[QOL research in child health. Present state and issues]

The evaluation of QOL (Quality of Life) in the medical field has revolved around the development of self-measurement scales comprising two or more questions based on psychometric theory. QOL research in the field of child health progressed in the latter half of the 80s in the United States, and aspects of ambiguity and adaptation to the environment of children were recognized. Objective health and subjective health differ significantly among children and are strongly influenced by environmental factors. In addition, QOL in early life anticipates the later health status in adolescence and youth. For these reasons, QOL research in the field of child health is very important. More than 20 scales, exemplified by CHQ, PedsQL, TACQOL/TAPQOL, and COOP charts, exist as standard generic QOL indices for children. Disease-specific scales cover epilepsy, asthma, and allergic disease, as discussed in a number of early studies. Diabetes, skin disease, and cancer are also major research subjects. Self-evaluation is one of the principles of QOL research; it is stated that children in the age group of 5-6 years are already capable of expressing pain and their physical condition and that the competency to describe abstract concepts such as pride and happiness matures around the age of 9-10 years. Sources of information such as the computer have developed and spread remarkably in recent years. The use of such technology facilitates the evaluation of young children with a high level of accuracy. The problems currently faced are the low reliability of responses of children, difficulties in cross-cultural comparison, and transformation of the sense of values according to growth. In conclusion, the development of QOL research in the field of child health should allow realization of an improved health situation in which children's points of view are included in the decision-making process for required treatments and health care policy. Further, health administration can be expected to thereby become more effective and balanced.