London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
University College London Hospitals NHS Foundation Trust, London, UK.
Eur J Health Econ. 2018 Jun;19(5):641-651. doi: 10.1007/s10198-017-0908-4. Epub 2017 Jun 15.
Associations between adolescent health-related quality of life (HRQoL), bullying, and aggression are not well understood. We used baseline data from a large-cluster randomized school trial to study the relationship between HRQoL, bullying experience, and other demographic factors.
Cross-sectional self-reported questionnaires collected pre-randomization from the on-going INCLUSIVE trial. The questionnaires were completed in the classroom. The Gatehouse Bullying Scale measured bullying victimization and the Edinburgh Study of Youth Transitions and Crime school misbehavior subscale (ESYTC) measured aggressive behaviors. HRQoL was assessed using the Child Health Utility 9 Dimensions (CHU-9D) and general quality of life using the Pediatric Quality of Life Inventory (PedsQL). Participants were a cohort of year 7 students (age 11-12 years) from 40 state secondary schools in England. Descriptive statistics for the CHU-9D and PedsQL were calculated using standard methods with tests for differences in median scores by sex assessed using quantile regression. Correlation between HRQoL measures was conducted using Spearman's rank correlation coefficients. Predictors of HRQoL were identified using univariate and multiple regressions.
A total of 6667 students filled out the questionnaire. The CHU-9D was correlated with the PedsQL (0.63, p < 0.001). The multivariable regression results suggest that if students were bullied frequently and upset it resulted in a decrement in CHU-9D scores of (-0.108) and fall in PedsQL score of (-16.2). The impact of the antisocial/aggressive behavior on the ESYTC scale resulted in a utility decrement of -0.004 and fall of -.5 on the PedsQL.
Adolescents' involvement in bullying and aggression is a strong correlate of HRQoL. These data have important implications for the potential cost-effectiveness of reducing bullying and aggression in schools.
青少年健康相关生活质量（HRQoL）、欺凌和攻击之间的关联尚不清楚。我们使用来自大型聚类随机学校试验的基线数据来研究 HRQoL、欺凌经历和其他人口统计学因素之间的关系。
横断面自我报告问卷调查在 INCLUSIVE 试验进行期间预先从正在进行的研究中收集。问卷在教室里完成。Gatehouse 欺凌量表测量欺凌受害情况，爱丁堡青年过渡和犯罪研究学校不良行为子量表（ESYTC）测量攻击行为。使用儿童健康效用 9 维度（CHU-9D）评估 HRQoL，使用儿科生活质量量表（PedsQL）评估总体生活质量。参与者为来自英格兰 40 所州立中学的 7 年级学生（年龄 11-12 岁）队列。使用标准方法计算 CHU-9D 和 PedsQL 的描述性统计数据，并使用分位数回归评估性别中位数评分差异的检验。使用 Spearman 等级相关系数进行 HRQoL 测量之间的相关性。使用单变量和多元回归确定 HRQoL 的预测因子。
共有 6667 名学生填写了问卷。CHU-9D 与 PedsQL 相关（0.63，p<0.001）。多变量回归结果表明，如果学生经常被欺负并且感到不安，CHU-9D 评分会降低（-0.108），PedsQL 评分会降低（-16.2）。反社会/攻击行为对 ESYTC 量表的影响导致效用降低（-0.004），PedsQL 降低（-0.5）。
青少年参与欺凌和攻击是 HRQoL 的一个重要相关因素。这些数据对在学校减少欺凌和攻击的潜在成本效益具有重要意义。
