Total Health-related Quality Of Life Score Research Articles

Predictive factors associated with health-related quality of life in patients with colorectal cancer in Iran: a cross-sectional study

ObjectivesThis study aims to identify the primary factors influencing health-related quality of life (HRQoL) in patients with colorectal cancer (CRC), hypothesising that specific patient characteristics and clinical factors significantly impact...

Health-related quality of life in young adults with perinatal HIV after transfer to adult health care in the Netherlands.

Health-related quality of life (HRQoL) in adult people with HIV is lower than that of the general population. Previously, no differences were detected in HRQoL of Dutch children with perinatal HIV (PHIV) compared to norm groups. In this study we compared HRQoL of PHIV young adults (PHIV-YA, aged 18-30) to two norm groups; the healthy Dutch YA population and YA with various chronic conditions. Participants received questionnaires on HRQoL, adherence and demographics. Additional social and healthcare-related variables were collected from patients' medical files. We explored correlations between HRQoL and demographic characteristics. Effect sizes (ES, Hedges' g with confidence intervals) were calculated to quantify the difference between PHIV-YA and norm groups. Of 81 participants, 53 filled out the questionnaires. Compared with the healthy Dutch YA population, PHIV-YA 18-30 had significantly lower HRQoL scores in the school/work subscale. PHIV-YA aged 26-30 had significantly lower total, physical and psychosocial HRQoL scores as well. Participants in the older age category had lower HRQoL scores throughout all subcategories as compared to the younger age group.For PHIV-YA aged 18-25 lower scores on the school/work subscale were correlated with substance use and being born outside the Netherlands. PHIV-YA had low HRQoL scores in school/work functioning compared with the healthy Dutch YA population. The circumstances driving these outcomes are likely to be multi-dimensional, including HIV infection, social background and challenges in growing up with a chronic condition.

SARS-CoV-2 vaccine hesitancy and its relationship with health-related quality of life in patients with heart failure - pilot cross-sectional study

Abstract Introduction Heart failure (HF) is a complex disease which influences various aspects of life. The latest COVID-19 outbreak exposed that HF patients were at higher risk of severe outcomes and mortality after being infected with SARS-CoV-2. Therefore, vaccination against SARS-CoV-2 is particularly recommended in that group. However, vaccine hesitancy is a growing problem, and it also affects vulnerable HF patients. Health-related quality of life (HRQoL) may be related to the resignation from vaccination against SARS-CoV-2. Purpose The study aims to assess the relationship between avoiding vaccinations against SARS-CoV-2 and HRQoL using the World Health Organisation Quality of Life Brief questionnaire of Life Brief (WHOQOL-BREF) in patients with heart failure. Methods To evaluate the HRQoL, the WHOQOL-BREF questionnaire was used. 117 patients hospitalized with a diagnosis of HF in 2022 irrespectively of left ventricle ejection fraction (LVEF) at the cardiology department were interviewed. Additionally, a detailed medical history was collected. Until the beginning of 2022, all patients could receive the vaccine. Patients were divided into two groups - vaccinated against SARS-CoV-2 and unvaccinated. HRQoL domain scores and total HRQoL were compared between the mentioned groups using the U-Mann Whitney test. Results The mean age of enrolled patients was 55.3±17.4 years, 21.4% were women, and the mean LVEF was 30.3±14.4%. 13 (11.1%) patients were not vaccinated against SARS-CoV-2 at the time of the interview. There was no difference in total HRQoL (p=0.437) and individual domains scores: somatic (p=0.787), psychological (p=0.171), social (p=0.261) and environmental (p=0.834) between both study groups. Patients avoiding vaccination against SARS-CoV-2 compared to vaccinated patients were younger (39.7±13.8 years vs. 57.3±6.9 years, p<0.001) and had lower LVEF (23.8±14.0% vs. 31.3±14.3%; p=0.04). In the unvaccinated group of patients, the duration of HF was three times shorter (mean 4.3 vs.12.4 years, p=0.002). Conclusions The study revealed no differences in domains of the WHOQoL-BREF questionnaire and overall HRQoL between patients who decided to vaccinate and those with the opposite decision. Almost 90% of the patients with HF were vaccinated against SARS-CoV-2. Younger HF patients are more hesitant to vaccinate against SARS-CoV-2, which is consistent with the trend observed in HF patients [1] and the general population [2]. Further studies could better characterize the patients with heart failure who are vaccine-hesitant. Eventually, it could help develop more specific care to convince them to vaccinate.

