Quality of life assessment in paediatric otolaryngology

Kubba, Haytham (2004) Quality of life assessment in paediatric otolaryngology. MD thesis, University of Glasgow.

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Abstract

Otolaryngologists are major providers of health care for children. The conditions treated by otolaryngologists can often have wide-ranging effects on a child's health-related quality of life (HRQOL). This thesis contains a review of the available instruments for assessing HRQOL in children, with studies of their applicability in the context of UK paediatric otolaryngology. In addition, two new instruments are described for assessing benefit after an intervention and for assessing quality of family life. The parents of 274 children referred to otolaryngology clinics with recurrent sore throats, recurrent acute otitis media or otitis media with effusion were asked, depending on the child's age, to complete at least two of the following instruments: the Health Utilities Index, the Child Health Questionnaire, TACQOL and TAPQOL. The responses showed that all the instruments measured HRQOL free from any obvious effect of age, sex or socioeconomic deprivation. HRQOL varied predictably with measures of disease severity (such as frequency of sore throats), although the CHQ and TAPQOL lacked sensitivity to the impairments present in otitis media with effusion. Ceiling effects were apparent in many domains in all instruments. The Quality of Family Life (QOFL) instrument was designed to assess the impact of a health condition on the family. It was applied in the same patient sample described above. QOFL scores were not affected by age, sex or socioeconomic deprivation. Internal consistency was high. More severe disease was associated with greater family impact. The Glasgow Children's Benefit Inventory (GCBI) was designed as a generic HRQOL measure specifically worded to assess benefit after an intervention and suitable for retrospective application. After initial piloting, it was posted out to the parents of 1777 children who had previously undergone tonsillectomy or ventilation tube insertion. 38% of questionnaires were returned. Correlation between GCBI scores and both technical success of surgery and parental satisfaction were strong. Internal consistency was high and the instrument had a coherent factor structure. As a result of the work described here, otolaryngologists have information to guide them in their choice of instrument from the wide range available, each suitable for a particular clinical situation.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: Stuart Gatehouse
Keywords: Medicine
Date of Award: 2004
Depositing User: Enlighten Team
Unique ID: glathesis:2004-71343
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 10 May 2019 10:49
Last Modified: 10 May 2019 10:49
URI: http://theses.gla.ac.uk/id/eprint/71343

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