of children with thalassemia. This study investigated the relationship between family support and quality of life in school-aged children with thalassemia at Immanuel Way Halim Hospital, Bandar Lampung.Methods: The research design was descriptive-analytic with a cross-sectional approach. The sample included all school-aged thalassemia patients in the Edelweiss Hospital room at Immanuel Way Halim, totaling 28 respondents. The sampling technique used was purposive sampling, with inclusion criteria being school-aged thalassemia patients (ages 7 to 18 years) who could communicate well. Data analysis was conducted using the Chi-square test.Results: The results indicated that 19 respondents (67.9%) had positive family support, and 14 (50%) had a high quality of life. Statistical analysis showed a p-value of 0.027 (<0.05).Conclusion: There is a significant relationship between family support and the quality of life of children with thalassemia in the Edelweiss Hospital room at Immanuel Way Halim, Bandar Lampung.

Health-Related Qualities of Life in School-Aged Children with Bronchopulmonary Dysplasia

To determine health-related quality of life (HRQOL) of school-aged children with bronchopulmonary dysplasia (BPD) using the standardized Patient-Reported Outcomes Measurement Information System (PROMIS) assessment tools. The Indoor Air Quality and Respiratory Morbidity in Children with BPD Study is an ongoing observational study of school-aged children with BPD. HRQOL is assessed at enrollment by 3 PROMIS questionnaires, Parent Proxy Scale-Global Health 7, Parent Proxy Psychological Stress Experiences-Short Form, and the Parent Proxy Profile-Profile-25. PROMIS data were tested for significant deviation from the standardized T-Score references for normative populations of children. Eighty-nine subjects enrolled in the AERO-BPD study had complete outcome data for HRQOL. The mean age was 9 (±2) years and 43% were female. Mean days on respiratory support totaled 96 (±40). Across all domains, school-aged children with BPD reported similar or slightly better outcomes than the reference sample. Statistically significant findings of lower depression (P<.0001), fatigue (P<.0001), and pain (P<.0001) scores were found; there was no difference in psychological stress experiences (P=.87), global health (P=.06), anxiety (P=.08), relationships (P=.80), and mobility (P=.59) domains. This study demonstrated that children with BPD may have less depression, fatigue, and pain HRQL than the general population. Once validated, these findings may offer reassurance to parents and providers caring for children with BPD.

Indicators of quality of life in schoolchildren with abdominal pain

Aim. To study the indicators of the quality of life in school-age children with abdominal pain in the assessment of children and their parents.Material and methods. The cross- sectional method collected data on the presence of gastroenterological complaints in 542 schoolchildren aged 7–17 years. To assess the quality of life of children, adapted Russian versions of the Child Health Questionnaire were used: parental (CHQ-PF28) and child (CHQ-PF45). The calculation of indicators was carried out according to the sections characterizing various areas of the child’s life, according to a 100-point system. The studies were approved by the ethics committee and the consent of the examined was obtained.Results. The indicators of the parent and child versions of the questionnaire indicated that schoolchildren with abdominal pain had a worse quality of life on many scales compared to children who had no complaints.However, the deterioration of life indicators in schoolchildren with abdominal pain, according to a survey of children, was noted on a signifi cantly larger number of scales, which may be a refl ection of their «social orphanhood».Conclusion. Thus, a signifi cant decrease in the quality of life in schoolchildren with abdominal pain was established. There are diff erences in the assessment of children and their parents in assessing the quality of life of this category of patients.

Effect of a partnership care programme on quality of life in school-age children with leukaemia: a controlled clinical trial.

