Kasturi Agnihotri1, Shally Awasthi. 1. Department of Pediatrics, Chhatrapati Shahuji Maharaj Medical University (Erstwhile King George's Medical University), Shahmina Road, Chowk, Lucknow, UP 226003, India.
Abstract
OBJECTIVE: To assess if Quality of Care (QoC) is a determinant of Health Related Quality of Life (HRQoL) in ill adolescents. METHODS: This Cross-sectional study, at a tertiary care hospital of Northern India was conducted after institutional ethical approval on ill adolescents availing ambulatory or in-patient care from Pediatrics department. From August 2009 through November 2010, 300 patients availing ambulatory or in-patient care were recruited, with mean age 11.5 years ±1.5SD, of which 65.7% were males. After obtaining parental written consent and oral assent from subjects, parents reported their perception of QoC as well as adolescent's HRQoL through Pyramid and culturally modified WHOQOL-BREF, respectively. Pyramid (score range 0-1) has 43 questions about awareness of 8 indices; namely illness, routines, accessibility, medical treatment, care processes, staff attitude, participation and staff work environment. WHOQOL-BREF (score range 0-100) has 4 domains: physical, psychological, social relations and environment. RESULTS: Mean HRQoL was 42.5 ± 5.6, mean QoC was 0.67 ± 0.07 and mean scores were not significantly different for patients on ambulatory and in-patient care. Correlation between overall HRQoL and QoC was 0.32 (p < 0.0001). Information about illness index was the only significant determinant of good HRQoL in binary logistic regression (Odd's Ratio 4.19, 95% CI 2.39-7.33; p < 0.0001). CONCLUSIONS: QoC is a significant determinant of ill adolescent's HRQoL at a tertiary care hospital.
OBJECTIVE: To assess if Quality of Care (QoC) is a determinant of Health Related Quality of Life (HRQoL) in ill adolescents. METHODS: This Cross-sectional study, at a tertiary care hospital of Northern India was conducted after institutional ethical approval on ill adolescents availing ambulatory or in-patient care from Pediatrics department. From August 2009 through November 2010, 300 patients availing ambulatory or in-patient care were recruited, with mean age 11.5 years ±1.5SD, of which 65.7% were males. After obtaining parental written consent and oral assent from subjects, parents reported their perception of QoC as well as adolescent's HRQoL through Pyramid and culturally modified WHOQOL-BREF, respectively. Pyramid (score range 0-1) has 43 questions about awareness of 8 indices; namely illness, routines, accessibility, medical treatment, care processes, staff attitude, participation and staff work environment. WHOQOL-BREF (score range 0-100) has 4 domains: physical, psychological, social relations and environment. RESULTS: Mean HRQoL was 42.5 ± 5.6, mean QoC was 0.67 ± 0.07 and mean scores were not significantly different for patients on ambulatory and in-patient care. Correlation between overall HRQoL and QoC was 0.32 (p < 0.0001). Information about illness index was the only significant determinant of good HRQoL in binary logistic regression (Odd's Ratio 4.19, 95% CI 2.39-7.33; p < 0.0001). CONCLUSIONS: QoC is a significant determinant of ill adolescent's HRQoL at a tertiary care hospital.