Fei Ling, Wu Yiheng, Guan Lejing, Shao Yifei, Li Fengting, Yu Limin, Liu Zhirou, Rafay Abdul, Ye Lizhen, Lu Meiping, Bai Guannan
Department of Allergy Immunology and Rheumatology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, Zhejiang Province, People's Republic of China.
Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei Province, People's Republic of China.
Eur J Pediatr. 2024 Dec 4;184(1):62. doi: 10.1007/s00431-024-05899-4.
Systemic lupus erythematosus (SLE) in children is a severe chronic illness. We aimed to assess the proxy-reported health-related quality of life (HRQoL) of children with SLE and the well-being of their caregivers. In total, 173 caregivers whose children were diagnosed with SLE were recruited from a tertiary children's hospital. The proxy-reported Pediatric Quality of Life Instrument™ Version 4.0 Generic Core Module (PedsQL™ 4.0 GCM) was used to measure the HRQoL of children, and the 5-item World Health Organization Well-Being Index (WHO-5) was applied to measure caregivers' well-being. T-tests and one-way ANOVA assessed differences in scale scores and total score of PedsQL 4.0 GCM. Effect sizes were calculated for clinical relevance. Multivariate linear regression analysis was used to identify the factors associated with children's HRQoL. Pearson correlation analysis was utilized to assess the correlation between children's HRQoL and the well-being of their caregivers. Children with SLE were reported by their caregivers to have lower scores in physical functioning, emotional functioning, school functioning, psychosocial health summary score, and total score of PedsQL™ 4.0 GCM compared to healthy children. The multivariate linear regression analysis showed parental employment status, perceived financial burden, and changes in body image were significantly associated with the relatively low HRQoL of children (p values < 0.05). A total of 30.6% of caregivers had symptoms of depression, and 10.4% had symptoms of major depression, as indicated by the score of WHO-5. Scale scores and total score of PedsQL™ 4.0 GCM were significantly correlated with the score of WHO-5 (p values < 0.05).
This study comprehensively analyzes proxy-reported HRQoL of SLE children in China and identifies multiple associated factors. The caregiver's well-being was correlated to the children's HRQoL. We emphasize the necessity for comprehensive support for children with SLE, their caregivers, and extended family members.
• Systemic lupus erythematosus (SLE) may impact the health-related quality of life for both the affected children and their families. • Most of such studies were conducted in developed countries.
• This study provided comprehensive data on health-related quality of life of SLE children and wellbeing of their caregivers in China.
儿童系统性红斑狼疮(SLE)是一种严重的慢性疾病。我们旨在评估SLE患儿通过代理人报告的健康相关生活质量(HRQoL)及其照顾者的幸福感。总共从一家三级儿童医院招募了173名其子女被诊断为SLE的照顾者。采用通过代理人报告的儿童生活质量量表™第4.0版通用核心模块(PedsQL™ 4.0 GCM)来测量儿童的HRQoL,并应用5项世界卫生组织幸福感指数(WHO-5)来测量照顾者的幸福感。采用t检验和单因素方差分析评估PedsQL 4.0 GCM量表得分和总分的差异。计算效应量以评估临床相关性。采用多元线性回归分析确定与儿童HRQoL相关的因素。利用Pearson相关分析评估儿童HRQoL与其照顾者幸福感之间的相关性。照顾者报告称,与健康儿童相比,SLE患儿在身体功能、情感功能、学校功能、心理社会健康汇总得分以及PedsQL™ 4.0 GCM总分方面得分较低。多元线性回归分析显示,父母的就业状况、感知到的经济负担以及身体形象的变化与儿童相对较低的HRQoL显著相关(p值<0.05)。根据WHO-5得分,共有30.6%的照顾者有抑郁症状,10.4%有重度抑郁症状。PedsQL™ 4.0 GCM量表得分和总分与WHO-5得分显著相关(p值<0.05)。
本研究全面分析了中国SLE患儿通过代理人报告的HRQoL,并确定了多个相关因素。照顾者的幸福感与儿童的HRQoL相关。我们强调有必要为SLE患儿及其照顾者和大家庭成员提供全面支持。
• 系统性红斑狼疮(SLE)可能会影响患病儿童及其家庭的健康相关生活质量。• 大多数此类研究在发达国家进行。
• 本研究提供了中国SLE患儿健康相关生活质量及其照顾者幸福感的全面数据。