Table 7.
Determinants of self-reported quality of life (QoL) in adolescents with cerebral palsy: regression coefficients of the baseline, pain, Parenting Stress Index (PSI), Strength and Difficulties Questionnaire (SDQ), and combined models (longitudinal sample, n=355)
| Physical wellbeing | Psychological wellbeing | Moods and emotions | Self-perception | Autonomy | Relationships with parents | Social support and peers | School life | Financial resources | Social acceptance | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Baseline models | ||||||||||||
| Corresponding KIDSCREEN domain in childhood | 0·2 (0·1 to 0·3)* | 0·3 (0·1 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·3 (0·2 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·1 (0·0 to 0·2) | 0·1 (0·0 to 0·2)† | ||
| R2, % (95% CI) | 14% (11 to 24) | 12% (9 to 22) | 17% (13 to 30) | 16% (11 to 26) | 11% (8 to 21) | 13% (9 to 23) | 14% (10 to 26) | 9% (7 to 18) | 7% (4 to 17) | 16% (12 to 27) | ||
| Pain models | ||||||||||||
| Corresponding KIDSCREEN domain in childhood | 0·2 (0·0 to 0·2)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·3 (0·2 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·1 (0·0 to 0·2) | 0·1 (0·0 to 0·2)* | ||
| Frequency of pain in previous week | ||||||||||||
| In childhood | ||||||||||||
| None | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | ||
| Once or twice | −0·7 (−3·1 to 1·7) | −2·6 (−4·7 to −0·5)† | −4·0 (−6·5 to −1·4)* | −1·4 (−3·8 to 1·0) | −1·3 (−3·8 to 1·5) | −2·5 (−4·9 to −0·2)† | −0·9 (−4·1 to 2·4) | −1·8 (−4·4 to 0·9) | 0·2 (−2·4 to 2·7) | 1·5 (−1·0 to 4·0) | ||
| Frequent | 0·4 (−2·2 to 2·9) | −2·7 (−5·0 to −0·5)† | −2·7 (−5·1 to −0·2)† | −1·4 (−4·0 to 1·3) | −1·5 (−4·1 to 0·9) | −2·9 (−5·3 to −0·4)† | −1·9 (−5·3 to 1·7) | −1·2 (−3·7 to 1·2) | −0·7 (−3·3 to 2·0) | −0·2 (−2·9 to 2·3) | ||
| In adolescence | ||||||||||||
| None | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | ||
| Once or twice | −2·1 (−4·5 to 0·3) | −3·4 (−5·7 to −1·1)* | −3·2 (−5·6 to −0·6)† | −3·8 (−6·4 to −1·3)* | −2·2 (−4·7 to 0·4) | −1·9 (−4·4 to 0·5) | −1·8 (−5·2 to 1·3) | −1·8 (−4·4 to 0·7) | −1·4 (−4·1 to 1·2) | −2·6 (−5·3 to −0·2)† | ||
| Frequent | −6·3 (−9·0 to −3·8)* | −5·0 (−7·5 to −2·8)* | −5·4 (−7·7 to −2·9)* | −5·2 (−7·8 to −2·7)* | −3·0 (−5·6 to −0·4)† | −2·6 (−5·1 to 0·0) | −1·8 (−5·1 to 1·5) | −3·6 (−6·4 to −0·9)† | −2·2 (−5·2 to 0·5) | −5·0 (−7·7 to −2·5)* | ||
| R2, % (95% CI) | 20% (18 to 32) | 19% (15 to 30) | 24% (21 to 37) | 21% (16 to 32) | 13% (11 to 24) | 16% (13 to 28) | 14% (12 to 28) | 12% (9 to 22) | 8% (6 to 19) | 20% (17 to 32) | ||
| PSI models | ||||||||||||