Background: Despite the low quality of life (QoL) of children with leukaemia, there is a lack of well-designed and culture-oriented care programmes to improve it. The Partnership Care Model (PCM), which was developed based on the Iranian culture, seems to be effective in improving the QoL in children living with chronic diseases. Aim: This study aimed to evaluate the effect of a care programme based on the PCM on the QoL of children with leukaemia. Methods: This controlled clinical trial encompassed 60 school-age children with leukaemia and their mothers. In the experimental group (n=30), a 2-month care programme was implemented based on the PCM, including the four stages of motivation, preparation, involvement and evaluation. Only standard care was provided to the control group (n=30). Children's QoL was assessed using the Paediatric Quality of Life Inventory 3.0 Cancer Module in the pre-test phase and 2 months after the intervention. Findings: The total score of QoL and all its subscales were significantly higher in the experimental group than the control group in the post-test phase (p<0.001). Moreover, a significant difference was observed between pre-test and post-test scores in all domains in the experimental group (p<0.001); however, no significant difference was noticed between the scores in the control group. Conclusion: The partnership care programme seems to improve the QoL in children with leukaemia. Future investigations are recommended to shed further light on the findings of this study.

Parent-report health-related quality of life in school-aged children with cerebral palsy: Across-sectional study.

Quality of life is both a goal and an outcome in Cerebral Palsy (CP) rehabilitation. Children with CP may show impaired health-related quality of life (HRQoL) compared to their typical peers. Parents' perceptions of HRQoL of their children could help rehabilitation professionals to identify areas for intervention aiming to improve health and wellbeing. This study aims to compare the proxy HRQoL of Portuguese school-aged children with CP and the general population, and to analyze child and family correlation. Differences were examined using European normative data for children from 8 to 18 years. Correlation and regression analysis examined the association between child and family variables in the CP group with statistically significant low scores. Sixty-eight parents of children and adolescents with CP (12.5 ± 2.91 years) answered the KIDSCREEN-52 parent version. We identified clinically significantly lower HRQoL in four out of ten HRQoL domains (Physical well-being, Autonomy, Moods & Emotions, and Bullying) than the norm peers. Correlations were found between the number of siblings and Autonomy (r = .315), meaning that having more siblings was associated with greater autonomy, and between mobility and Moods & Emotions (r = -.261), where children with impaired mobility shown low scores as perceived by their parents. Age, sex, mobility and cognitive impairment explained 32% of Physical well-being scores (p < .001). Mobility and cognitive impairment explained 16% of Bullying scores (p = .001). Although the family and child variables identified in this study are non-modifiable, they can help in the identification and early intervention aimed at improving HRQoL. Rehabilitation professionals should assess parent perceptions, extending the HRQoL assessment to children who can report and other informants, aiming at fostering wellbeing in children and adolescents with CP.

COVID-19-related future anxiety is associated with the health-related quality of life in school-aged children and adolescents-A cross-sectional study.

Over the course of the COVID-19 pandemic, previous studies have shown that the physical as well as the mental health of children and adolescents significantly deteriorated. Future anxiety caused by the COVID-19 pandemic and its associations with quality of life has not previously been examined in school children. As part of a cross-sectional web-based survey at schools in Mecklenburg-Western Pomerania, Germany, two years after the outbreak of the pandemic, school children were asked about COVID-19-related future anxiety using the German epidemic-related Dark Future Scale for children (eDFS-K). Health-related quality of life (HRQoL) was assessed using the self-reported KIDSCREEN-10. The eDFS-K was psychometrically analyzed (internal consistency and confirmatory factor analysis) and thereafter examined as a predictor of HRQoL in a general linear regression model. A total of N = 840 8-18-year-old children and adolescents were included in the analysis. The eDFS-K demonstrated adequate internal consistency reliability (Cronbach's α = 0.77), and the confirmatory factor analysis further supported the one-factor structure of the four-item scale with an acceptable model fit. Over 43% of students were found to have low HRQoL. In addition, 47% of the students sometimes to often reported COVID-19-related fears about the future. Children with COVID-19-related future anxiety had significantly lower HRQoL (B = - 0.94, p < 0.001). Other predictors of lower HRQoL were older age (B = - 0.63, p < 0.001), and female (B = - 3.12, p < 0.001) and diverse (B = - 6.82, p < 0.001) gender. Two years after the outbreak of the pandemic, school-aged children continue to exhibit low HRQoL, which is further exacerbated in the presence of COVID-19-related future anxiety. Intervention programs with an increased focus on mental health also addressing future anxiety should be provided.

