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      Perception of health-related quality of life in children with chronic kidney disease by the patients and their caregivers: Multicentre national study results

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          Abstract

          Objective

          The aim of the study was to analyse the health-related quality of life (HRQoL) in Polish children with chronic kidney disease (CKD) dependant on the CKD stage, treatment modality and selected social life elements in families of the patients. Furthermore, potential differences between self-report and parent/proxy reports and the factors influencing them were assessed.

          Methods

          A total of 203 CKD children (on haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT)) and their 388 parent/proxies were enrolled into a cross-sectional national study. The demographic and social data were evaluated. We used the Paediatric Quality of Life Inventory 4.0 Generic Core Scales to assess the HRQoL in children.

          Results

          Health-related quality of life scores for all CKD groups were significantly lower in all domains compared with population norms, the lowest one being in the HD group. In CT children, HRQoL did not depend on the CKD stage. Both parents assessed the HRQoL of their children differently depending on their involvement in the care. There are differences between the HRQoL scores of the children and their parents.

          Conclusion

          The HRQoL in children with CKD is lower than in healthy children. This is already observed in the early stages of the disease. The disease itself influences the child’s mental state. Children on HD require special support on account of the lowest demonstrated overall HRQoL. Children’s lower rating of the quality of life observed by their parents may render the patients unmotivated and adversely affect their adjustment to life in later years. It may also create conflicts between the parents and the children.

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          Most cited references24

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          The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity.

          The application of health-related quality of life (HRQOL) as a pediatric population health measure may facilitate risk assessment and resource allocation, the tracking of community health, the identification of health disparities, and the determination of health outcomes from interventions and policy decisions. To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a measure of pediatric population health for children and adolescents. Mail survey in February and March 2001 to 20 031 families with children ages 2-16 years throughout the State of California encompassing all new enrollees in the State's Children's Health Insurance Program (SCHIP) for those months and targeted language groups. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 10 241 families through a statewide mail survey to evaluate the HRQOL of new enrollees in SCHIP. The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha =.89 child;.92 parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was also related to indicators of health care access, days missed from school, days sick in bed or too ill to play, and days needing care. The results demonstrate the feasibility, reliability, and validity of the PedsQL 4.0 as a pediatric population health outcome. Measuring pediatric HRQOL may be a way to evaluate the health outcomes of SCHIP.
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            Parent-child agreement across child health-related quality of life instruments: a review of the literature.

            To systematically review the literature published since 1999 on paediatric health-related quality of life (HRQL) in relation to parent-child agreement. Literature searches used to identify studies which evaluated parent-child agreement for child HRQL measures. Nineteen studies were identified, including four HRQL instruments. The Pediatric Quality of Life Inventory (PedsQL) was most commonly used. Differences in parent-child agreement were noted between domains for different measures. The impact of child and parent characteristics were not consistently considered; however parents of children in a nonclinical sample tended to report higher child HRQL scores than children themselves, while parents of children with health conditions tended to underestimate child HRQL. Despite increasing numbers of studies considering children's HRQL, information about variables contributing to parent-child agreement levels remains limited. Authors need to consistently provide evidence for reliability and validity of measures, and design studies to systematically investigate variables that impact on levels of parent-child agreement.
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              The PedsQL 4.0 as a school population health measure: feasibility, reliability, and validity.

              The application of health-related quality of life (HRQOL) as a school population health measure may facilitate risk assessment and resource allocation, the tracking of student health at the school and district level, the identification of health disparities among schoolchildren, and the determination of health outcomes from interventions and policy decisions at the school, district, and county level. To determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a school population health measure for children and adolescents. Survey conducted in 304 classes at 18 elementary schools, 4 middle schools, and 3 high schools within a large metropolitan school district. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by 2437 children ages 8-18 and 4227 parents of children ages 5-18. The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha = 0.89 child, 0.92, parent report), and distinguished between healthy children and children with chronic health conditions. The PedsQL 4.0 was related to indicators of socioeconomic status (SES) at the school and district level. The PedsQL School Functioning Scale was significantly correlated with standardized achievement scores based on the Stanford 9. The results demonstrate the feasibility, reliability and validity of the PedsQL 4.0 Generic Core Scales as a school population health measure. The implications of measuring HRQOL in schoolchildren at the school, district, and county level for identifying and ameliorating health disparities are discussed.
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                Author and article information

                Contributors
                +48-7364400 , +48-7364409 , katarzyna.kilis-pstrusinska@am.wroc.pl
                Journal
                Qual Life Res
                Qual Life Res
                Quality of Life Research
                Springer Netherlands (Dordrecht )
                0962-9343
                1573-2649
                18 April 2013
                18 April 2013
                2013
                : 22
                : 2889-2897
                Affiliations
                [ ]Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland
                [ ]Department of Paediatric and Adolescent Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
                [ ]Department of Nephrology, Kidney Transplantation and Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland
                [ ]Department of Paediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
                [ ]Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
                [ ]Nephrology Division, Polish Mother’s Memorial Hospital Research Institute, Łodź, Poland
                [ ]Department of Nephrology, Children Hospital, Toruń, Poland
                [ ]Polish-American Children’s Hospital, Jagiellonian University, Krakow, Poland
                [ ]Clinic of Paediatrics, Nephrology and Endocrinology, Silesian Medical University, Zabrze, Poland
                [ ]Department of Pediatrics and Nephrology, Medical University of Białystok, Białystok, Poland
                [ ]Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland
                Article
                416
                10.1007/s11136-013-0416-7
                3853413
                23595412
                489c1625-786c-44a7-b873-3daea10fbfe7
                © The Author(s) 2013

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

                History
                : 10 April 2013
                Categories
                Article
                Custom metadata
                © Springer Science+Business Media Dordrecht 2013

                Public health
                chronic kidney disease,children,health-related quality of life,family life
                Public health
                chronic kidney disease, children, health-related quality of life, family life

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