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Pediatric health-related quality of life: a structural equation modeling approach

Ester Villalonga-Olives1, Ichiro Kawachi2, Josué Almansa3

  • 1Institute of Medical Psychology and Medical Sociology, Georg-August-University Göttingen, Göttingen, Germany; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America.

Plos One
|November 22, 2014
PubMed

Insights

The Wilson and Cleary framework for measuring Health Related Quality of Life (HRQoL) was tested in German children. Results showed differences from adult models, highlighting a need for pediatric-specific HRQoL theory and evaluation.

Area of Science:

  • Pediatric Health Outcomes Research
  • Quality of Life Measurement

Background:

  • The Wilson and Cleary framework is a key model for assessing Health Related Quality of Life (HRQoL).
  • While validated in adults, this framework has not been empirically tested in pediatric populations.
  • A lack of standardized measures and definitions for pediatric HRQoL exists.

Purpose of the Study:

  • To empirically investigate the applicability of the Wilson and Cleary framework in a pediatric population.
  • To assess the measurement structure of the framework in young children.

Main Methods:

  • Structural equation modeling was employed.
  • Data were collected from 214 German children aged 3-5 years.
  • Factors assessed included symptom status, functional status (developmental), social-emotional behavior, and social environment (socioeconomic status, area of education).

Main Results:

  • The model demonstrated good fit (χ2 = 5.5, df = 6, p = 0.48, SRMR = 0.01).
  • Area of education and developmental status significantly influenced HRQoL, explaining 15% of its variance.
  • Symptom status did not significantly impact the model. Developmental status was influenced by area of education, socioeconomic status, and individual behavior.

Conclusions:

  • The Wilson and Cleary framework shows potential for use in children, but significant differences exist compared to adult applications.
  • These discrepancies indicate a conceptual gap in understanding pediatric HRQoL.
  • Further development of pediatric-specific HRQoL theory and evaluation methods is recommended.
Abstract

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