What predicts the proxy-reported health-related quality of life of adolescents with cerebral palsy in Bangladesh?

Abstract

Background: The health-related quality of life (HRQoL) of adolescents with CP in low and middle-income countries is often poor, as is the case in Bangladesh. This exploratory study examined what factors predict the proxy-reported HRQoL of adolescents with CP in rural Bangladesh, a typical low-and middle-income country (LMIC). Methods: Adolescents with CP (10 to 18y) were identified using the Bangladesh Cerebral Palsy Register. HRQoL was assessed using the Cerebral Palsy Quality of Life-Teens proxy-report questionnaire (CPQoL-Teens), adolescent mental health using the Strengths and Difficulty Questionnaire (SDQ) and caregiver mental health using the Depression, Anxiety and Stress Scale (DASS-21). Theoretical and statistical interests (i.e. bivariate analysis, p < 0.05) identified potential predictors which were entered into hierarchical multiple linear regression (HMLR) models in order of clinical significance; HMLR related adolescent clinical characteristics, adolescent and caregiver mental health and proxies of socioeconomic status to CPQoL-Teens dimensions. Results: One hundred fifty-four adolescents with CP (mean age 15y 1mo, SD 1y 8mo, female 31.2%) participated in this study. Twenty-four factors were identified to explore for relationship to adolescent proxy-reported HRQoL. Fifteen of the factors correlated to one or more CPQoL-Teens dimension; strongest correlation was between 'feelings about functioning' and motor impairment (r = 0.545). Nine were predictive of CPQoL-Teens dimensions; adolescent sex, school attendance, severity of motor impairment, hearing and speech impairment, mother's education, primary caregiver depression and stress, and having a sanitary latrine at home resulting in score changes of between 0.79 (95% CI 0.24 to 1.35) to 35.1 (95% CI 6.03 to 64.22). Conclusions: Many of the factors predicting the proxy-reported HRQoL of adolescents with CP are amenable to intervention, and have the potential to improve adolescent wellbeing. Several determinants are priorities of the sustainable development goals (SDGs); these findings should inform resource prioritization to improve the wellbeing of adolescents with CP in Bangladesh and other LMICs.

An implementation science approach to evaluating pathogen whole genome sequencing in public health

“…Relevant indicators may include epidemiological measures such as the number of identified cases; size, duration and number of identified clusters; the proportion of cases linked to clusters; and the proportion of cases/clusters traced to a contamination source. Although challenging to collect economic data, additional indicators may relate to financial costs such as resource allocation for epidemiological investigations and infection control investigations and actions [ 24 , 29 ]; direct health care costs [ 30 ]; financial losses relating to food-borne disease outbreaks (e.g. food recalls); clean-up costs in relation to water and environmental outbreaks [ 29 , 31 , 32 ]; and costs associated with sick leave, both for employers in the form of reduced productivity and for employees as loss of income [ 30 ].…”

“…Although challenging to collect economic data, additional indicators may relate to financial costs such as resource allocation for epidemiological investigations and infection control investigations and actions [ 24 , 29 ]; direct health care costs [ 30 ]; financial losses relating to food-borne disease outbreaks (e.g. food recalls); clean-up costs in relation to water and environmental outbreaks [ 29 , 31 , 32 ]; and costs associated with sick leave, both for employers in the form of reduced productivity and for employees as loss of income [ 30 ]. Data collection and analyses may vary significantly depending on the epidemiology of the pathogen under consideration, the type of data available and the context (i.e.…”

Prevalence and impact of the use of electronic gadgets on the health of children in secondary schools in Bangladesh: A cross‐sectional study

“…14,15 According to a study, 90% of the adolescents in Bangladesh use smartphones. 16 It is notable that this population does not always use their phones, the internet and other gadgets for merely socializing or learning purposes. 15 Hence, owing to the above-mentioned facts, the present study was carried out in various cities of Bangladesh to find out the effect of the use of electronic gadgets on the overall behavior and health of secondary school-going children.…”

Functional and environmental predictors of health‐related quality of life of school‐age children with cerebral palsy: A cross‐sectional study of caregiver perspectives

“…Although CP per definition affects mobility, gross motor functioning had no predictive value. Previous literature concerning the relationship between motor impairment and HRQoL has shown little predictive value of impairment severity and no association between GMFCS level and HRQoL (Alsem et al, 2013; Power et al, 2020; Radsel et al, 2017; Rapp et al, 2017; Shikako‐Thomas et al, 2009). In contrast, studies focused on the long‐term trajectories of HRQoL found that the functional effect of CP was particularly predictive of physical well‐being (Tan et al, 2014) and that motor severity was associated with HRQoL (Lai et al, 2017).…”