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Association of Family Stressful Life-Change Events and Health-Related Quality of Life in Fifth-Grade Children
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Details:
  • Pubmed ID:
    21464383
  • Pubmed Central ID:
    PMC4582781
  • Funding:
    K23 HD062677/HD/NICHD NIH HHS/United States
    U48 DP000056/DP/NCCDPHP CDC HHS/United States
    U48DP000046/DP/NCCDPHP CDC HHS/United States
    U48DP000056/DP/NCCDPHP CDC HHS/United States
    U48DP000057/DP/NCCDPHP CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    Objective

    To examine the association of recent family-related stressful life-change events (SLEs) with health-related quality of life (HRQOL) in fifth graders.

    Design

    Population-based, cross-sectional survey.

    Setting

    Three US metropolitan areas; 2004–2006.

    Participants

    A total of 5147 fifth graders and their parents.

    Main Exposures

    Nine recent family-related SLEs: a parent's death, another family member's death, a family member's injury/illness, a family member's alcohol/drug problems, loss of a pet, recent change of residence, addition of a new baby or child to the household, parental separation, and parental divorce.

    Main Outcome Measure

    The HRQOL measured using the 23-item Pediatric Quality of Life Inventory.

    Results

    Twenty-four percent of children had no reported recent SLEs; 33% had 1, 25% had 2, 12% had 3, and 6% had 4 or more. Mean HRQOL scores (total, physical, and psychosocial scales) were lower for children with more SLEs. The mean total HRQOL score was 80.4 (95% confidence interval, 79.4–81.3) for children with no recent SLEs and 71.8 (70.2–73.5) for children with 4 or more SLEs (P<.001). In adjusted logistic regression analyses, children with more SLEs had greater odds of impaired HRQOL compared with children without any SLEs. Psychosocial HRQOL fully mediated the relationship between SLEs and physical HRQOL.

    Conclusions

    The occurrence of multiple family-related SLEs in children is associated with less positive HRQOL. By incorporating the needs of families as part of comprehensive, high-quality care, health care professionals can identify these types of family-level needs and assist families in accessing community resources for support.