Lost in transition? Loss of follow-up and quality of life in adults after resection of choledochal malformation in childhood.

Choledochal malformation (CM) is a rare disease that can lead to malignancy and potential long-term sequelae despite surgical resection. There is no long-term follow-up data on patients after CM resection in Germany. We aimed to determine the long-term outcome of our patients with a duration of follow-up >10 years and focused on long-term sequelae and health-related quality of life (HRQOL). All patients who had undergone CM-resection in our department from 01/1978 to 06/2009 were contacted. Patients were interviewed about postoperative complications and their present medical attendance. HRQOL was determined using Pediatric Quality of Life Inventory 4.0 (PedsQL), version for adults. The PedsQL scales the HRQOL from 0 to 100, with higher scores indicating a better HRQOL. Scores were compared to those published for a healthy population. Out of 56 patients who were contacted, 23 (41 %) participated. The median age at time of surgery was 3.1 years (6days-16.1 years) and at time of the survey 24.3 years (11.1-53.8 years). Eighteen patients (78 %) had ceased their gastroenterologic follow-up at a median time of 4.3 years after surgery. Five (22 %) were still in gastroenterologic follow-up, two of these had an uneventful clinical course, and three (13 %) had ongoing complications attributed to the CM. One of these had undergone hemihepatectomy 34 years postoperatively due to bile duct stenosis, one had undergone removal of bile duct stones 14 years postoperatively, and one suffered from portal vein thrombosis with esophageal and jejunal varices. There was no mortality in our series. Median total HRQOL score was 89. There was no significant difference in the median total health, physical health, and psychosocial health scores of our patients in comparison to the healthy population. We confirmed that the majority of patients after CM resection are lost to follow-up. Those who answered our questionnaire showed a good HRQOL. Given the high rate of severe long-term complications and the life-long risk of malignancy, we recommend a transition program for all patients.

Physical function, physical activity, and health-related quality of life among Japanese children aged 8–12 years

Background Health-related quality of life (HRQOL) is indicative of an individual’s overall health status, and identifying factors that influence HRQOL is important in improving HRQOL. This study investigated associations between the physical function, with focus being placed on the balance ability, and HRQOL. Methods This cross-sectional study assessed HRQOL using the Paediatric Quality of Life Inventory. Based on their total, physical, and psychosocial HRQOL scores, participants were divided into higher and lower score groups. Multivariate logistic regression analysis was used to identify physical function that affect HRQOL. Results This study included 323 Japanese children aged 8–12 (167 girls, mean age 10.5 ± 1.4 years). The analysis revealed that the total score correlated with balance ability (odds ratio 1.030; p = 0.017) and cardiorespiratory fitness (odds ratio 0.963; p = 0.004). Physical scores correlated with lower body muscle strength (odds ratio 1.020; p = 0.029) and balance ability (odds ratio 1.034; p = 0.006). Psychosocial scores correlated with balance ability (odds ratio 1.024; p = 0.042) and cardiorespiratory fitness (odds ratio 0.972; p = 0.023). Conclusion Notably, the balance function was tied to all HRQOL scores among physical functions. The results suggest that improving balance ability is important for maintaining and improving HRQOL.

