Telethon Kids Institute, The University of Western Australia, PO Box 855, Perth, Western Australia, 6872, Australia.
Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Qual Life Res. 2021 Oct;30(10):2875-2885. doi: 10.1007/s11136-021-02855-9. Epub 2021 May 3.
The measurement of quality of life (QOL) in children with intellectual disability often relies upon proxy report via caregivers. The current study investigated whether caregiver psychological distress mediates or moderates the effects of impairment on their ratings of QOL in children with intellectual disability.
Caregivers of 447 children with an intellectual disability reported their child's day-to-day functioning, their own psychological distress using the Kessler Psychological Distress Scale, and the Quality of Life Inventory-Disability (QI-Disability), a measure of QOL for proxy report of a child's observable behaviours that indicate quality of life. Linear regression was used to assess the effects of the child's functional abilities on their QI-Disability score and causal mediation analysis to estimate the extent to which these effects were mediated by caregivers' psychological distress.
A minority of caregivers (n = 121, 27.1%) reported no psychological distress. Lower day-to-day functional abilities, such as being fully dependent on others to manage their personal needs were associated with lower total QOL scores. There was no significant mediation effect of caregiver psychological distress on the association between child functioning and total QOL scores. Moderation analyses revealed small and largely nonsignificant interaction coefficients, indicating that caregiver psychological distress did not influence the strength of the relationship between child functioning and total QOL scores.
Caregiver psychological distress did not mediate or moderate the relationship between the level of functional abilities and QOL in children with intellectual disability. QI-Disability measured observable child behaviours which may reduce the influence of caregiver factors on the accurate measure of QOL for children with intellectual disability.
儿童智力障碍的生活质量（QOL）的测量通常依赖于照顾者的代理报告。本研究调查了照顾者的心理困扰是否在智力障碍儿童的损伤对其 QOL 评分的影响中起中介或调节作用。
447 名智力障碍儿童的照顾者报告了他们孩子的日常功能，使用 Kessler 心理困扰量表报告了自己的心理困扰，以及生活质量问卷残疾（QI-Disability），这是一种用于代理报告孩子可观察行为的 QOL 测量，这些行为表明生活质量。线性回归用于评估儿童的功能能力对其 QI-Disability 评分的影响，因果中介分析用于估计这些影响在多大程度上被照顾者的心理困扰所中介。
少数照顾者（n=121，27.1%）报告没有心理困扰。日常功能能力较低，例如完全依赖他人来满足个人需求，与总 QOL 评分较低相关。照顾者心理困扰对儿童功能与总 QOL 评分之间的关联没有显著的中介作用。调节分析显示，交互系数较小且基本上无统计学意义，表明照顾者心理困扰并未影响儿童功能与总 QOL 评分之间的关系强度。
照顾者的心理困扰没有中介或调节智力障碍儿童的功能能力水平与 QOL 之间的关系。QI-Disability 测量了可观察到的儿童行为，这可能减少了照顾者因素对智力障碍儿童准确测量 QOL 的影响。