8-14 Yaş Grubu Çocukların COVID-19 Pandemi Döneminde Sağlıkla İlgili Yaşam Kalitelerinin ve Etkileyen Faktörlerin Belirlenmesi

Amaç: Araştırmada çocukların pandemi döneminde sağlıkla ilgili yaşam kalitesi düzeyleri ve ilişkili faktörlerin belirlenmesi amaçlanmıştır.Materyal ve Metot: Kesitsel tasarım tipindeki araştırma üç ayrı ilde belirlenen altı okulda 8-14 yaş arası çocuğu olan gönüllü 1221 aile üyesi ile yürütülmüştür. Çalışmada sosyo-demografik özellikler soru formu, COVID-19 pandemi sürecinde çocuğun sağlıklı yaşam biçimi davranışları soru formu ve KIDSCREEN-27 ölçeği kullanılmıştır.Bulgular: Çalışmada; erkek, 12-13 yaş grubu, dört ve daha fazla kardeşe sahip, ailesi düşük ekonomik düzeyde olan, sessiz-sakin, duygusal-alıngan, içe dönük kişilik özelliğine sahip olan çocukların yaşam kalite puanları daha düşük bulunmuştur. Ayrıca, pandemi sürecinde uyku alışkanlığı, sosyal ilişkileri, kişisel hijyen alışkanlıkları ve sağlıklı besinleri tüketim davranışları olumsuz olarak etkilenen, dersleri için kullanımları dışında ekran maruziyeti süresi artış gösteren, kitap okumaya, hobilerine, spor ve egzersize ayırdığı süre azalan çocukların yaşam kalitesi puanları da düşük bulunmuştur.Sonuç: Çalışma sonuçları düşük yaşam kalitesi riski altında olan çocuklar için planlanacak müdahale programlarına rehber olması açısından önemlidir.

Assessment of the quality of life of school-age children with asthma and sensitization to cat allergens

Background. The medical and social significance of asthma is emphasized by the impact on various aspects of children's lives — physical, emotional, social, educational. The aim of the study: to assess the quality of life of school-age children with asthma and sensitization to cat allergens in the dynamics of treatment. Materials and methods. The study included 128 children aged 6–17 years with asthma and sensitization to cat allergens. A mini-Pediatric Asthma Quality of Life Questionnaire (MiniPAQLQ) was used. Results. All patients have a decrease in quality of life, both overall and in the assessment of symptoms, emotional function and activity. Overall quality of life is inversely correlated with the severity of asthma. There was a statistically significant difference between the overall quality of life after 12 months of treatment in children who received allergen-specific immunotherapy on the background of basic therapy and in children who received only basic therapy in favor of allergen-specific immunotherapy. The same dynamics is indicated according to symptoms, emotional function and activity. A direct correlation between overall quality of life and allergen-specific immunotherapy has been shown. Conclusions. In schoolchildren with asthma and sensitization to cat allergens, there is a decrease in quality of life. Against the background of basic therapy, their positive dynamics is observed, which is statistically significant, except for the assessment of symptoms in children with severe asthma. The inclusion of allergen-specific immunotherapy in the complex treatment of school-age children with asthma and sensitization to cat allergens to improve the quality of life of patients is justified.

Relationship Between Weight Status and Health-Related Quality of Life in School-age Children in China.