Health-related quality of life among paediatric patients with coarctation of the aorta: an observational study

ABSTRACT Advancements in early diagnosis and paediatric cardiac surgery have improved the long-term survival of patients with congenital heart disease, necessitating a thorough assessment of their health-related quality of life (HRQoL). This study aimed to assess HRQoL in paediatric patients with coarctation of the aorta (CoA) (both as reported by patients and caregivers), and to evaluate associated factors. Patients aged 5–18 years diagnosed with CoA and their parents were enrolled at Bambino Gesù Children’s Hospital between September 2016 and December 2017. Socio-demographic characteristics were recorded using a family form, and the Pediatric Quality of Life Inventory (PedsQL) 3.0 cardiac module was used to evaluate HRQoL. Clinical data were retrieved from medical chart reviews. In this observational study, sixty-five pediatric patients (39 males, median [IQR] age 12 [9–14]) with CoA and their parents (65 mothers and 65 fathers) were enrolled. These patients exhibited overall good HRQoL. Mothers reported significantly lower total HRQoL scores compared to patient self-reports (p = .037), as well as treatment anxiety (p = .033), and cognitive problems (p = .021). Pediatric patients with CoA perceived their HRQoL better than their mothers did. Female sex and older age were associated with lower HRQoL scores.

Quality of life in children and adolescents after treatment for acute lymphoblastic leukemia according to the NOPHO ALL2008 protocol.

The improved outcome of childhood acute lymphoblastic leukemia (ALL) over the last decades has increased the importance of assessing late effects and health-related quality of life (HRQoL), particularly when evaluating and comparing outcomes in clinical trials. This study aimed to assess HRQoL in children treated for ALL according to the NOPHO ALL2008 protocol. Children, aged 1 to less than 18years at diagnosis, alive in first remission, and their parents, were asked to complete PedsQL 4.0 Generic Core Scales (self- and proxy-report) at ≥6months after end of therapy. Data on socioeconomic factors and parent-reported toxicity were collected through a study-specific questionnaire, and the NOPHO ALL2008 database was used to identify eligible families and add additional disease- and treatment-related data. HRQoL data were collected during 2013-2019 in Sweden, Finland, and Denmark. A total of 299 children were included. The older children (8years and older) reported similar HRQoL scores compared to Finnish reference data, except lower scores for School Functioning in high-risk patients. Scores from the parent-proxy and self-reports from 5-7-year olds were notably lower than reference. Parent-reported toxicity was associated with lower total and physical HRQoL scores in adjusted models for younger as well as older children in the self-report and parent-proxy versions, and also with lower psychosocial score in the parent-proxy. Self-reported HRQoL was similar to reference population. The most important determinant for HRQoL after end of ALL treatment was parent-reported toxicity during treatment. Thus, minimizing complications is an obvious focus for future treatment protocols.

Functional gastrointestinal disorders, quality of life, and behaviour in adolescents with history of infant colic.

To assess the prevalence of functional gastrointestinal disorders (FGIDs), health-related quality of life (HRQOL), and behavioural problems in a cohort of adolescents with a history of infant colic (IC), as defined by Wessel's criteria. 388 adolescents, aged 15-18 years, who participated in a randomised controlled trial for infants with colic, were invited for our observational follow-up study. Prevalence of FGIDs was assessed with the Rome IV Questionnaire on Paediatric Gastrointestinal Disorders (RIV-QPGD), HRQOL through self-report of the Paediatric Quality of Life Inventory (PedsQL), and behavioural problems through parent-report of the child behaviour checklist (CBCL). Multivariable models were used to compare prevalence rates of FGIDs and HRQOL scores. 190 (49%) adolescents with a history of IC (cases) and 381 controls were included (median age 17.0 [IQR 16.0-17.0] and 16.0 [15.0-17.0] years, respectively). Cases had a significantly higher risk for postprandial distress syndrome compared to controls (aOR 2.49 (95%CI 1.18-5.25), p = 0.002). After multivariable regression, total, physical and school HRQOL scores were significantly lower in cases compared to controls (p = 0.003, 0.001, and 0.009). Adolescents with a history of IC demonstrate higher prevalence rates of postprandial distress syndrome compared to controls. However, conclusions should be made with caution due to attrition and information bias.

