Effectiveness of Generic and Disease-Specific Questionnaires in Assessing Quality of Life in Children With Type 1 Diabetes

TL;DR

This study shows that combining general and diabetes-specific questionnaires gives a better understanding of quality of life in children with type 1 diabetes.

Contribution

The study demonstrates the added value of combining generic and disease-specific HRQoL tools in pediatric type 1 diabetes.

Findings

Combined use of PedsQL 4.0 and PedsQL 3.0 provides the most accurate HRQoL assessment.

Diabetes symptoms and physical functioning are key factors in explaining HRQoL variability.

Abstract

Background: Health-related quality of life (HRQoL) evaluates the impact of health conditions on personal functioning. Type 1 diabetes mellitus (T1DM) in children and adolescents can significantly affect HRQoL due to the demands of daily disease management, psychological burden, and potential complications. The use of validated tools like Pediatric Quality of Life Inventory (PedsQL™) questionnaires is essential in assessing HRQoL. Combining generic and disease-specific scales offers a comprehensive evaluation.

Aim: The aim of this study is to assess the extent to which the PedsQL 4.0 and PedsQL 3.0 questionnaires explain the overall quality of life of children and adolescents with type 1 diabetes when used separately and in combination. Additionally, the study aims to identify which specific domains within these questionnaires are most significant in explaining the variability in overall quality of life scores.

Methods: A cross-sectional descriptive-analytical study was conducted from October 2021 to February 2022. The study assessed the quality of life of 50 children and adolescents (aged five to 18 years) diagnosed with type 1 diabetes mellitus, residing in Sarajevo Canton. Of these, 47 children/adolescents provided self-reports, while three children aged five to seven years were excluded from self-report analyses due to developmental limitations. However, parent proxy-reports were obtained for all 50 participants, including the three younger children. Accordingly, the final analysis included 47 child/adolescent self-reports and 50 parent proxy-reports. The study included children with a disease duration of >6 months and parental consent. The PedsQL™ 4.0 and PedsQL™ 3.0 Diabetes Module were used. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 26 (IBM Corp., Armonk, New York), including reliability testing, descriptive statistics, and multiple linear regression. Linear regression was selected to quantify the contribution of each questionnaire domain to overall HRQoL, offering an interpretable and robust method for assessing additive domain effects.

Results: The combined use of generic and diabetes-specific measures provided the most accurate assessment of HRQoL, capturing both general well-being and disease-specific challenges. Diabetes symptoms and physical functioning were key explainors.

Conclusion: The combined use of generic and diabetes-specific tools enables a more nuanced and comprehensive assessment of HRQoL in children and adolescents with T1DM. This study demonstrates that neither tool alone offers sufficient coverage, reinforcing the necessity of integrated assessment.