Background: Some studies from high-income countries suggest that overweight and/or obesity in children are negatively associated with health-related quality of life (HRQOL). However, the relationship between weight status and HRQOL is not well established in China, where obesity trends follow a different pattern compared with high-income countries. The risk of obesity is greater in children from higher socioeconomic backgrounds and higher in boys compared with girls.Objective: The aim of this study was to examine the relationship between weight status and HRQOL in children between 6 and 7 years old in this unique country context.Methods: Baseline HRQOL and demographic data were collected from children recruited to the CHIRPY DRAGON obesity prevention trial in China. HRQOL was measured using the Chinese version of the Child Health Utility-9D (CHU-9D-CHN) and the Pediatric Quality of Life Inventory™ (PedsQL™) instruments. CHU-9D-CHN utility scores were generated using 2 scoring algorithms (UK and Chinese tariffs). Height and weight measures were taken at school by trained researchers using standardized methods, and BMI z scores were calculated using the World Health Organization 2007 growth charts. The relationship between HRQOL and weight status was examined using multivariable analyses, adjusting for age, gender, and socioeconomic status.Results: Full data were available for 1539 children (mean age, 6 years). In both unadjusted and adjusted analyses, HRQOL, using both the CHU-9D-CHN and the PedsQL™, was marginally higher in children who were overweight or living with obesity compared with children with healthy weight, although this difference did not reach statistical significance. Separate analyses and models by gender showed that the relationship between weight status and HRQOL scores was similar in boys and girls.Conclusions: Our results suggest no statistically significant difference in HRQOL between children with overweight/obesity compared with those with healthy weight. These results have implications for the methods of economic evaluation for obesity treatment and prevention interventions within this population cohort and country setting, as there appears to be no discernible consequences on children’s HRQOL from living with overweight and obesity.

The association of social capital with depression and quality of life in school-aged children

Social capital is an important factor that affects mental health. The purpose of this study was to examine the relationship between social capital and depression and between social capital and quality of life (QoL) in children in elementary and junior high school and to examine how this relationship differs in relevant patterns at both the individual- and school-level. The study was conducted in all elementary and junior high schools in a single municipality; the subjects consisted of 3,722 elementary school and 3,987 junior high school students (aged from 9 to 15). A multilevel linear mixed effect model analysis revealed that all three subscales of social capital were associated with depression and QoL at the individual-level: The school social capital at the individual-level showed the strongest association with depression and QoL. We also found that some of social capital at the school-level was associated with depression and QoL. An interactive effect was observed between educational stage (elementary and junior high) and some of social capital subscales. Specifically, the inverse association between school social capital and depression was stronger among the junior high students, while the positive association between school and neighborhood social capital and QoL was stronger among the elementary students. These interactions suggest that social capital impacts depression and QoL differently in elementary and junior high students. These findings suggest that the degree of association of social capital domains differs in mental health among the educational stage.

Psychological Status Associated With Low Quality of Life in School-Age Children With Neurodevelopmental Disorders During COVID-19 Stay-At-Home Period.

Background: This study seeks to ascertain how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders (NDDs) who had experienced sleep schedules alteration and clarify what psychological status predicted low QOL in children with and without altered sleep patterns.Materials and Methods: Study participants were 86 children between 8 and 17 years of age (mean age, 11.7 years; 70 boys, 16 girls; mean intellectual quotient, 83.6). QOL was evaluated using the self-assessment KINDLR. Participants answered questions regarding depression and anxiety on a visual analog scale (VAS) for temporary mood. Their parents answered questionnaires regarding their maladaptive behaviors and differences in sleep patterns before and during the COVID-19 pandemic. The student's t-test was performed to examine the presence or absence of sleep changes in the children, which affected QOL, temporary mood, and maladaptive behaviors. Multiple or simple linear regression analyses were also performed to identify the psychogenic factors that significantly affected decreased QOL for each group with and without changes in sleep schedule.Results: During the COVID-19 stay-at-home period, 46.5% of participants experienced changes in sleep patterns. These changes were associated with decreased QOL as well as internalized symptoms. The decreased QOL of children with sleep patterns changed was predicted by a high level of depression. In addition, low QOL in children with unchanged sleep patterns was predicted by a high level of depression and low current mood status.Conclusions: Almost half of the participants experienced a poor sleep schedule during the stay-at-home period. These alterations in sleep patterns were associated with a low QOL. The QOL of children with a stable life schedule was affected not only by depressive tendencies but also temporary moods. Therefore, they need to live a fulfilling life to maintain their QOL. However, the QOL of children with poor sleep patterns was affected only by depressive tendencies. Hence, clinicians need to ensure that children with NDDs are well-diagnosed with depression and treated for sleep problems.

