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HRQoL in HIV-infected children using PedsQL 4.0 and comparison with uninfected children
Tanushree Banerjee1, Tripti Pensi, Dipankar Banerjee
1Department of Statistics, University of Delhi, A-123 Vikaspuri, New Delhi 110018, India. tanushree@aidsresearcher.org
Insights
The Pediatric Quality of Life Inventory 4.0 (PedsQL™ 4.0) is reliable for assessing health-related quality of life in children with HIV. HIV infection negatively impacts QoL, while antiretroviral treatment shows improvement.
Area of Science:
- Pediatric Health
- Quality of Life Research
- Infectious Diseases
Background:
- Assessing health-related quality of life (HRQoL) in pediatric populations living with HIV is crucial for comprehensive care.
- The Pediatric Quality of Life Inventory 4.0 (PedsQL™ 4.0) is a widely used tool, but its validity and reliability in children with HIV require specific evaluation.
- Understanding the impact of HIV infection, treatment, and care settings on HRQoL is essential for targeted interventions.
Purpose of the Study:
- To evaluate the reliability and validity of the PedsQL™ 4.0 in children diagnosed with HIV.
- To investigate the association between HIV status, antiretroviral treatment regimens, and the type of care received on the HRQoL of pediatric patients.
- To compare HRQoL between HIV-infected and uninfected children.
Main Methods:
- A cross-sectional study was conducted at a pediatric HIV outpatient department in New Delhi, India.
- The PedsQL™ 4.0 was administered to 100 HIV-infected children and 200 uninfected children aged 8-12 years.
- Both self-report and parent proxy-report measures were utilized, with statistical analyses including reliability testing (internal consistency, ICC) and factor analysis.
Main Results:
- The PedsQL™ 4.0 demonstrated good internal consistency (reliability > 0.70) and high intraclass correlation coefficients for both self- and proxy-reports.
- Factor analysis confirmed that the PedsQL™ 4.0 items primarily aligned with its five established scales.
- HIV infection was linked to diminished physical, school, and emotional functioning, and increased health symptoms. Antiretroviral therapy was associated with improved HRQoL in HIV-infected children. Children living at home reported greater psychosocial distress than those in care homes.
Conclusions:
- The PedsQL™ 4.0 is a valid and reliable instrument for measuring HRQoL in both HIV-infected and uninfected children.
- The findings highlight the significant impact of HIV infection on various aspects of a child's quality of life.
- Data derived from this study can inform program managers in developing effective care and support strategies for pediatric populations affected by HIV.
Purpose:
To assess the reliability and validity of Pediatric Quality of Life Inventory 4.0 (PedsQL(TM) 4.0) in children living with HIV. Also to determine the association of HIV infection, treatment regimens, and type of care received on quality of life (QoL) in pediatric patients.
Methods:
Study was conducted from January to December 2008 at Dr. Ram Manohar Lohia Hospital, New Delhi, India at the HIV pediatric outpatient department (OPD). PedsQL(TM) 4.0 was administered to 100 HIV-infected and 200 uninfected children aged 8-12 years and their primary caregivers.
Results:
Internal consistency reliability exceeded 0.70 for both proxy-reported and self-reported scales. Intraclass correlation coefficient demonstrated mainly larger values for parent proxy-report (interval of 0.926-0.952 with 95% confidence) than for child self-report (interval of 0.891-0.928 with 95% confidence). Factor analysis was performed and it indicated that five factors were extracted from the PedsQL(TM) 4.0 and these five factors correspond mainly to the five scales. HIV infection was associated with a negative impact on QoL among children with lower scores for physical, school, and emotional functioning and health symptoms. In contrast, uninfected children had lower social functioning scores. Our results showed antiretroviral treatment to be associated with improved QoL among HIV-infected children. We even identified infected children living at home to be at a higher distress of psychosocial functioning and health symptoms when compared with children living in care homes.
Conclusions:
PedsQL(TM) is an acceptable and valid measure of health-related quality of life (HRQoL) for HIV-infected children and uninfected group. Application of this data will be helpful for program managers to devise care and support programme for both infected and uninfected children.
