Children's self-reported health-related quality of life after intensive care treatment

Introduction

A number of studies have reported on parental/clinician reports of children's health-related quality of life (HRQoL) after intensive care treatment [1]. The aim of this study was to establish children's own views as to their outcome in this regard.

Methods

A cohort of 102 children aged over 7 years, with no pre-existing learning difficulties, completed the PedsQL 4.0 Pediatric Quality of Life Inventory [2] and a post-traumatic stress screener in face-to-face interviews, 3 months after discharge from the PICU. Of this group, 76 also completed questionnaires, by post or telephone, at 12 months.

Results

Children's total PedsQL scores were significantly lower than those of healthy children at 3 months (PICU mean = 79.3; healthy mean = 83.9, P < 0.01), but at 12 months they were comparable. By 12 months, the mean score for the PICU group on the physical functioning subscale had improved significantly (from 73.1 to 81.5, P < 0.001) but was still below normal population levels (healthy mean = 88.5, P < 0.01). The total PedsQL score at 12 months was not associated with PIM score or length of stay, but was significantly negatively associated with post-traumatic stress symptoms (r = -0.40, P < 0.001). Within-group analyses revealed that electively admitted children reported higher emotional functioning than healthy children at 3 months (PICU elective mean = 91.0 vs healthy mean = 78.5, P < 0.01).

Conclusions

The self-report version of the PedsQL proved to be a feasible and responsive tool for assessing HRQoL in this group of PICU survivors. However, in order to assess this aspect of outcome for the majority of children admitted to the PICU, who are younger and/or have significant cognitive impairment, administration of the parent-proxy version of this questionnaire would be necessary.