Quality of life in school-age children with shunt implantation due to neonatal posthemorrhagic hydrocephalus

To assess the functional outcome in school-age children shunted in the neonatal period due to post-hemorrhagic hydrocephalus (PHH), using the HOQ-Spanish version (HOQ-sv), and to analyze predictors of quality of life in this group. A cross-sectional study was performed between 2015 and 2018. Parents of pediatric patients with PHH attending our neurosurgery outpatient clinic were invited to complete the HOQ-sv and to enroll in the study. Clinical variables regarding the patients' neonatal course and surgical outcome were recorded. A descriptive analysis was done, and independent variables related to the HOQ scores were studied in univariate and multivariate analyses with regression trees. The study comprised a total of 52 patients. The mean overall HOQ score was 0.67 (on a scale from 0 [worse] to 1 [best]). The quality of life for the PHH children at school age was related to perinatal factors (gestational age at birth, time until shunt surgery, length of hospitalization at the time of shunt implantation, and comorbidity), shunt complications (symptomatic overdrainage, number of shunt revisions, and shunt revisions related to infection during the first year after treatment), and clinical background (seizures, spasticity, Gross Motor Function Classification System level or visual impairment). HOQ dimension scores in school-age children shunted due to PHH in our center were similar to those of referral centers for other etiologies of pediatric hydrocephalus. Future goals should be the prevention of complications related to worse outcomes at the time of diagnosis and to try to improve shunt performance later.

Impacts of Respiratory Muscle Training on Respiratory Functions, Maximal Exercise Capacity, Functional Performance, and Quality of Life in School-Aged Children with Postoperative Congenital Diaphragmatic Hernia.

Objectives Congenital diaphragmatic hernia (CDH) is a birth defect affecting the respiratory functions, functional performance, and quality of life (QOL) in school-aged children. Rarely have studies been conducted to evaluate the impacts of respiratory muscle training on school-aged children with postoperative CDH. The current study was designed to evaluate the impacts of respiratory muscle training on respiratory function, maximal exercise capacity, functional performance, and QOL in these children. Methods This study is a randomized control study. 40 children with CDH (age: 9-11 years) were assigned randomly into two groups. The first group conducted an incentive spirometer exercise combined with inspiratory muscle training (study group, n = 20), whereas the second group conducted only incentive spirometer exercise (control group, n = 20), thrice weekly for twelve consecutive weeks. Respiratory functions, maximal exercise capacity, functional performance, and pediatric quality of life inventory (PedsQL) were assessed before and after the treatment program. Results. Regarding the posttreatment analysis, the study group showed significant improvements in all outcome measures (FVC%, p < 0.001; FEV1%, p = 0.002; VO2max, p = 0.008; VE/VCO2 slope, p = 0.002; 6-MWT, p < 0.001; and PedsQL, p < 0.001), whereas the control group did not show significant changes (p > 0.05). Conclusion Respiratory muscle training may improve respiratory functions, maximal exercise capacities, functional performance, and QOL in children with postoperative CDH. Clinical commendations have to be considered to include respiratory muscle training in pulmonary rehabilitation programs in children with a history of CDH.

