Gastrointestinal symptoms predictors of health-related quality of life in pediatric patients with functional gastrointestinal disorders

Objectives To investigate the patient-reported multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs). Methods The Pediatric Quality of Life Inventory™ (PedsQL™) Gastrointestinal...

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Bibliographic Details
Published in:Quality of life research 2017-04, Vol.26 (4), p.1015-1025
Main Authors: Varni, James W., Shulman, Robert J., Self, Mariella M., Nurko, Samuel, Saps, Miguel, Saeed, Shehzad A., Patel, Ashish S., Dark, Chelsea Vaughan, Bendo, Cristiane B., Pohl, John F.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Pain - psychology
Adolescent
Child
Child Health Services
Child, Preschool
Clinical outcomes
Consortia
Constipation
Dentistry
Diarrhea
Fecal incontinence
Female
Gastroenterology
Gastroesophageal reflux
Gastrointestinal Diseases - psychology
Hepatology
Hospitals
Humans
Irritable bowel syndrome
Landscape architecture
Linear Models
Male
Medicine
Medicine & Public Health
Nutrition research
Pain
Patients
Pediatrics
Predictive Value of Tests
Public Health
Quality of Life
Quality of Life Research
Severity of Illness Index
Sociology
Stomach
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Summary:Objectives To investigate the patient-reported multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs). Methods The Pediatric Quality of Life Inventory™ (PedsQL™) Gastrointestinal Symptoms Scales and PedsQL™ 4.0 Generic Core Scales were completed in a 9-site study by 259 pediatric patients with functional constipation, functional abdominal pain (FAP), or irritable bowel syndrome (IBS). Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL. Results Gastrointestinal symptoms were differentially associated with decreased HRQOL in bivariate analyses for the three FGIDs. In predictive models utilizing hierarchical multiple regression analyses controlling for age, gender, and race/ethnicity, gastrointestinal symptoms differentially accounted for an additional 47, 40, and 60 % of the variance in patient-reported HRQOL for functional constipation, FAP, and IBS, respectively, reflecting large effect sizes. Significant individual gastrointestinal symptoms predictors were identified after controlling for the other gastrointestinal symptoms in the FGID-specific predictive models. Conclusions Gastrointestinal symptoms represent potentially modifiable predictors of generic HRQOL in pediatric patients with FGIDs. Identifying the condition-specific gastrointestinal symptoms that are the most important predictors from the patient perspective facilitates a patient-centered approach to targeted interventions designed to ameliorate impaired overall HRQOL.
ISSN:0962-9343
1573-2649
DOI:10.1007/s11136-016-1430-3