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Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires

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Abstract

Purpose

This meta-analytic review aimed to estimate the magnitude of health-related quality of life (HrQoL) impairments, as assessed by the KIDSCREEN questionnaires, both self- and parent-reported, in 8- to 18-years-old children/adolescents with chronic health conditions.

Methods

To identify studies using the KIDSCREEN questionnaires, three electronic databases (PubMed, PsycINFO, EBSCOhost Psychology & Behavioral Sciences) were searched. The final search (February 14–15, 2018) revealed 528 non-duplicated articles, of which 23 papers (21 studies) directly compared the HrQoL of pediatric patients to community/healthy controls and were included in the meta-analysis. Pooled mean differences (MD) with 95% CIs were estimated using the inverse-variance random-effects method.

Results

Of the 21 studies, 16 used self-reports, one used parent-reports and four adopted a multi-informant approach. Self-reported data were retrieved from 20 studies (4852 cases/28,578 controls), and parent-reported data were retrieved from four studies (511 cases/433 controls). Pediatric patients presented significant HrQoL impairments in the domains of physical well-being (MD = − 4.84, 95% CI − 6.44/− 3.24 for self-reports; MD = − 6.86, 95% CI − 10.42/− 3.29 for parent-reports) and peers and social support (MD = − 1.29, 95% CI − 2.25/− 0.34 for self-reports; MD = − 3.90, 95% CI − 5.28/− 2.52 for parent-reports), compared to community/healthy peers. Between-studies heterogeneity was explained by diagnostic categories, instrument version and informants.

Conclusions

The identification of significant HrQoL impairments among pediatric patients, specifically in the physical and social domains, highlights the importance of routine psychosocial assessment and intervention in primary pediatric healthcare services. Specific recommendations include the use of profile measures, both self- and parent-reports, and the prioritization of oncology, endocrinology and neurology services.

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Acknowledgements

We would like to thank the authors of the original articles included in this meta-analysis, specifically to those who kindly supplied additional data upon our request: H. Moreira (Faculty of Psychology and Education Sciences, University of Coimbra, Portugal); L. Hedman (Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University; Department of Health Sciences, Division of Nursing, Luleå University of Technology, Sweden), and I. Duarte (Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal).

Funding

This study was funded by a Post-doctoral Fellowship (Grant No. SFRH/BPD/116841/2016) from the Portuguese Foundation for Science and Technology, and conducted at the Centre for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences of the University of Coimbra, and at the Department of Medical Psychology, University Medical Center Hamburg-Eppendorf.

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Authors and Affiliations

  1. Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal

    Neuza Silva, Marco Pereira & Maria Cristina Canavarro

  2. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany

    Neuza Silva & Monika Bullinger

  3. Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany

    Christiane Otto & Ulrike Ravens-Sieberer

Authors
  1. Neuza Silva
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  2. Marco Pereira
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  3. Christiane Otto
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  4. Ulrike Ravens-Sieberer
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  5. Maria Cristina Canavarro
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  6. Monika Bullinger
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Corresponding author

Correspondence to Neuza Silva.

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The authors declare no conflicts of interest.

Ethical approval

This study was approved by the Scientific Council of the Faculty of Psychology and Education Sciences of the University of Coimbra. All studies included in this meta-analytic review were approved by their institutional and/or national ethical committees and were in accordance with the 1964 Helsinki Declaration and its subsequent amendments and with their national ethical and legal requirements, including parental informed consent and, for some studies, additional assent from the children.

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Silva, N., Pereira, M., Otto, C. et al. Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires. Qual Life Res 28, 1725–1750 (2019). https://doi.org/10.1007/s11136-019-02189-7

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