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Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?

ABSTRACT: PURPOSE:We examined if child maltreatment (CM) is associated with worse health-related quality of life (HRQoL) in midlife women and if the association is mediated by psychosocial factors. METHODS:A total of 443 women were enrolled in the Pittsburgh site of the longitudinal Study of Women's Health Across the Nation-Mental Health Study. The analytic sample included 338 women who completed the SF-36 and the Childhood Trauma Questionnaire. Generalized linear regression was used to assess the association between CM and two HRQoL component scores. Structural nested mean models were used to evaluate the contribution of each psychosocial mediator (lifetime psychiatric history, depressive symptoms, sleep problems, very upsetting life events, low social support) to the association. RESULTS:Thirty-eight percent of women reported CM. The mean mental (MCS) and physical (PCS) SF-36 component scores were 2.3 points (95% CI -?4.3, -?0.3) and 2.5 points (95% CI -?4.5, -?0.6) lower, respectively, in women with any CM than in those without. When number of CM types increased (0, 1, 2, 3+?types), group mean scores decreased in MCS (52, 51, 48, 47, respectively; p?

SUBMITTER: Lin HS

PROVIDER: S-EPMC7366611 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?

Lin Hsing-Hua S HS Naimi Ashley I AI Brooks Maria M MM Richardson Gale A GA Burke Jessica G JG Bromberger Joyce T JT

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 20180818 12

<h4>Purpose</h4>We examined if child maltreatment (CM) is associated with worse health-related quality of life (HRQoL) in midlife women and if the association is mediated by psychosocial factors.<h4>Methods</h4>A total of 443 women were enrolled in the Pittsburgh site of the longitudinal Study of Women's Health Across the Nation-Mental Health Study. The analytic sample included 338 women who completed the SF-36 and the Childhood Trauma Questionnaire. Generalized linear regression was used to ass ...[more]

PMID: 30121897

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Project description:BackgroundChild maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes.MethodsWe reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D) for appropriateness in measuring change in quality of life due to child maltreatment.ResultsWe did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3. Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D) have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment.ConclusionRecommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However, if relevant domains are not included in existing instruments or if valuing health for children less than 6 years of age, direct valuation with a proxy respondent is recommended. The choice of a proxy respondent is not clear in the case of child maltreatment since the parent may not be a suitable proxy. Adult survivors should be considered as appropriate proxies. Longer-term research should focus on identifying the key domains for measuring child health and the development of preference-based quality-of-life instruments that are appropriate for valuing child maltreatment outcomes.

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Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?

Publications

Child maltreatment as a social determinant of midlife health-related quality of life in women: do psychosocial factors explain this association?

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