Pediatric Quality of Life Inventory (PedsQL)

Posted on: February 24, 2017 | By: rmatalon2 | Filed under: Pediatric Quality of Life Inventory (PedsQL)

The Pediatric Quality of Life Inventory (PedsQL) is a useful tool to evaluate the reported quality of life in children within a healthcare setting as per the child’s self-report or the parent/caregiver’s observations. The preliminary post addresses many details about this inventory measure, however, there are some additional facts to be mentioned.

In addition to this inventory having usefulness in healthcare settings, the tool was designed for employment in community and school populations. Due to the nature of this design, the inventory contains segments that address the physical, emotional, social, and scholastic functioning of the child, in question. These segments are broken into two categories of scores, the physical health summary score and the psychosocial health summary score. Together, these scores give a more well-rounded and complete depiction of the child’s status. Even more useful about this tool, is that there are disease-specific modules of the measure that are available to tend to the unique circumstances of a particular child. Further, since the tool can be administered at different points in the child’s experience, it is known to be a responsive measure of change. Despite the efficacy of such a tool, it is fully protected under copyright, with all rights reserved to Dr. James W. Varni; thus the mention of cost variances in the preceding post.

Since the inception of this measurement tool, there have been a number of studies performed to validate the reliability and validity of the inventory. One such article is that by authors, Desai et al. This publication’s purpose is to assess the validity of the Pediatric Quality of Life Inventory (PedsQL) in the pediatric hospital inpatient setting. The authors provided the PedsQL to children between the ages of 1 month and 18 years old who were admitted to Seattle Children’s Hospital between October 1, 2011 and December 31, 2013. The exclusionary factors implemented precluded the following patients and their families from participating: those who are younger than 1 month old, those who require protective isolation, those who were asked to participate within 2 months prior to this study, those who require 24-hour video EEG or pH probe studies, those of suspected child abuse, or those with developmental delays. Approximately 38% of qualified participants completed the surveys from the time of admission as well as upon discharge. The responses to the inventory were either reported by the parents or caregivers, or the child, him/herself.

Methods: Those who participated received the inventory within 72 hours of admission to the hospital as well as 2-8 weeks after discharge from the hospital. Overall, the PedsQL assesses 4 domains of a child’s experience with his/her quality of life: physical functioning, emotional functioning, social functioning, and school functioning. The inventory can be designed either for the child to assess him/herself or for the parent/caregiver to act byproxy. However, there is also the PedsQL Infant Scale, for those between the ages of 1-24 months, that assesses 5 domains of the child and is filled out by a parent/caregiver. These domains are as follows: physical functioning, physical symptoms, emotional functioning, social functioning, and cognitive functioning. The scale score responses were converted into numbers ranging from 0 to 100 and were statistically analyzed. A higher score means a better quality of life. The PedsQL Inventory is the actual outcome measure being assessed in this study, rather than any intervention. The purpose of the authors’ work is to assess the validity and efficacy of the PedsQL as an outcome measure, rather than assess an intervention applied. The participants in the study received the interventions that were suited for their individual diagnoses and needs, as per the hospital’s standards. The PedsQL was administered to gauge the quality of life of each participant and assess whether the scores followed the theoretical trends, making the inventory a useful tool for measuring children’s experience while they are inpatients in a hospital. The scores were analyzed via the calculations of improvement from admission to discharge follow up. The data was applied towards a paired t-test and Cohen d analysis to identify the significance in the score changes.

Results: The findings from the study indicate that the PedsQL has the ability to accurately assess the quality of life of children in the inpatient setting. The results showed that those with more complex conditions and/or chronic illnesses, held a decreased quality of life as compared to those without chronic conditions. The results of the inventory also showed that the scores improved between the time of admission and discharge, as predicted. These results indicate that the PedsQL does have the ability to demonstrate the QOL as reported by patients and their caregivers, that is in keeping with the expected norms and trends.

The strengths of this study are that it is the first of its kind to fill a gap in the known data regarding the PedsQL. It is the first study to evaluate quality of life in a large and diverse population of children within a hospital setting. The participants included in the study are from various backgrounds, diagnoses, and ages. This study found that the PedsQL has the strength to be integrated into the protocol of patient case-load to assess and track patient experience. Due to the authors’ comparison of the calculated results to expected norms, this study is also the first to identify the predictive properties of the PedsQL in a hospital setting. Another strength is that the inventory has the ability to act as a subjective and objective outcome measure. Additionally, the authors were able to run statistical data analysis, which adds to the validity of their findings.

As with any study, there are limitations. In this particular instance, the downfalls include the following: caregiver reports may not be as reliable as patient report in terms of psychological health, the study was conducted at one hospital and may be considered lacking in true heterogeneity, there was a very limited response after discharge that has the potential to contribute to bias, and the authors allowed for an exaggerated timeframe for families and patients to submit their discharge surveys, which may have produced responses with added variables that affected the follow up scores.

Conclusion: The PedsQL has the ability to evaluate and record the quality of life of juvenile patients in hospitals through either patient report or by parent/caregiver report. This inventory is a simple way to assess the status of patients as well as to administer within hospital settings. With the implementation of the PedsQL in hospitals, there can begin to be a valid and reliable method of determining how effective interventions are and how appropriate patient care and management are. Further, the inventory may be used as a predictive tool to determine length of stay, rehab potential, and potential re-admission risk.

 

 

References:

Desai, A. D., Zhou, C., Stanford, S., Haaland, W., Varni, J. W., & Mangione-Smith, R. M. (2014). Validity and Responsiveness of the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in the Pediatric Inpatient Setting. JAMA Pediatrics, 168(12), 1114-1121. doi:10.1001/jamapediatrics.2014.1600

Varni, J. W. (1998). PedsQL TM (Pediatric Quality of Life Inventory TM). Retrieved February 22, 2017, from http://pedsql.org/about_pedsql.html

 

2 responses to “Pediatric Quality of Life Inventory (PedsQL)”

  1. hmchugh says:

    Although the PedsQL is mainly used in community and school settings, I think that it was beneficial this study concluded this outcome measure could be used in the inpatient/hospital setting. Although this study did not let children under the age of 1 month participate, I thought it was smart that there was also a PedsQL infant scale available. I would also agree that a major limitation of this study and the tool is that it is based on caregiver reporting, which may be subjective, and could skew the results and scoring.

  2. dstirparo says:

    The PEDsQL offers a reliable and valid way to track progress of pediatric patients as they progress through their treatment. This is a useful test and measure as it can be administered over a wide range of ages and diagnoses while still maintaining its accuracy. It is an interesting thought for this inventory to be potentially used as a way to determine LOS, rehab potential, and readmissions risk. I would like to see more research aimed at investigating the PEDsQL in this manner.

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