目标:在儿科肿瘤学中,对疾病认知的轨迹及其与健康相关生活质量(HRQoL)的纵向关联知之甚少.因此,本研究的目的是调查一年内儿童和父母对疾病认知的变化,并调查1年后儿童QoHRL急性治疗期间儿童和父母对疾病认知的预测价值.
方法:N=65个儿童-父母-二分体参与了一项纵向研究(保留率:80.2%)。儿童年龄为4-18岁,在基线时接受急性癌症治疗。儿童和父母报告了他们自己的疾病感知(疾病感知问卷修订),以及基线和一年随访时儿童的HRQoL(KINDL-R)。计算配对样品t检验以调查随时间的变化。进行分层多元回归分析,以研究儿童和父母的疾病感知对儿童HRQoL的预测价值。
结果:儿童的HRQoLt(63)=-6.73,p<0.001,他们对连贯性的看法(即理解;t(54)=-2.36,p=0.022)和疾病的后果(t(54)=2.86,p=0.006),父母对周期性轨迹的感知(t(61)=2.06,p=0.044)从基线到1年随访有所改善。所有其他疾病的看法保持稳定。探索性事后分析显示,年龄变化模式存在差异-性别-,和诊断特异性亚组。在控制HRQoL的基线水平后,儿童对症状和后果的感知是1年后HRQoL的独立预测因子(R2=0.396,F(2,52)=10.782,p<0.001),而没有父母的疾病感知增加预测价值。
结论:在儿科,应该评估孩子和父母对疾病的看法。我们的发现强调了疾病感知作为改善儿童HRQoL的干预措施中潜在可修改变量的重要性。
OBJECTIVE: In paediatric oncology, little is known about trajectories of illness perceptions and their longitudinal associations with health-related quality of life (HRQoL). Therefore, the aim of this
study was to investigate changes in illness perceptions in children and parents over a one-year-period and to investigate predictive value of child\'s and parent\'s illness perceptions during acute treatment for child\'s HRQoL 1 year later.
METHODS: N = 65 child-parent-dyads participated in a longitudinal
study (retention rate: 80.2%). Children were 4-18 years of age and underwent acute cancer treatment at baseline. Children and parents reported on their own illness perceptions (Illness-Perception-Questionnaire-Revised), as well as on the child\'s HRQoL (KINDL-R) at baseline and one-year-follow-up. Paired-samples t-tests were calculated to investigate changes over time. A hierarchical multiple regression analysis was performed to investigate predictive value of child\'s and parent\'s illness perceptions for child\'s HRQoL.
RESULTS: Child\'s HRQoL t(63) = -6.73, p < 0.001, their perceptions of coherence (i.e. understanding; t(54) = -2.36, p = 0.022) and consequences of their illness (t(54) = 2.86, p = 0.006), and parent\'s perception of cyclical trajectory (t(61) = 2.06, p = 0.044) improved from baseline to 1-year-follow-up. All other illness perceptions remained stable. Exploratory post-hoc analyses showed differences in the pattern of change in age-, gender-, and diagnosis-specific subgroups. After controlling for baseline levels of HRQoL, child\'s perceptions of symptoms and consequences were independent predictors of their HRQoL 1 year later (R2 = 0.396, F(2,52) = 10.782, p < 0.001), whereas no parent\'s illness perceptions added predictive value.
CONCLUSIONS: In paediatrics, child\'s and parent\'s illness perceptions should be assessed. Our findings highlight the importance of illness perceptions as potential modifiable variables in interventions to improve child\'s HRQoL.