Effect of Implementing Family-centered Empowerment Model on the Quality of Life in School-age Children Diagnosed with Rheumatoid Arthritis

Background: Rheumatoid arthritis is the most prevalent chronic rheumatologic disease of children. The quality of life (QOL) in these individuals is affected by physical pain, discomfort, treatment complications, and frequent absences from school leading to academic failure. No research similar to the present investigation was performed in this area. Aim: We aimed to evaluate the problems of children with rheumatoid arthritis. Moreover, we assessed the effect of family-centered empowerment on the QOL of these children. Method: This randomized clinical trial was performed on 60 children aged 8-12 years diagnosed with rheumatoid arthritis in Akbar Pediatrics Hospital, Mashhad, Iran in 2018. The subjects were divided into test and control groups. The four stages of family-centered empowerment model, namely improvement of knowledge, self-efficacy, self-esteem, and assessment were executed for the test group. After a month, the inventory of pediatric quality of life was completed again. Data analysis was performed by Mann-Whitney U test, independent t-test, and paired t-test using SPSS version 16. Results: No significant difference was observed between the groups regarding age (P=0.351). In addition, the post-intervention QOL of the test group was significantly higher than the control group (P=0.004). There was a significant difference between the pre- and post-intervention QOL in the test group (P < 0.001). Implications for Practice: This study indicated the effect of family-centered empowerment model on the physical, emotional, educational, and social dimensions of QOL of children aged 8-12 years diagnosed with rheumatoid arthritis. As a result, this model is recommended to empower the children with this disease or other chronic diseases and their caregivers.

Perceptions of Methotrexate Intolerance and Its Impact on Daily Life in School-Age Children with Juvenile Idiopathic Arthritis

PurposeMethotrexate (MTX) is a disease modifying anti-rheumatic drug commonly used to treat children with Juvenile Idiopathic Arthritis (JIA). Unfortunately, half of children taking MTX will experience MTX intolerance, which includes distressing gastrointestinal and behavioural symptoms associated with weekly MTX treatment. This qualitative study aimed to explore the perceptions of school-age children with JIA experiencing MTX intolerance, how they managed MTX intolerance, and how it impacted their daily life. Design and methodsAn interpretive descriptive design was used. Twelve children participated in one individual 30-minute semi-structured interview using a storyboard technique to elicit their perceptions through storytelling. Interview transcripts and observational data collected during the interviews were analyzed using inductive content analysis. ResultsChildren described MTX intolerance as extremely challenging. Three themes emerged from the data: (1) “No kid likes taking MTX”. This theme was comprised of two subthemes related to: (a) associative MTX intolerance; namely, “Talking about it sometimes makes me feel sick”; and (b) anticipatory MTX intolerance, “Before [I take it], I have a little stomach ache”. Other themes included: (2) The importance of strategies and routines; and (3) Working hard to live with MTX intolerance. ConclusionsThis study sheds new light on MTX intolerance as perceived by school-aged children with JIA. Results highlight the importance of providing families and healthcare professionals with the necessary information for early recognition of MTX intolerance and optimizing care through the development of early intervention strategies. Practice implicationsStudy findings highlight the importance of prioritizing early identification and prevention of MTX intolerance.

Adaptive behaviour and quality of life in school-age children with congenital visual disorders and different levels of visual impairment

BackgroundAdaptive behaviours are vital skills that allow individuals to function independently and are potentially amenable to behavioural interventions. Previous research indicated that adaptive behaviours are reduced in children and adolescents with severe to profound VI, but it was unclear if this was also the case for children with mild to moderate VI. AimThe aim of the study was to assess differences in adaptive behaviour in children with congenital visual disorders and different levels of visual impairment and their influence on quality of life and everyday strengths and difficulties. Methods and proceduresQuestionnaires about adaptive behaviour, strengths and difficulties, and quality of life were completed by parents of school-age children with severe-to-profound VI (S/PVI, n = 9, 0.9 logMAR – light perception only), mild-to-moderate VI (MVI, n = 9, 0.1–0.7 logMAR), or typical sight (control, n = 18, −0.3 to 0.1 logMAR). Differences in questionnaire domains by the severity of VI and relationships between adaptive behaviour and quality of life were analysed in general linear models. Outcomes and resultsThe questionnaire ratings indicated reduced adaptive behaviour, more difficulties, and reduced quality of life in children with S/PVI compared to typically-sighted peers. Effects were smaller for children with MVI, but indicated a significant reduction in quality of life compared to typically-sighted children. The effect of visual impairment on quality of life in school was partially mediated by adaptive behaviour. Conclusion and implicationSevere congenital visual impairment affects adaptive behaviour in children with verbal abilities in the typical range. This effect is less pronounced in children with mild-to-moderate VI, but still impacts on quality of life, particularly in school.

