Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany.
Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Qual Life Res. 2018 Apr;27(4):879-890. doi: 10.1007/s11136-017-1753-8. Epub 2017 Nov 30.
PURPOSE: Health-related quality of life (HRQoL) is an important patient-reported outcome in clinical and health research. The EQ-5D-Y assesses child and adolescent HRQoL by five items on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression as well as a visual analogue scale (VAS) on the current health state. This study investigates predictors of self-reported HRQoL according to the EQ-5D-Y in chronically ill children and adolescents using longitudinal data. METHODS: Data from the German Kids-CAT study on children and adolescents with asthma, diabetes, and juvenile arthritis gathered over a period of six months were analyzed (n = 310; 7-17 years old; 48% female). Self-, parent-, and pediatrician-reported data were collected from June 2013 to October 2014. Generalized linear mixed models and linear mixed models served to examine effects of socio-demographic as well as disease- and health-specific predictors on the items as well as on the VAS of the EQ-5D-Y. RESULTS: Ceiling effects for the EQ-5D-Y indicated low burden of disease in the analyzed sample. Longitudinal analyses revealed associations between less health complaints and better HRQoL for all investigated HRQoL domains. Further, age- and gender-specific effects, and associations of better disease control, longer duration of the disease and less mental health problems with better HRQoL were found. CONCLUSIONS: Subjective health complaints and mental health problems should be considered in the care of children and adolescents with asthma, diabetes, and juvenile arthritis. Future research should suggest administering the items of the EQ-5D-Y with five instead of three response options, and investigate HRQoL over a longer period.
目的:健康相关生活质量(HRQoL)是临床和健康研究中重要的患者报告结果。EQ-5D-Y 通过五个项目评估儿童和青少年的 HRQoL,包括移动能力、自理能力、日常活动、疼痛/不适以及焦虑/抑郁,以及当前健康状况的视觉模拟量表(VAS)。本研究使用纵向数据,根据 EQ-5D-Y 调查慢性疾病儿童和青少年的自我报告 HRQoL 的预测因素。
方法:对德国儿童 CAT 研究中患有哮喘、糖尿病和青少年关节炎的儿童和青少年的数据进行了分析(n=310;7-17 岁;48%女性)。自我、父母和儿科医生报告的数据收集于 2013 年 6 月至 2014 年 10 月。广义线性混合模型和线性混合模型用于检查社会人口统计学以及疾病和健康特定预测因素对 EQ-5D-Y 项目和 VAS 的影响。
结果:EQ-5D-Y 的天花板效应表明分析样本中的疾病负担较低。纵向分析显示,所有调查的 HRQoL 领域中,健康抱怨越少,HRQoL 越好。此外,还发现了年龄和性别特异性效应,以及更好的疾病控制、更长的疾病持续时间和更少的心理健康问题与更好的 HRQoL 之间的关联。
结论:在照顾哮喘、糖尿病和青少年关节炎的儿童和青少年时,应考虑主观健康抱怨和心理健康问题。未来的研究应建议使用五个而不是三个反应选项来管理 EQ-5D-Y 的项目,并在更长的时间内调查 HRQoL。
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