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Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS.

ABSTRACT: BACKGROUND:To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents. METHODS:Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003-2006 baseline survey; N =?14,835, aged 3 to 17?years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models. RESULTS:Of 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta?=?-?1.02; 95%CI: -1.86 to -?0.18; p =?0.018) and sub-scale 'friends' (adjusted beta?=?-?2.18; 95%CI: -3.56 to -0.80; p =?0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like 'hyperactivity/inattention' (adjusted OR?=?1.50; 95%CI: 1.14 to 1.98; p =?0.005), and 'peer problems' (adjusted OR?=?1.35; 95%-CI: 1.05 to 1.74; p?=?0.018) as reported by parents. CONCLUSIONS:Strabismus in children and adolescents is associated with lower health-related quality of life.

SUBMITTER: Schuster AK

PROVIDER: S-EPMC6505127 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS.

Schuster Alexander K AK Elflein Heike M HM Pokora Roman R Schlaud Martin M Baumgarten Franz F Urschitz Michael S MS

Health and quality of life outcomes 20190507 1

<h4>Background</h4>To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents.<h4>Methods</h4>Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003-2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the ...[more]

PMID: 31064363

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Project description:BackgroundThe well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account.MethodsThe sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014-2017). Sex-and age-specific BMI (kg/m2) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses.Results18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = -.14, standard error [SE] = .03, p < .001, and obesity: β = -.16, SE = .03, p < .001; girls with overweight: β = -.09, SE = .04, p = .011, and obesity: β = -.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = -.10, SE = .04, p = .002) and parent-related well-being (β = -.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers.ConclusionHRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.

Project description:BackgroundMalaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients.MethodsIn April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads.ResultsAt the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT.ConclusionsMalawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have basic case management tools, and health worker performance in diagnosing malaria must be improved.

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Project description:AimTo assess the health-related quality of life (HRQoL) and mental health of adolescents with cerebral palsy (CP) in rural Bangladesh.MethodsCase-control study of adolescents with CP (10 to ?18-years) and age and sex matched controls without disability. Primary caregivers were included for proxy report. HRQoL was measured with Bengali versions CP Quality of Life-Teens (CPQoL-Teens) and KIDSCREEN-27. Mental health was measured with Strengths and Difficulties Questionnaire (SDQ).Results154 cases and 173 controls matched on age and sex participated (mean age 15.1 (1.6) and 14.9 (1.6) respectively; female n = 48, n = 55 respectively, p>0.05). CPQoL-Teens was administered to adolescents with CP only; mean outcomes ranged from 38.5 (27.4) to 71.5 (16.1) and 'feelings about functioning' was poorest domain for both self- and proxy-report groups. KIDSCREEN-27 was administered to adolescents with CP and controls; adolescents with CP mean outcomes ranged from 25.9 (12.2) to 48.7 (10.56) and were significantly poorer than controls, mean difference 4.3 (95% CI 0.7 to 7.8) to 16.7 (95% CI 14.5 to 18.5), p<0.05. 'Peers and social support' was poorest domain for all groups. In regards to mental health, adolescents with CP reported significantly poorer mean SDQ than peers without disability, mean difference 0.7 (95% CI 0.3 to 1.1) to 7.8 (95% CI 6.7 to 8.9), p<0.05; and were for self-report 7.8 (95% CI 2.6 to 23.0) and proxy-report 12.0 (95% CI 6.9 to 20.9) times more likely to report 'probable' range 'total difficulties' score. Individual item analysis of CPQoL-Teens and KIDSCREEN-27 identified unique areas of concern for adolescents with CP related to pain, friendships, physical activity and energy, what may happen later in life, and feelings about having CP. Financial resources were of concern for both cases and controls.InterpretationAdolescents with CP in rural Bangladesh are at high risk of poor HRQoL and mental health problems. Effort to reduce the disparity between adolescents with CP and those without disability should consider wellbeing holistically and target dimensions including physical, psychological and social wellbeing. Specific interventions to alleviate modifiable aspects of HRQoL including pain, social isolation, and physical in-activity are recommended.

Project description:This study's aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003-2006, follow-up: 2009-2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents' health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.Because the direct effects of family structure on adolescents' health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents' health, prevention programmes and interventions should be directed towards the parent-adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.

Dataset Information

Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS.

Publications

Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS.

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