Executive Function and Psychosocial Quality of Life in School Age Children with Congenital Heart Disease

To test a model to predict psychosocial quality of life (QOL) in children with congenital heart disease (CHD) via executive dysfunction. Parents of 91 children with CHD requiring surgery in the first year of life completed questionnaires by mail or as part of their cardiology clinic visit. Latent class analysis identified 2 groups of patients with different likelihoods of executive dysfunction. Select medical and demographic characteristics and executive dysfunction group membership were evaluated as predictors of QOL using structural equation modeling. In children with CHD, aortic obstruction, male sex, and premature birth predicted worse executive function, explaining 59% of the variance. Structural equation modeling results indicated that executive dysfunction plays an important mediating role, through which CHD with aortic obstruction, male sex, and premature birth indirectly affect psychosocial QOL. Neurologic abnormalities and single-ventricle CHD did not significantly predict executive dysfunction or QOL. Executive dysfunction is a strong predictor of psychosocial QOL at school age. Select medical and demographic risk factors did not directly predict QOL at school age in CHD; however, aortic obstruction, premature birth, and male sex impacted QOL indirectly by contributing to executive dysfunction. These findings suggest important risk factors for executive dysfunction that can be monitored, allowing for provision of early supports for executive skills development in an effort to improve long term psychosocial QOL in at-risk children with CHD.

THE COLLABORATION STRATEGY BETWEEN PUPIL AND TEACHER ON NURSING COMMUNITY TO IMPROVE THE BEHAVIOUR OF HEALTHY AND HYGIENIC LIFE TO THE WHOLE SCHOOL-AGE CHILDREN

School-age children is a golden period for embeding the values of healthy and hygienic-life behaviour (PHBS). The objective of this scientific writing was to provide an overview about the implementation of collaboration strategy between pupil and teacher in improving the behaviour of healthy and hygienic life in school-age children by utilizing the management approach of community nursing services, community nursing care, and family nursing care through the integration of community as a partner model, comprehensive school health model, family center nursing model, and management theory. Participants were pupils of Madrasah Ibtidaiyah Terpadu (MIT) at Cisalak Pasar sub-village, Cimanggis District, Depok City. The result indicated there was a significant result to the improvement of knowledge, healthy behaviour skills, and the improvement of school role and the indepedence of family. This scientific paper is expected to be fundamental of health promotion programs for school-age children.

Effects of Perceived Daily Stress and Sense of Humor on Quality of Life among School-Age Children

Purpose Quality of life is important to everyone including school-age children. Therefore this study was done to identify the effects perceived daily stress and sense of humor on quality of life for these children. Methods The study was a cross-sectional, descriptive study design with 371 participants from 5th and 6th grade children in 5 elementary schools. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 24.0 program. Results Factors influencing quality of life in school-age children were daily stress, sense of humor, satisfaction with daily life, academic performance and home atmosphere. These variables explained 63.0% of quality of life in school-age children. Conclusion Results showed that lower daily stress and higher sense of humor are associated with higher quality of life. Therefore, to improve quality of life in school-age children, healthcare providers should develop intervention programs considering these factors. Key words: ìœ ë¨¸; 삶의 질; í•™ë ¹ê¸°; ìŠ¤íŠ¸ë ˆìŠ¤ Key words: Humor; Quality of Life; School-Age; Stress