Psychological and quality of life outcomes in pediatric populations: a parent-child perspective

OBJECTIVES: To compare the levels of quality of life (QoL) and psychological adjustment of children with different chronic health conditions with healthy children; to compare the QoL of parents of children with a chronic condition with parents of healthy children; and to examine the role of parents' QoL and children's psychological adjustment (ie, internalizing/externalizing problems) on children's QoL.

STUDY DESIGN: The sample comprised 964 family dyads composed of 1 parent and 1 child/adolescent aged 8-18 years with diabetes (n = 85), asthma (n = 308), epilepsy (n = 68), cerebral palsy (n = 94), obesity (n = 110), or no medical conditions (n = 299). The children completed self-report measures of QoL and psychological adjustment, and the parents completed a questionnaire on QoL.

RESULTS: Children with epilepsy and obesity reported the lowest levels of QoL and elevated levels of psychological problems, and parents of children with obesity reported the lowest levels of QoL. Adolescents reported worse adjustment than children. Regression models revealed that children's internalizing and externalizing problems were important, although distinct, explanatory factors of QoL across all groups.

CONCLUSION: Children with chronic conditions, particularly epilepsy and obesity, are at increased risk for maladjustment. A routine assessment of QoL and psychological functioning should be performed in these children to better understand how specific conditions affect the lives of children with chronic conditions and their families. Family-oriented pediatrics should be considered, particularly in the treatment of obesity.