| Corresponding KIDSCREEN domain in childhood | 0·2 (0·0 to 0·2)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·3 (0·2 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·1 (0·0 to 0·2) | 0·1 (0·0 to 0·2)* | ||
| Total PSI score in childhood | −0·1 (−0·1 to 0·0)† | −0·1 (−0·1 to 0·0)* | 0·0 (−0·1 to 0·0) | 0·0 (−0·1 to 0·1) | −0·1 (−0·1 to 0·0)* | −0·1 (−0·1 to 0·0)* | −0·1 (−0·2 to 0·0)† | 0·0 (−0·1 to 0·1) | 0·0 (−0·1 to 0·0) | −0·1 (−0·1 to 0·0) | ||
| Change in PSI | −0·1 (−0·2 to 0·0)* | −0·1 (−0·2 to 0·0)* | −0·1 (−0·1 to 0·0)* | 0·0 (−0·1 to 0·0) | −0·1 (−0·2 to 0·0)* | −0·1 (−0·1 to 0·0)* | −0·1 (−0·2 to 0·0)† | −0·1 (−0·1 to 0·0)* | −0·1 (−0·1 to 0·0) | −0·1 (−0·1 to 0·0)* | ||
| R2, % (95% CI) | 17% (13 to 29) | 16% (12 to 25) | 18% (15 to 32) | 16% (12 to 27) | 14% (13 to 25) | 16% (13 to 27) | 16% (13 to 29) | 11% (8 to 21) | 8% (5 to 18) | 18% (16 to 30) | ||
| SDQ models | ||||||||||||
| Corresponding KIDSCREEN domain in childhood | 0·2 (0·0 to 0·2)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·3 (0·2 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·4)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·1 (0·0 to 0·2) | 0·1 (0·0 to 0·2)† | ||
| Total SDQ Score in childhood | −0·3 (−0·4 to −0·1)† | −0·3 (−0·4 to −0·1) | −0·2 (−0·4 to 0·0)† | 0·0 (−0·2 to 0·2) | −0·2 (−0·4 to 0·0)† | −0·1 (−0·3 to 0·1) | −0·3 (−0·6 to −0·1)* | −0·2 (−0·4 to 0·0) | −0·2 (−0·4 to 0·0)† | −0·2 (−0·4 to −0·1)† | ||
| Change in SDQ | −0·2 (−0·4 to 0·0) | −0·2 (−0·4 to 0·0)† | −0·4 (−0·6 to −0·2)* | −0·2 (−0·4 to 0·0) | −0·2 (−0·5 to 0·0)† | −0·1 (−0·4 to 0·1) | −0·5 (−0·7 to −0·2)* | −0·3 (−0·6 to −0·1)* | −0·2 (−0·5 to 0.0) | −0.4 (−0.6 to −0.2)* | ||
| R2, % (95% CI) | 15% (13 to 27) | 15% (11 to 25) | 21% (17 to 34) | 17% (13 to 28) | 12% (10 to 23) | 13% (11 to 24) | 17% (14 to 29) | 11% (8 to 21) | 9% (6 to 19) | 19% (16 to 31) | ||
| Combined models | ||||||||||||
| Corresponding KIDSCREEN domain in childhood | 0·1 (0·0 to 0·2)† | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·3 (0·2 to 0·4)* | 0·1 (0·0 to 0·2)† | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·2 (0·1 to 0·3)* | 0·1 (−0·1 to 0·2) | 0·1 (0·0 to 0·2)† | ||
| Frequency of pain in previous week | ||||||||||||
| In childhood | ||||||||||||
| None | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | ||
| Once or twice | −0·6 (−3·1 to 1·8) | −2·5 (−4·7 to −0·5)† | −4·3 (−6·8 to −1·7)* | −1·6 (−4·0 to 0·9) | −1·2 (−3·8 to 1·4) | −2·4 (−4·8 to 0·0)† | −0·9 (−3·9 to 2·2) | −1·9 (−4·5 to 0·9) | 0·1 (−2·5 to 2·6) | 1·4 (−1·2 to 3·9) | ||
