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Health-related quality of life in children with and without physical–mental multimorbidity

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Abstract

Purpose

This study examined health-related quality of life (HRQL) in children across different physical illnesses; estimated parent–child agreement on HRQL reports; compared HRQL between children with and without physical–mental multimorbidity; and tested if multimorbidity was associated with HRQL.

Methods

Children aged 6–16 years (mean = 11.1; n = 198) with one physical illness and their parents were recruited from a pediatric hospital. Physical illnesses were classified according to the International Statistical Classification of Diseases and Related Health Problems (ICD)-10, mental illnesses were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents, and HRQL was measured using the KIDSCREEN-27. Children who screened positive for ≥ 1 mental illness were classified as having physical–mental multimorbidity. χ2/t tests compared sample characteristics of children with vs. without multimorbidity; Kruskal–Wallis tests compared KIDSCREEN-27 scores across ICD-10 categories; interclass correlation coefficients estimated parent–child agreement; and multiple regression examined effects of the number of mental illnesses on HRQL.

Results

HRQL was similar across ICD-10 categories. Parent–child agreement was fair to good for all HRQL domains, regardless of multimorbidity status. Parent-reported HRQL was significantly lower for children with multimorbidity compared to norms across all domains, whereas child-reported HRQL was significantly lower for physical well-being, psychological well-being, and school environment. Number of mental illnesses was negatively associated with psychological well-being and school environment in a dose–response manner.

Conclusion

Children with physical–mental multimorbidity are vulnerable to experiencing lower HRQL, particularly for psychological well-being and school environment. Longitudinal studies documenting trajectories of HRQL and school-based interventions that target these domains of HRQL for children with multimorbidity are warranted.

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Acknowledgements

The authors gratefully acknowledge the children, parents, and health professionals and their staff at McMaster Children’s Hospital without whose participation this study would not have been possible. We especially thank Jessica Zelman, Robyn Wojicki, and Charlene Attard for coordinating the study and Melissa Elgie and Sophie Rosen for assisting with data collection. Thank you to Serafina Abbruzzese for providing important insights related to school-based accommodations for children.

Funding

This study was funded by the Canadian Institutes of Health Research (PJT-148602). Dr. Ferro holds the Canada Research Chair in Youth Mental Health and the Early Researcher Award from the Ministry of Research, Innovation, and Science.

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Authors and Affiliations

  1. School of Public Health Sciences, University of Waterloo, Waterloo, Canada

    Mark A. Ferro & Saad A. Qureshi

  2. Jacobs Center for Productive Youth Development & Department of Psychology, University of Zurich, Zurich, Switzerland

    Lilly Shanahan

  3. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Christiane Otto & Ulrike Ravens-Sieberer

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  1. Mark A. Ferro
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Contributions

MAF conceptualized and designed the study, coordinated and supervised data collection, supervised the analysis, and reviewed and revised the manuscript. SAQ conducted the initial analysis, drafted the initial manuscript, and reviewed and revised the manuscript. LS, CO, and URS revised the manuscript and critically reviewed it for important intellectual content. All authors approved the final manuscript.

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Correspondence to Mark A. Ferro.

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The authors have no conflicts of interest relevant to this article to disclose.

Ethical approval

MY LIFE received ethical approval from the University of Waterloo Human Research Ethics Board (ORE-22183) and the Hamilton Integrated Research Ethics Board (2797).

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All participants 16 years and older provided informed consent, children 7–15 provided assent, and children 6 and younger were consented by their parents.

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Ferro, M.A., Qureshi, S.A., Shanahan, L. et al. Health-related quality of life in children with and without physical–mental multimorbidity. Qual Life Res 30, 3449–3461 (2021). https://doi.org/10.1007/s11136-021-02963-6

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