ABSTRACT
OBJECTIVE: To describe health-related quality of life (HRQOL) among youth with spinal cord injury (SCI), examine agreement between child and caregiver report HRQOL, investigate relationships between HRQOL and demographic, injury and psychological variables. METHODS: Caregivers and youth with SCI completed a pediatric HRQOL measure and mental health measures; injury information was gathered from medical records. RESULTS: One hundred and ninety-seven youth with SCI and their caregivers participated. HRQOL was associated with current age, age at injury, level of injury and child and caregiver anxiety/depression. Child mental health significantly predicted child-report HRQOL (p < .001, f(2)=1.07), whereas child (p < .001, f(2) = 0.098) and caregiver (p < .001, f(2) = 0.277) mental health both significantly predicted caregiver-report HRQOL. Agreement between child-report and caregiver-report was moderate at best, with youth rating their HRQOL as better than their caregivers. CONCLUSION: Mental health of youth and caregivers is critical to HRQOL in pediatric SCI. Interventions to optimize psychological adjustment should be provided to both caregivers and youth.
Subject(s)
Adaptation, Psychological , Mental Health , Parents/psychology , Quality of Life/psychology , Spinal Cord Injuries/psychology , Adolescent , Anxiety/psychology , Child , Child, Preschool , Depression/psychology , Health Status , Humans , Interviews as Topic , Psychiatric Status Rating Scales , Surveys and QuestionnairesABSTRACT
Aim To determine the levels of anxiety and depression in young people with spinal cord injuries (SCI) and their associated factors and outcomes. Method Children and adolescents aged 7 to 17 years at interview who had sustained SCI at least 1 year before the study were assessed using the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Pediatric Quality of Life Inventory, the Children's Assessment of Participation and Enjoyment, and a demographic questionnaire designed for the study. Results The 118 participants (61 males, 57 females) had a mean age of 12 years 4 months, SD 3 y 1 mo, range 7-17 y. Mean age at injury was 5 years 11 months, SD 4 y 11 m, range 0-16 y; 89 participants (75%) had paraplegia and 29 (25%) had tetraplegia. Fifty-seven (52%) had complete injuries and 52 (48%) had incomplete injuries according to the American Spinal Injury Association impairment scale. Thirteen participants (13%) reported significant symptoms of anxiety, and seven (6%) reported significant levels of depression, which were comparable to the normative population. Age, race, and sex were not associated with anxiety or depression, but participants with shorter duration of injury were more likely to be anxious, and those with less functional independence were more likely to be depressed. Only one dimension of participation was associated with anxiety and depression, but all aspects of quality of life were decreased among those with anxiety or depression. Interpretation The levels of anxiety and depression in young people with SCI are comparable to the normative range. When anxiety and depression occur they are associated with reduced levels of quality of life.
