Defenderfer Ellen K, Rybak Tiffany M, Davies W Hobart, Berlin Kristoffer S
Psychology Department, University of Wisconsin-Milwaukee, 2441 E Hartford Ave., 413, Milwaukee, WI, 53201, USA.
Psychology Department, University of Memphis, Memphis, TN, USA.
Qual Life Res. 2017 Jun;26(6):1405-1415. doi: 10.1007/s11136-016-1491-3. Epub 2017 Feb 22.
Parents of children with chronic illnesses are at risk for poor health-related quality of life (HRQoL), with numerous identified risk factors, but the most informative statistical model considering their combined impact is unclear. The authors conceptualized risk for poor HRQoL using a summed model, comprehensive multivariate model, and latent profile analysis (LPA).
Community parents completed an online survey, providing information about demographics, child's chronic illness, family functioning, and parent and child HRQoL. Parents reported that their children had a variety of chronic conditions (e.g., asthma, headaches, attention deficit/hyperactivity disorder, neurofibromatosis).
The summed model did not account for a significant proportion of variance in parent HRQoL. The comprehensive multivariate model (R = 0.614) and LPA (R = 0.305) both significantly predicted parent HRQoL. The LPA identified two risk profiles for lower HRQoL: parents who reported milder illnesses, but poorer family functioning; and parents who reported greater disease severity, but better family functioning.
Comprehensive multivariate models or LPAs best conceptualize patterns of risk for poor parental HRQoL in the community; though the findings in the current community sample may not extend to parents recruited from specialty clinics whose children may have more severe chronic illnesses. Parents of children with mild chronic conditions are still at risk for poor HRQoL, warranting attention from health care providers.
患有慢性病儿童的父母面临健康相关生活质量(HRQoL)较差的风险,存在众多已确定的风险因素,但考虑这些因素综合影响的最具信息量的统计模型尚不清楚。作者使用求和模型、综合多变量模型和潜在剖面分析(LPA)对HRQoL较差的风险进行了概念化。
社区父母完成了一项在线调查,提供了有关人口统计学、孩子的慢性病、家庭功能以及父母和孩子的HRQoL的信息。父母报告称他们的孩子患有多种慢性病(如哮喘、头痛、注意力缺陷多动障碍、神经纤维瘤病)。
求和模型未解释父母HRQoL中很大比例的方差。综合多变量模型(R = 0.614)和LPA(R = 0.305)均显著预测了父母的HRQoL。LPA确定了HRQoL较低的两种风险概况:报告疾病较轻但家庭功能较差的父母;以及报告疾病严重程度较高但家庭功能较好的父母。
综合多变量模型或LPA能最好地概念化社区中父母HRQoL较差的风险模式;尽管当前社区样本中的研究结果可能不适用于从专科诊所招募的父母,这些诊所的孩子可能患有更严重的慢性病。患有轻度慢性病儿童的父母仍面临HRQoL较差的风险,值得医疗保健提供者关注。