Sleep duration and quality are associated with health-related quality of life in adults aged 60years and older.

The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons. This study was conducted on a representative sample of 3452 Iranian older people (≥ 60years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL. More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7h) and long sleepers (equal or more than 9h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001). The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.

Multicomponent Intervention for Overactive Bladder in Women

Although the cognitive components of behavioral therapy for overactive bladder (OAB) are widely recognized, there is a lack of studies evaluating the effectiveness of multicomponent interventions that include cognitive components as a treatment for OAB. To examine the efficacy of a multicomponent intervention in improving health-related quality of life (HRQOL) for women with moderate to severe OAB. This multicenter, open-label, randomized clinical trial was conducted in Japan among women aged 20 to 80 years who had moderate to severe OAB. Participants were recruited from 4 institutions between January 16, 2020, and December 31, 2022, through self-referral via advertisement or referral from the participating institutions. Participants were randomized 1:1 by minimization algorithm using an internet-based central cloud system to four 30-minute weekly sessions of a multicomponent intervention or waiting list. Both groups continued to receive baseline treatment throughout the study period. The primary outcome was the least-squares mean changes from baseline through week 13 in HRQOL total scores of the OAB questionnaire between 2 groups. Secondary outcomes included OAB symptom score and frequency volume chart. A total of 79 women were randomized to either the intervention group (39 participants; mean [SD] age, 63.5 [14.6] years) or the waiting list control group (40 participants; mean [SD] age, 63.5 [12.9] years). One participant from each group dropped out from the allocated intervention, while 5 participants in the intervention group and 2 in the control group dropped out from the primary outcome assessment at week 13. Thirty-six participants (92.3%) in the intervention group and 35 (87.5%) in the control group had moderate OAB. The change in HRQOL total score from baseline to week 13 was 23.9 points (95% CI, 18.4-29.5 points) in the intervention group and 11.3 points (95% CI, 6.2-16.4 points) in the waiting list group, a significant difference of 12.6 points (95% CI, 6.6-18.6 points; P < .001). Similar superiority of the intervention was confirmed for frequency of micturition and urgency but not for OAB symptom score. These findings demonstrate that a multicomponent intervention improves HRQOL for women with moderate to severe OAB and suggest that the cognitive component may be an effective treatment option for women with OAB. UMIN Clinical Trials Registry Identifier: UMIN000038513.

Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance

Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance. A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance. Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively. IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.

Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction

Abstract Objective To determine factors that affect the health-related quality of life (HRQOL) of congestive heart failure (CHF) patients with preserved and reduced ejection fraction. Methods A cross-sectional study design was used for this study. The stratified random sampling was applied for each subgroup. HRQOL was measured with the Minnesota Living with Heart Failure Questionnaire. The data were analyzed using chi-square, Spearman’s correlation analysis, and independent t-test. Results A number of 67 respondents participated in the recent study. The total mean scores of HRQOL were significantly different (P = 0.001) between heart failure (HF) patients with reduced and preserved ejection fractions, 41.07 ± 7.54 and 54.97 ± 4.36, respectively. It related with the physical (mean ± standard deviation [SD] = 10.4 ± 2.14; t = −10.08, 95% CI = −12.46 to −8.34; P-value = 0.001) and psychological (mean ± SD = 3.5 ± 0.5; t = −6.68, 95% CI = −4.55 to −2.45; P-value = 0.001) domain. Strong correlation was found between age (r = −0.898, P &lt; 0.05), NYHA functional classes (r = −0.858, P &lt; 0.01), duration of HF (r = −0.807, P &lt; 0.01), family support (r = 0.927, P &lt; 0.01), and quality of life (QoL). Conclusions HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction. Family support is a further determinant factor that has a positive correlation to the QoL.

Health-related quality of life of Indonesian children with hemophilia.

