Health-related quality of life of child and adolescent retinoblastoma survivors in the Netherlands

Abstract

Background: To assess health-related quality of life (HRQoL) in children (8-11 years) and adolescents (12-18 years) who survived retinoblastoma (RB), by means of the KIDSCREEN self-report questionnaire and the proxy-report version.

Methods: This population-based cross-sectional study (participation rate 70%) involved 65 RB survivors (8-18 years) and their parents. Child/adolescents' and parents' perception of their youth's HRQoL was assessed using the KIDSCREEN, and the results were compared with Dutch reference data. Relations with gender, age, marital status of the parents, and visual acuity were analyzed.

Results: RB survivors reported better HRQoL than did the Dutch reference group on the dimensions "moods and emotions" and "autonomy". Increased ratings of HRQoL in RB survivors were mainly seen in perceptions of the younger children and adolescent girls. RB survivors with normal visual acuity scored higher on "physical well-being" than visually impaired survivors. Age was negatively associated with the dimensions "psychological well-being", "self-perception" (according to the child and parent reports) and "parent relations and home life" (according to the child). "Self-perception" was also negatively associated with visual acuity (according to the child). Only parents of young boys surviving RB reported lower on "autonomy" than the reference group, and parents of low visual acuity and blind RB survivors reported higher on "autonomy" than parents of visually unimpaired survivors. Survivors' perceptions and parents' perceptions correlated poorly on all HRQoL dimensions.

Conclusion: RB survivors reported a very good HRQoL compared with the Dutch reference group. The perceptions related to HRQoL differ substantially between parents and their children, i.e. parents judge the HRQoL of their child to be relatively poorer. Although the results are reassuring, additional factors of HRQoL that may have more specific relevance, such as psychological factors or coping skills, should be explored.

Figure 1

Deviation from mean in the Dutch reference group (z = 0), expressed as a z score for RB children (8–11 yrs) and RB adolescents (12–18 yrs) separately. KIDSCREEN-52 child/adolescent self-report subscales: FI = Financial; BU = Bullying; SC = School; PE = Peers; PR = Parent relations and home life; AU = Autonomy; SP = Self-perception; ME = Moods & Emotions; PS = Psychological well-being; PH = Physical well-being. Significance between Dutch reference group and RB children or adolescents: * p < 0.005.

Figure 2

Deviation from mean in the total RB group (z = 0), expressed as a z score for children (8–11 yrs) and adolescents (12–18 yrs) separately. KIDSCREEN-52 child/adolescent self-report subscales: FI = Financial; BU = Bullying; SC = School; PE = Peers; PR = Parent relations and home life; AU = Autonomy; SP = Self-perception; ME = Moods & Emotions; PS = Psychological well-being; PH = Physical well-being. Significance between RB child survivors and adolescent RB survivors: * p < 0.005