Factors Associated With Quality of Life in Children Receiving Pediatric Palliative Care

• Published in: Journal of pain and symptom management Vol. 63; no. 3; pp. 395 - 403
• Main Authors: Lee, Jung, Kim, Min Sun, Kim, Cho Hee, Moon, Yi Ji, Choi, Yu Hyeon
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2022; Elsevier Limited
• Subjects: Caregiver depression; Caregivers; Caregivers - psychology; Child; Children; Cross-Sectional Studies; Enrollments; Family characteristics; Health status; Hospice and Palliative Care Nursing; Humans; Life-limiting condition; Medical records; Mental depression; Palliative Care; Pediatrics; Psychosocial factors; Psychosocial intervention; Psychosocial problems; Quality of life; Quality of Life - psychology; Symptoms; Underlying disease; LLC; PPC; Life-limiting condition; Caregiver depression; HRQoL; Underlying disease; Quality of life
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2021.10.005

Since pediatric palliative care (PPC) aims to improve the health-related quality of life (HRQoL) of children with life-limiting conditions (LLC), assessment of their HRQoL and identification of its determinants is crucial. To examine the clinical and family factors associated with HRQoL of children with LLC This was a cross-sectional study of 136 pediatric patients with LLC who were enrolled in the PPC services at Seoul National University Hospital in South Korea. Patients’ HRQoL was measured using the Pediatric Quality of Life 4.0. Clinical and family characteristics were gathered from the medical records and PPC registry database. Most children with LLC have a poor HRQoL at their enrollment for PPC services with significant variation in their total HRQoL scores according to the diagnostic categories. Patients with nonmalignant conditions showed significantly lower HRQoL scores than patients with malignancy. Lower HRQoL scores were associated with more caregiver depressive symptoms. In a multivariable regression model, total HRQoL scores of patients were significantly associated with diagnostic categories and caregiver's depressive symptoms after controlling for other clinical and family variables. Physical health summary scores were significantly associated with diagnostic categories and caregiver depressive symptoms. Psychosocial health summary scores were significantly associated with diagnostic categories, patient location, and caregiver's depressive symptoms. The HRQoL of children with LLC receiving PPC differed among underlying disease categories. Lower HRQoL was associated with more caregiver depressive symptoms. These findings suggest the needs for optimized intervention in palliative care for children with nonmalignant conditions and family-centered intervention to address caregivers’ psychosocial problems.