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Conceptual framework for health-related quality of life assessment in acute gastroenteritis
Bradley C Johnston1, Rachel Donen, Amrita Pooni
1Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. bradley.johnston@sickkids.ca
Insights
Pediatric acute gastroenteritis significantly impacts child and parent quality of life, affecting physical and emotional well-being. This study developed a framework to measure these effects, aiding future intervention assessments.
Area of Science:
- Pediatric Health
- Quality of Life Research
- Gastroenterology
Background:
- Traditional pediatric acute gastroenteritis trials focus on clinical or laboratory outcomes.
- Health-related quality of life (HRQoL) is an important, yet often overlooked, measure for intervention effectiveness.
- Existing HRQoL instruments may not adequately capture the specific impacts of gastroenteritis in children.
Purpose of the Study:
- To explore how acute gastroenteritis affects the quality of life for both children and their parents.
- To develop a conceptual framework for a quality of life instrument tailored to pediatric acute gastroenteritis.
- To gather parent and child perspectives on the impact of gastroenteritis on their well-being.
Main Methods:
- Conducted individual interviews and focus groups with parents of children diagnosed with gastroenteritis.
- Included children aged 3 months to 5 years presenting to a hospital emergency department.
- Gathered parental perceptions of gastroenteritis's effect on child and parent quality of life.
Main Results:
- Developed a conceptual framework for pediatric acute gastroenteritis quality of life, encompassing physical and emotional domains for children.
- Proposed a framework for parents, including physical, emotional, and social domains with multiple subdomains.
- Created a preliminary quality of life questionnaire for parents and children based on the framework.
Conclusions:
- Acute gastroenteritis adversely affects the health-related quality of life for both children and parents.
- Impacts include physical symptoms, functional limitations, and emotional distress.
- Future pediatric gastroenteritis trials should incorporate HRQoL measures as patient-important outcomes.
Background And Objectives:
To date, most trials in pediatric acute gastroenteritis have evaluated short-term clinical disease activity (eg, duration of diarrhea or vomiting, level of dehydration), laboratory outcomes (eg, rotavirus, norovirus), or a composite of these outcomes. Measuring health-related quality of life may also be important in evaluating the effect of interventions for acute gastroenteritis in children. The objectives of this study were to conduct individual interviews and, when possible, focus group discussions, with parents of children with acute gastroenteritis; to determine how parent and child quality of life is negatively affected by acute gastroenteritis; and, from the perspective of parents and children, to develop a conceptual framework for quality of life instrument specific to pediatric acute gastroenteritis.
Methods:
We conducted interviews and focus groups with parents of children (3 months-5 years of age) given a diagnosis of gastroenteritis in a hospital emergency department. Interviews and focus groups were conducted to determine the effect of gastroenteritis on quality of life in parents and children (as perceived by the parents).
Results:
Interviews and focus groups involving 25 parents suggested a conceptual framework that, for children, includes 2 domains (physical and emotional function) and 14 subdomains. For parents, our framework includes 3 domains (physical, emotional, and social function) with physical function including 4 subdomains, emotional function including 7 subdomains, and social function including 2 subdomains. The framework has been used to develop a preliminary quality of life questionnaire for parents and children.
Conclusions:
Acute gastroenteritis has an important adverse effect on health-related quality in both children and parents involving physical symptoms and restrictions in physical function and disturbed emotional function. Upon further research on the psychometric properties of the proposed questionnaires, future trials of effectiveness should consider measuring patient important outcomes such as health-related quality of life.
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