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Mothers’ health-related quality of life: Its relationship with children’s health-related quality of life and behavior in low-income families

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      Objective: To examine the association between mothers’ health-related quality of life (HRQOL) and their children’s HRQOL and behavior in low-income families.

      Methods: Mothers of 278 children aged 6–12 years from low-income families were invited to complete the Child Health Questionnaire Parent Form 50 (CHQ-PF50) and the Strength and Difficulties Questionnaire (SDQ) for their children as well as the 12-item Short-Form Health Survey version 2 (SF-12v2) and the Patient Health Questionnaire-2 (PHQ-2). Multiple linear regressions with mother–child pairs as the unit of analysis were performed to examine the associations between maternal and child variables with adjustment of mother- and child-level confounders.

      Results: Compared with the general population, low-income mothers had a lower mean SF-12v2 mental component summary score and their children also had lower mean CHQ-PF50 physical and psychosocial summary scores and SDQ total difficulties score. Children of mothers with SF-12v2 scores below the population mean of 50 had significantly worse CHQ-PF50 scores and higher SDQ total difficulties scores. The mother’s PHQ-2 depression status had no association with the child’s CHQ-PF50 scores.

      Conclusion: Our findings suggest that more attention should be paid to reducing the negative impact of health problems on mothers’ daily roles in childcare in low-income families.

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      Most cited references 58

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      The Patient Health Questionnaire-2: validity of a two-item depression screener.

      A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
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        Maternal depression and child psychopathology: a meta-analytic review.

        Although the association between maternal depression and adverse child outcomes is well established, the strength of the association, the breadth or specificity of the outcomes, and the role of moderators are not known. This information is essential to inform not only models of risk but also the design of preventive interventions by helping to identify subgroups at greater risk than others and to elucidate potential mechanisms as targets of interventions. A meta-analysis of 193 studies was conducted to examine the strength of the association between mothers' depression and children's behavioral problems or emotional functioning. Maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of positive affect/behavior, with all associations small in magnitude. These associations were significantly moderated by theoretically and methodologically relevant variables, with patterns of moderation found to vary somewhat with each child outcome. Results are interpreted in terms of implications for theoretical models that move beyond main effects models in order to more accurately identify which children of depressed mothers are more or less at risk for specific outcomes.
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          Measuring health-related quality of life


            Author and article information

            1Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, China
            2Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
            Author notes
            CORRESPONDING AUTHOR: Cindy Lo Kuen Lam, MD Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F., Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, China, E-mail:
            Family Medicine and Community Health
            Compuscript (Ireland)
            December 2016
            December 2016
            : 4
            : 4
            : 4-12
            Copyright © 2016 Family Medicine and Community Health

            This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See

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