Measuring health-related quality of life (HRQoL) in haemophilia patients provides a comprehensive patient's functional and the impact of the disease and its treatment. This study aimed to assess the HRQoL of haemophilia children and related factors. We conducted a cross-sectional study from 6 April 2019 to 29 April 2019. We recruited children aged 8-16years old who were members of the Yogyakarta Province Branch, Indonesian Haemophilia Society. Children filled in the Indonesian Haemo-QoL short-version questionnaire that consists of nine dimensions, and the score ranges from 0 to 100, in which a higher score shows a higher impartment. Forty-four children participated in this study. The mean age was 11.99+2.49. The median age of the first bleeding episode was 5years, and the median frequency of spontaneous bleeding during the previous year was 13.5. All children received antihemophilic factor (AHF) on-demand; most (81.8%) received AHF in the advanced symptoms. The mean total score of HRQoL was 42.7±15.5, with the highest impairment in the family dimension, with a mean score of 68.0±22.3. The severity of haemophilia was significantly correlated with the total score of HRQoL and dimensions of physical health, feeling, view, and family (effect size ranges from 0.30 to 0.42). The frequency of bleeding was significantly related to the total score of HRQoL and the feeling dimension (effect size of 0.47 and 0.34). The HRQoL of our study was lower than in countries where AHF prophylactic is provided. More severe haemophilia and more frequent bleeding significantly lower HRQoL.

Body Dissatisfaction, Weight Status and Health-related Quality of Life in Adolescents

Background: Studies on the effect of weight on quality of life provide conflicting results. The purpose of the research was to assess the interconnection between the anthropometric variables and health-related quality of life (HRQoL) in a community-based sample of schoolchildren and to establish the role of body dissatisfaction (BD) in this association. Methods: A number of tenth-year schoolchildren ( n = 413) completed a questionnaire making it possible to describe their sociodemographic and behavioral characteristics and assess body satisfaction and HRQoL (PedsQL 4.0, France). The hypothesis of BD as reflecting the relationship between anthropometric variables and HRQoL was tested using the logistic regression method. Results: No significant correlation was found between BMI and integral HRQoL scores. Waist circumference showed a significant negative correlation with the HRQoL scores in the girls, but not in the boys. The frequency of BD was 60.3% ( n = 249). The relationship between BD and anthropometric variables proved to be differently directed in the boys and the girls. BD had a significant negative correlation with psychosocial and total HRQoL scores in adolescents of both sexes and with the girls’ physical functioning scores. The relationship between HRQoL and anthropometric indices in the girls, after making adjustment for sociodemographic, behavioral variables and BD in multivariate models, was no longer significant. Conclusion: This study has shown that BD is widespread among adolescents and has a significant impact on HRQoL. The impact of actual weight status on girls’ quality of life is entirely mediated by their dissatisfaction with their own bodies, thus justifying the approach to BD as a stand-alone problem having important psychosocial implications and requiring active identification and targeted intervention.

Effect of thyroid-stimulating hormone suppression on quality of life in thyroid lobectomy patients: interim analysis of a multicenter, randomized controlled trial in low- to intermediate-risk thyroid cancer patients (MASTER study).

Current clinical practices favor less or no thyroid-stimulating hormone (TSH) suppression for low- to intermediate-risk thyroid cancer patients who receive thyroid lobectomy. The association of TSH suppression on health-related quality of life (HR-QoL) in patients after thyroid lobectomy is not well studied. This study aimed to evaluate the effect of TSH suppression on patient HR-QoL after thyroid lobectomy. This study included patients enrolled in an ongoing, multicenter, randomized controlled study investigating the effects of TSH suppression. Patients were randomized to either the low-TSH group (TSH target range, 0.3-1.99 µIU/mL) or the high-TSH group (TSH target range, 2.0-7.99 µIU/mL). The HR-QoL, hyperthyroidism symptom, and depression symptom questionnaires performed preoperatively and 2 weeks and 3 months postoperatively were evaluated. Total of 669 patients (low-TSH group, 340; high-TSH group, 329) were included. Although total HR-QoL score changes were not different between the 2 groups, the high-TSH group had a significantly higher score in the physical domain at postoperative 3 months (P = 0.046). The 2 groups did not have significant differences in hyperthyroidism and depression scores. In the short-term postoperative period, the physical HR-QoL scores in thyroid lobectomy patients were better when they did not receive TSH suppression. This study suggests the importance of considering HR-QoL when setting TSH suppression targets in thyroid lobectomy patients.

