Determinants of health-related quality of life in polish patients with CF - adolescents' and parents' perspectives

Abstract

Aim: 1. Evaluation of health-related quality of life (HRQOL) in adolescents with cystic fibrosis (CF). 2. Evaluation of HRQOL in children with CF from the parents' perspective. 3. Evaluation of the relationship between HRQOL and both medical and psychosocial factors.

Material and methods: Health-related quality of life was measured with the Cystic Fibrosis Questionnaire - Revised. Seventy patients with cystic fibrosis, aged 14-18 years completed the version for adolescents and adults (CFQ-R 14⁺ and 70 parents of children aged 6-13 years filled out the version for parents (CFQ-R 6-13). Scores ranged from 0 to 100, with higher scores indicating a better quality of life. Disease severity was assessed by lung function test, nutritional status, chronic Pseudomonas aeruginosa infection and type of CFTR gene mutation. Social indices i.e. the patient's school attendance and the parent's work status were collected.

Results: In the adolescents' opinion, Eating problems and Digestive functioning got the highest rate, whereas Vitality, Treatment burden, Health perceptions and Weight got the lowest. Boys estimated their Physical functioning significantly higher than girls. When evaluating their children's quality of life, parents granted the highest score to Physical, Respiratory and Digestive functioning and the lowest results were attributed to Treatment burden. Nutritional status and lung function impairment turned out to be predictors of some other domains but not psychosocial ones. The chronic Pseudomonas aeruginosa infection had an influence on several quality of life areas from the parents' perspective. School attendance had a significant impact on many aspects of the adolescents' functioning.

Conclusions: 1. The study revealed that the health-related quality of life of CF children and adolescents is moderately good. 2. Digestive functioning was one of the highest scored domains, while Treatment burden was one of the lowest, according to both the adolescents' and the parents' perception. 3. The potential impact of disease severity was clearly marked in the group of younger children, whose health related quality of life was assessed by the parents. Self-evaluation conducted by adolescents was more subjective. 4. School attendace was an important factor of the quality of life. Further research is required in order to find other psychosocial indices.