| Frequent | 0·7 (−1·9 to 3·2) | −2·4 (−4·8 to −0·2)† | −2·5 (−4·9 to −0·2)† | −1·5 (−4·2 to 1·1) | −1·4 (−3·9 to 1·0) | −2·9 (−5·2 to −0·5)† | −1·5 (−4·7 to 2·0) | −1·1 (−3·5 to 1·3) | −0·4 (−3·0 to 2·2) | 0·0 (−2·7 to 2·5) | ||
| In adolescence | ||||||||||||
| None | 0·0 (reference) | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | 0·0 | ||
| Once or twice | −1·8 (−4·2 to 0·6) | −3·1 (−5·4 to −0·9)* | −2·9 (−5·4 to −0·4)† | −3·8 (−6·3 to −1·3)* | −2·0 (−4·5 to 0·6) | −1·9 (−4·3 to 0·6) | −1·5 (−4·8 to 1·6) | −1·4 (−4·0 to 1·1) | −1·1 (−3·9 to 1·6) | −2·3 (−4·9 to 0·0)* | ||
| Frequent | −5·9 (−8·5 to −3·3)* | −4·5 (−6·9 to −2·3)* | −4·9 (−7·2 to −2·6)* | −5·1 (−7·7 to −2·5)* | −2·4 (−5·0 to 0·3) | −2·1 (−4·6 to 0·5) | −1·0 (−4·3 to 2·2) | −3·2 (−6·1 to −0·3)† | −1·9 (−4·8 to 0·9) | −4·5 (−7·1 to −2·0)* | ||
| Total PSI score in childhood | 0·0 (−0·1 to 0·0) | 0·0 (−0·1 to 0·0) | 0·0 (−0·1 to 0·1) | 0·0 (−0·1 to 0·1) | −0·1 (−0·1 to 0·0)† | −0·1 (−0·2 to 0·0) | −0·1 (−0·1 to 0·0) | 0·0 (0·0 to 0·1) | 0·0 (−0·1 to 0·1) | 0·0 (−0·1 to 0·0) | ||
| Change in PSI | −0·1 (−0·1 to 0·0)† | −0·1 (−0·1 to 0·0)† | 0·0 (−0·1 to 0·1) | 0·0 (−0·1 to 0·1) | −0·1 (−0·2 to 0·0)† | −0·1 (−0·2 to 0·0) | −0·1 (−0·1 to 0·0) | 0·0 (−0·1 to 0·0) | 0·0 (−0·1 to 0·0) | 0·0 (−0·1 to 0·0) | ||
| Total SDQ score in childhood | −0·2 (−0·4 to 0·1) | −0·1 (−0·4 to 0·1) | −0·2 (−0·4 to 0·0) | 0·0 (−0·2 to 0·3) | 0·0 (−0·3 to 0·2) | 0·1 (−0·1 to 0·3) | −0·2 (−0·5 to 0·1) | −0·2 (−0·5 to 0·1) | −0·2 (−0·4 to 0·1) | −0·1 (−0·4 to 0·1) | ||
| Change in SDQ | 0·0 (−0·3 to 0·2) | −0·1 (−0·3 to 0·2) | −0·4 (−0·6 to −0·2)* | −0·2 (−0·5 to 0·1) | 0·0 (−0·3 to 0·2) | 0·1 (−0·2 to 0·3) | −0·3 (−0·7 to 0·0)† | −0·2 (−0·5 to 0·0) | −0·1 (−0·4 to 0·1) | −0·3 (−0·6 to 0·0)† | ||
| R2, % (95% CI) | 22% (20 to 35) | 22% (18 to 34) | 28% (25 to 41) | 22% (18 to 34) | 16% (15 to 29) | 19% (16 to 32) | 18% (16 to 32) | 14% (12 to 26) | 9% (8 to 21) | 22% (21 to 36) | ||
Data are β coefficient (95% CI) unless otherwise stated. β coefficients for continuous covariates (QoL in childhood, SDQ, and PSI scores, changes in SDQ and PSI scores) show the average change in QoL in adolescence associated with a change of 1 point in the covariate. β coefficients for categorical covariates (pain) show the estimated average difference in QoL between the relevant category and the reference category. All regression models were adjusted for region, age, sex, and impairments that were significant in cross-sectional analyses. Changes in PSI and SDQ were calculated as adolescent scores minus childhood scores. CIs were calculated by bootstrapping. Statistical significance:
*
99% CI excluding zero
†
95% CI excluding zero.