BACKGROUND

STUDY AIMS

Contact : Gustavo Medrano at gmedrano@uwm.edu

FOR INFORMATION

DESCRIPTIVES

Child and Parent Health-Related Quality of Life in Families Receiving Treatment for Pediatric Chronic Pain

Gustavo R. Medrano1, Paul D. Gallo2, Keri R. Hainsworth4, Kim J. Anderson Khan3,4, Lynn M. Rusy3,4, W. Hobart Davies1, Steven J. Weisman 3,4

University of Wisconsin-Milwaukee1,University of Wisconsin-Milwaukee1,

Marquette University2,,Marquette University2,,

Children’s Hospital of Wisconsin 3Children’s Hospital of Wisconsin 3

Medical College of Wisconsin 4,Medical College of Wisconsin 4,

Pediatric psychology research has shown that the effects of having a health problem include psychological effects on patients and their families (Kazak et al., 2009).

Jastrowski Mano and colleagues (2011) found that child health-related quality of life (HRQOL) was positively correlated with both mothers' and fathers' own HRQOL and their reports of family functioning.

To elucidate the relationship between child and parent HRQOL in a pediatric chronic pain sample in a longitudinal fashion

HYPOTHESES We hypothesized that mother and father reports of their own HRQOL and family functioning at pre-intake and one month post-intake would predict child-reported HRQOL at 1 and 3 months post-intake.

METHODOLOGYParticipants consisted of families receiving treatment for pediatric chronic pain at an outpatient clinic at a pediatric hospital. Participants completed questionnaires at pre-intake, and at 1 month and 3 months post-intake.

Of the 230 families that agreed to participate in the longitudinal study, 108 families (47.0%) had returned at least a child and one parent report 2 out of 3 waves, and were subsequently included in the study.

The majority of the children were female (75.7%), White (85.8%) and adolescents (M = 14.5 years, SD= 2.5 years).

CONCLUSIONS Results of this study suggest that meaningful changes occur in the dynamics of parent and family functioning and child functioning early after treatment begins.

While understudied in pediatric pain, parent HRQOL and family functioning are related to child's HRQOL, and both potentially change once the child is involved in multidisciplinary treatment.

Moving forward, it is critical that we elucidate the aspects of the complex interplay between family and child functioning that are responsive to treatment early in the treatment process.

SELECTED REFERENCESJastrowski Mano, K., Khan, K., Ladwig, R. & Weisman, S. (2011). The impact of pediatric chronic pain on parent’s health-related quality of life and family functioning: reliability and validity of the PedsQL 4.0 Family Impact Module. Journal of Pediatric Psychology, 36(5), 517-527.

Kazak, A.E. Rourke, M.T., Navsaria, N. (2009). Families and other systems in pediatric psychology. In Roberts, M.C. & Steele, R.G. Handbook of pediatric psychology (4th ed. pp. 656-671). New York: Guilford Press.

Varni, J.W., Seid, M., & Rode, C.A. (1999). The PedsQL. Measurement model for the Pediatric Quality of Life Inventory. Medical Care, 37, 126-139.

Varni, J.W. Sherman, S.A. Burwinkle, T.M., Dickinson, P.E., & Dixon, P. (2004). The PedsQL Family Impact Module: Preliminary reliability and validity. Health and Quality of Life Outcomes, 2, 55.

MEASURESChildren completed the Pediatric Quality of Life Inventory (PedsQLTM; Varni et al., 1999) while parents completed the Family Impact Module (FIM; Varni et al., 2004).

The Parent HRQOL Summary and Family Functioning Summary Scores of both parents were alternatively used as predictors.

DATA ANALYSIS A series of regression models were created. The first set had the child's HRQOL at 1 month as the dependent variable, while the second set of regression models had the child's HRQOL at 3 months as the dependent variable.

Pre-Intake 1-Month 3-Month

Mother-FIM PHRQOL

70.51 (20.66) 71.63 (22.99) 76.19 (21.66)

Mother-FIM FF 68.13 (22.65) 68.82 (24.39) 70.54 (26.50)

Father-FIM PHRQOL

79.43 (18.41) 74.45 (23.61) 83.66 (14.49)

Father-FIM FF 71.49 (22.52) 67.72 (24.98) 75.00 (18.75)

Child HRQOL 59.09 (16.61) 61.57 (18.32) 64.13 (18.54)

Parent HRQOL Predicting Child HRQOL

Predictors Outcome F (df1, df2) R2 p f2

Pre-intakeMother PHRQOL, Father PHRQOL

1-Month Child HRQOL

8.54 (2, 41) 0.294 0.001 0.416

Pre-intakeMother PHRQOL, Father PHRQOL

3-Month 3-Month Child Child HRQOLHRQOL

0.92 (2, 31) 0.056 0.410 0.059

1-Month1-MonthMother PHRQOL, Mother PHRQOL, Father PHRQOLFather PHRQOL

3-Month 3-Month Child Child HRQOLHRQOL

4.41 (2, 36)4.41 (2, 36) 0.1970.197 0.019 0.245

Family Functioning Predicting Child HRQOLPredictors Outcome F (df1, df2) R2 p f2

Pre-intake Mother FF, Father FF

1-Month child HRQOL

6.65 (2, 40) 0.250 0.003 0.333

Pre-intake Mother FF,Father FF

3-Month Child HRQOL

1.52 (2, 30) 0.092 0.236 0.101

1-MonthMother FF,Father FF

3-Month Child HRQOL

7.74 (2, 36) .301 .002 .431