Young traffic victims' long-term health-related quality of life: Child self-reports and parental reports

Abstract

Young traffic victims' long-term health-related quality of life Sturms, LM; van der Sluis, Corry K.; Groothoff, J.W.; ten Duis, HJ; Eisma, WH Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Objectives: To describe the long-term health-related quality of life (HRQOL) reported by young traffic injury victims and to assess the child-parent agreement on the child's HRQOL.Design: Cohort study with a mean follow-up of 2.4 years. Setting: Traumatology department in a university hospital in The Netherlands.Participants: All traffic injury victims treated at the traumatology department in 1996 -1997 and aged 8 to 15 years at follow-up (Nϭ254). The data of 157 child-parent pairs were available for analysis (mean follow-up age, 12Ϯ2.4y; 57% boys; 24% hospitalized).Interventions: Not applicable. Main Outcome Measure: TNO-AZL Children's Quality of Life parent and child questionnaires.Results: Young traffic injury victims reported a significantly lower HRQOL in the motor and autonomy scales compared with contemporaries in the reference group. The child-parent agreement ranged from low to moderate (intraclass correlations, .35-.67). A comparison made between the children and their parents found that the children were more negative regarding the physical complaints and the motor, autonomy, and positive-emotion scales.Conclusions: Young traffic injury victims reported a reasonably good long-term HRQOL, and, surprisingly, few psychologic problems were revealed. Physicians who rely only on parental reports may overestimate the child's HRQOL, especially when assessing the physical functioning. The child's own reports should not be neglected in the assessment of a comprehensive picture of the child's HRQOL.

Prevalence and Prognostic Factors of Disability After Childhood Injury

“…The literature mentions that parental reports may overestimate the child's functioning, especially when assessing the physical functioning. 7 This can also be confirmed by our research outcomes, because parents valued their children's health better than children themselves (0.93 vs 0.91 after 2.5 months). The higher prevalence of disability of girls in the long term is not influenced by parent proxy reports.…”

“…28 First, children's self-report may be theoretically preferable because it is consistent with the subjective nature of the EuroQol (made for self-completion), and evidence is emerging that children are able to provide accurate and reliable information concerning their health status. 7 Hennessy and Kind 29 argued that it is at least possible to use the EQ-5D for self completion with a school-aged population (12-18 years). Particularly younger children are not able to provide reliable information on abstract, health-related concepts.…”

“…The parents may realize that the injury could have resulted in a worse outcome and that, with respect to the initial injury, their child is doing well. 7 Although the exact values between child and adult might be different, previous research suggested that at least the ranking order largely will be the same. 21 We compared our estimates with EuroQol data from a Dutch study of children in the general population, which found a mean EQ-5D summary score of 0.92 for children (aged 5-15 years).…”

“…[3][4][5][6] However, functional outcome in children has received little or no attention. 7 Assessment of patient outcome after injury for children so far has focused mainly on the psychological effects, [8][9][10] or only on the most severely injured trauma patients, including children with traumatic brain injury. [11][12][13][14][15] Few studies have described the impact of injuries on the health status of children with both minor and major injuries over time with a generic quality-of-life measure.…”

“…[11][12][13][14][15] Few studies have described the impact of injuries on the health status of children with both minor and major injuries over time with a generic quality-of-life measure. 7,16 This article describes a large follow-up study in injured children who were aged 5 to 14 years and had visited an emergency department in the Netherlands. This study is an extension of an earlier follow-up study on functional outcome of injured people who were aged 15 years and older with a similar design.…”