Childhood chronic conditions and health-related quality of life: Findings from a large population-based study

The objective of this study was to assess the impact of health-related quality of life (HRQOL) across prevalent chronic conditions, individually and comorbid, in school-aged children in the Netherlands. 5301 children aged 4–11 years from the Dutch Health Interview Survey were included. Parents completed questionnaires regarding child and parental characteristics. HRQOL of children was measured using the Child Health Questionnaire Parent Form 28 (CHQ-PF28). Independent-t tests were used to assess differences in the mean scores of the CHQ-PF28 summary scales and profile scales between children with a prevalent chronic condition (excluding or including children with multiple chronic conditions) and children without a chronic condition. Cohen’s effect sizes (d) were calculated to assess the clinical significance of difference. The mean age of children was 7.55 (SD 2.30) years; 50.0% were boys. In children without any chronic condition, the mean score of physical summary scale (PhS) was 58.53 (SD 4.28) and mean score of the psychosocial summary scale (PsS) was 53.86 (SD 5.87). Generally, PhS and/or PsS scores in children with only one condition were lower (p<0.05) than for children without chronic conditions. When children with multiple conditions were included, mean scores of CHQ-PF28 summary and profile scales were generally lower than when they were excluded. The present study shows important information regarding the impact of prevalent chronic conditions on HRQOL in a representative population-based sample of school-aged children in the Netherlands. The information could be used for developing a more holistic approach to patient care and a surveillance framework for health promotion.

本研究旨在评估荷兰学龄儿童中，单发及共患的现患慢性疾病对健康相关生命质量（health-related quality of life, HRQOL）的影响。研究纳入荷兰健康访谈调查中5301名4至11岁的儿童，由家长填写关于儿童与父母特征的调查问卷。采用儿童健康问卷父母量表28项版（Child Health Questionnaire Parent Form 28, CHQ-PF28）测评儿童的健康相关生命质量。通过独立样本t检验，对比患现患慢性疾病（分别排除和纳入多慢性疾病儿童）的儿童与无慢性疾病儿童的CHQ-PF28总维度与剖面维度平均分差异，并计算科恩效应量（d）以评估差异的临床意义。受试儿童的平均年龄为7.55（标准差2.30）岁，其中男孩占比50.0%。在无任何慢性疾病的儿童中，躯体总维度（physical summary scale, PhS）平均分为58.53（标准差4.28），心理社会总维度（psychosocial summary scale, PsS）平均分为53.86（标准差5.87）。总体而言，仅患一种慢性疾病的儿童的PhS和/或PsS得分显著低于无慢性疾病的儿童（p<0.05）。当纳入多慢性疾病儿童时，CHQ-PF28总维度与剖面维度的平均分普遍低于排除该类儿童时的结果。本研究基于荷兰具有代表性的学龄儿童人群抽样，揭示了现患慢性疾病对HRQOL影响的重要信息，该结果可用于制定更全面的患者照护方案与健康促进监测框架。