Influence of gait analysis on decision-marketing for lower extremity surgery

Parent proxy reports of quality of life of children with cerebral palsy:are they associated with parental depression?

E DAVIS PHD A, E WATERS DPHIL A, A MACKINNON PHD B, R BOYD
MSC (PT) PHD C,E,F,G, D REDDIHOUGH MD BSC FRACP FAFRM C,D,E,
A SHELLY BSC (HONS) A, h K GRAHAM MD FRCS (ED) FRACS C,E,F,H

  1. 1. School of Health and Social Development, Deakin University;
  2. 2. Centre for Mental Health Research, Australian National University ;
  3. 3. Murdoch Children’s Research Institute;
  4. 4. Department of Child Development and Rehabilitation, Royal Children’s Hospital;
  5. 5. University of Melbourne;
  6. 6. Department of Orthopaedics, Royal Children’s Hospital;
  7. 7. School of Physiotherapy, La Trobe University, Melbourne;
  8. 8. Clinical Center for Research Excellence (CGRE) in Gait Rehabilitation, Australia

Objective: Although parent proxy reports of Quality of Life (QoL) are often used to guide health care decisions, a distinct paucity of research has examined factors associated with parent-proxy reported QoL. The aim of this study was to examine if parental depression is related to parent-proxy reported QoL and child self-reported QoL. It was hypothesized that parental depression would be associated with children’s QoL, even after controlling for child functioning.

Study Design: A cross-sectional survey.

Study Participants/Setting: From an elibile total of 695 families, 205 primary caregivers of children aged 4 to 12 years with cerebral palsy (CP) and 53 children aged 9 to 12 years with CP participated within their homes. The children, evenly distributed across sex (56% male) were sampled across Gross Motor Functioning Classification System (GMFCS) levels (Level I=18%, II=28%, III=14%, IV=11%, V=27%).

Method: Participants completed a mail-out questionnaire Both primary caregivers and children (if aged 9-12y and had sufficient cognitive ability) completed the Cerebral Palsy QoL Questionnaire for Children (CP QoL-Child), a new QoL instrument that has demonstrated reliability and  validity. The CP QoL-Child measures seven domains of life including social wellbeing and acceptance, feelings about functioning, participation and physical health, emotional wellbeing, access to services, pain and impact of disability, and family health. Primary caregivers also completed a measure of psychological distress, the Kessler 6, and parent-report GMFCS.

Results: Child functioning was positively correlated with parental depression (r=0.20) and some domains of proxy reported QoL (r=0.11 to r=0.62) across the whole sample of primary caregivers, depression was negatively correlated with all domains of parent-proxy reported QoL, after controlling for child functioning (ranging from r=-0.21 for emotional wellbeing to r=-0.52 for family health). For the sub-sample of families whose children completed the self-report questionnaire (n=53), parental depression was negatively correlated with parent proxy social wellbeing and acceptance (r=-0.29) and family health (r=-0.48). Parental depression was not correlated with any domains of child self-reported QoL (r=0.02 to r=-0.20).

Conclusions: Although causality cannot be attributed, this study highlights the association between parental depression and proxy-related QoL, which may be important for the interpretation of QoL scores in research and clinical settings and mental health service planning. The stronger correlation that is observed between parental depression and parent-proxy family health suggests that it is important to understand the relationship between parental depression, child self-reported QoL, and proxy ratings of QoL.

 
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