Hölling Heike, Schlack R, Dippelhofer A, Kurth B-M
Robert Koch-Institut, Berlin, BRD.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Jun;51(6):606-20. doi: 10.1007/s00103-008-0537-2.
The present publication describes chronic conditions of children and adolescents (asthma, ADHD, obesity) in relation to personal, familial and social resources and to health-related quality of life (HRQOL). A database of these investigations is the German health interview and examination survey of children and adolescents (KiGGS), which is representative for 0 to 17 year-olds. The above mentioned chronic conditions occur frequently in this age group and are assumed to have an influence on quality of life and to be related to a lower level of protective factors.
The investigations used the data of 6813 children and adolescents within the age group of 11 to 17 who participated in the KiGGS study. Information about diagnosed chronic conditions was given by the parents within the framework of the computerassisted medical interview (CAPI) and by completing questionnaires. The personal, familial and social protection factors as well as the quality of life were assessed by the questionnaires, filled in by the adolescents themselves. Instruments used were the Social Support Scale, the Family Climate Scale and KINDL-R.
Children and adolescents with asthma seem to have no deficits in the health-related quality of life and in the field of protective factors. This differs from the situation of the obese children as well as from the children with ADHD. Both groups show significant deficits in the health-related quality of life and protection factors.
The chronic conditions investigated show remarkable differences in the scale values for measuring protective factors and health-related quality of life. Possible explanations are: For asthma as a chronic disease with somatic manifestation effective treatments and therapies exist, so that it has nearly no influence on the self-assessed quality of life. ADHD and obesity result in a decrease of quality of life and in the field of protective factors, possibly caused by social stigmatisation, isolation and demotivation of the concerned children and adolescents. Therefore it is important to support those children and adolescents to cope with their disease-related problems. The results illustrate that in addition to the immediate effects of chronic conditions on the concerned children and their families, it is the quality of life and the familial and social environment that should be specifically addressed in further studies.
本出版物描述了儿童和青少年的慢性病(哮喘、注意力缺陷多动障碍、肥胖症)与个人、家庭和社会资源以及健康相关生活质量(HRQOL)之间的关系。这些调查的一个数据库是德国儿童和青少年健康访谈与检查调查(KiGGS),该调查对0至17岁的人群具有代表性。上述慢性病在这个年龄组中经常出现,并被认为会对生活质量产生影响,且与较低水平的保护因素有关。
调查使用了参与KiGGS研究的6813名11至17岁儿童和青少年的数据。关于已诊断慢性病的信息由父母在计算机辅助医学访谈(CAPI)框架内并通过填写问卷提供。个人、家庭和社会保护因素以及生活质量由青少年自己填写的问卷进行评估。使用的工具包括社会支持量表、家庭氛围量表和儿童青少年生活质量量表(KINDL-R)。
患有哮喘的儿童和青少年在健康相关生活质量和保护因素方面似乎没有缺陷。这与肥胖儿童以及患有注意力缺陷多动障碍的儿童的情况不同。这两组在健康相关生活质量和保护因素方面都显示出显著缺陷。
所调查的慢性病在衡量保护因素和健康相关生活质量的量表值上存在显著差异。可能的解释是:对于哮喘这种具有躯体表现的慢性病,存在有效的治疗方法,因此它对自我评估的生活质量几乎没有影响。注意力缺陷多动障碍和肥胖症导致生活质量下降以及在保护因素方面出现问题,这可能是由相关儿童和青少年的社会污名化、孤立和积极性降低所引起的。因此,支持这些儿童和青少年应对与疾病相关的问题非常重要。结果表明,除了慢性病对相关儿童及其家庭的直接影响外,生活质量以及家庭和社会环境应在进一步研究中得到具体关注。