Longitudinal evaluation of health-related quality of life after removal of high-risk melanoma in a setting where adjuvant therapy is not available.

To evaluate health-related quality of life (HRQoL) of people with a high-risk skin melanoma after completion of the primary surgical treatment over time, as well as, to identify factors associated with better HRQoL at the beginning and at the end of follow-up. The study included subjects with histopathologically confirmed high-risk skin melanoma in clinical stages IIC, IIIA, IIIB, and IIIC, in whom clinical and radiographic signs of the disease were not confirmed after primary surgical treatment. The HRQoL was evaluated using Short Form-36 (SF-36) after completion of primary surgical treatment (start of follow-up) and after 6 to 12months (end of follow-up). A total of 71 people completed SF-36 at both points in time. There were no significant differences between the initial and the follow-up total HRQoL score (t = 1.118; p = 0.267). At the start of follow-up, having fewer depressive symptoms, better functional status and lower vitamin D serum levels were associated with a better total HRQoL score. At the end of follow-up, having lower Breslow depth and being employed at the start of follow-up, having fewer depressive symptoms and lower C-reactive protein (CRP) serum levels at follow-up, and not developing metastases over follow-up were associated with a higher total HRQoL scores. The HRQoL of people with high-risk melanoma did not change in the year following the complete removal of the tumor. However, presence of depressive symptoms and metastases seem to have the strongest impact on poorer quality of life after surgery.

Assessing Health-related Quality of Life in Children with Chronic Kidney Disease in Indonesia: A Single Tertiary Hospital Study.

Health-related quality of life (HRQOL) is an important patient-reported outcome. However, HRQOL research in pediatric patients with chronic kidney disease (CKD) in developing countries is limited. This cross-sectional study involved children with CKD who attended Dr. Sardjito General Hospital between January 2017 and September 2018. In total, 82 child-parent pairs were enrolled. Total HRQOL scores were significantly lower in children with Stages 3a-5 CKD than in children with Stages 1-2 CKD in the child (69.89 vs. 82.12, P = 0.004) and parent questionnaires (72.26 vs. 81.20, P = 0.02). The scores for the physical, school, and social function domains were significantly decreased. This study showed that children with Stages 3a-5 CKD had significantly lower HRQOL scores compared with children in the Stages 1-2 CKD group. Multidisciplinary teams can provide patient-centered and comprehensive management to optimize HRQOL scores during childhood and in future adult life.

Health-Related Quality of Life after Pediatric Traumatic Brain Injury: A Quantitative Comparison between Children’s and Parents’ Perspectives of the QOLIBRI-KID/ADO Questionnaire

Pediatric health-related quality of life (HRQoL) as a measure of subjective wellbeing and functioning has received increasing attention over the past decade. HRQoL in children and adolescents following pediatric traumatic brain injury (pTBI) has been poorly studied, and performing adequate measurements in this population is challenging. This study compares child/adolescent and parent reports of HRQoL following pTBI using the newly developed Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO) questionnaire. Three hundred dyads of 8–17-year-old children/adolescents and their parents were included in the study. The parent–child agreement, estimated using intraclass correlation coefficients and Cohen’s κ, displayed poor to moderate concordance. Approximately two-fifths of parents (39.3%) tended to report lower HRQoL for their children/adolescents on the total QOLIBRI-KID/ADO score. At the same time, about one-fifth (21.3%) reported higher HRQoL Total scores for their children/adolescents. The best agreement for parents rating adolescents (aged 13–17 years) was found in terms of the Total score and the Cognition and Self scale scores. To date, parent-reported HRQoL has been the preferred choice in pediatric research after TBI. However, with a parent–child disagreement of approximately 60%, our results highlight the importance of considering self-reports for children/adolescents capable of answering or completing the HRQoL measures.

The quality of life among children with epilepsy in resource-limited settings: A pilot study in a paediatric neurology clinic at a quaternary care teaching hospital

Background. An important part of holistic care management of children with epilepsy (CWE) is measuring their health-related quality of life (HRQOL). However, little is known about the HRQOL of CWE who live in resource-limited settings, particularly in South Africa. Objectives. To assess the HRQOL of CWE and to identify the possible factors that correlate with HRQOL including demographic variables and epilepsy health-related factors. Methods. A cross-sectional prospective quantitative study was undertaken at the paediatric neurology outpatient clinic at Inkosi Albert Luthuli Hospital (IALCH), a quaternary care teaching hospital in Durban, South Africa. Participants were recruited during the period between December 2019 and February 2020. CWE between 2 and 12 years old with no comorbid syndromic disorder or other chronic diseases accompanied by English-speaking caregivers were included in the study. We used the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) generic core parent-proxy questionnaire modified with separate sociodemographic and epilepsy data collection sheets. Results. One hundred and twenty participants were recruited. The majority of patients (54.2%) had generalised epilepsy. The aetiology of epilepsy was unknown in 40.8% of patients. The most commonly used anti-seizure medication was sodium valproate (39.2%). The mean of the total score of HRQOL (SD) (coefficient of variation %) was 66.7 (24.1 (36.1). School attendance p-value&lt;0.001, financial aid for indigent families p 0.047, monotherapy p&lt;0.001, absence of disability p&lt;0.001 and absence of comorbidity p &lt;0.001were strongly associated with good HRQOL total scores. Conclusion. CWE attending IALCH in Durban, South Africa, have compromised HRQOL scores. The variables that significantly correlate with better HRQOL scores are school attendance, receiving financial aid for indigent families, monotherapy, and absence of disabilities and comorbidities. We recommend a multicentre study that involves a larger number of epileptic children with the employment of the epilepsy-specific PedsQL 4.0 module translated into local languages.

Potential Mediating Roles of Children's Health-Related Quality of Life and Weight-Related Behaviors in the Relationship Between Socio-Educational Advantage and Weight Status.

Background: Socioeconomic status is inversely associated with weight status in developed countries. Underlying mechanisms are still to be clarified. Our aim was to determine if weight-related behaviors and health-related quality of life (HRQoL) mediate the relationship between socio-educational advantage and weight status in Australian children 9 to 13 years of age. Methods: Secondary analysis of data collected by two cluster randomized trials (2019 wave). We measured children's (n = 3978) height, weight, diet, physical activity, sedentary behavior, and HRQoL. Socio-.educational advantage was assessed at school level using the Index of Community Socio-Educational Advantage (ICSEA). A counterfactual framework was used to explore potential mediators in the relationship between socio-educational disadvantage and (1) overweight/obesity and (2) BMI z-score (BMIz). Results: Low socio-educational advantage was associated with increased overweight/obesity and BMIz. The overweight/obesity association was mediated by sedentary behavior (natural indirect effect as a proportion of total, 7.5%) sugar-sweetened beverage (SSB) consumption (12.7%), physical functioning (11.9%), psychosocial health (10.9%), school (6.8%) and social functioning (15.6%), and total HRQoL score (13.8%). The ICSEA-BMIz relationship was mediated by sedentary behavior (5.7%), sleep duration (4.1%), SSB (10.6%), physical functioning (9.9%), psychosocial health (9.1%), school (5.5%) and social (13.7%) functioning, and total HRQoL score (11.7%). Conclusion: Victorian Children with low socio-educational advantage were more likely to be living with overweight or obesity. This relationship was mediated by children's sedentary behavior, SSB consumption, and HRQoL. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000980437 (registered July 26, 2016, retrospectively registered) and ACTRN12618001986268 (registered December 11, 2018, prospectively registered). https://www.anzctr.org.au/Trial/Registration.