title: A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system.
abstract: BACKGROUND
  Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model.
  
  
  METHODS
  In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data.
  
  
  RESULTS
  The model fitted the data closely (CHISQ(14) = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: beta = .21) and emotional support (PCS: beta = .14; MCS: beta = .28). Also, female gender (beta = -.10), age (beta = .10), being chronically ill as a parent (beta = -.34), and care dependency of the child (beta = -.14; beta = -.15) were directly related to parental HRQoL.
  
  
  CONCLUSIONS
  The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.
authors.affiliation: Psycho Social Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, The Netherlands. j.hatzmann@amc.uva.nl
authors.forename: Janneke
authors.initials: J
authors.lastname: Hatzmann
authors.forename: Heleen
authors.initials: H
authors.lastname: Maurice-Stam
authors.forename: Hugo S A
authors.initials: HS
authors.lastname: Heymans
authors.forename: Martha A
authors.initials: MA
authors.lastname: Grootenhuis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008962:Models, Theoretical; D010290:Parents; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires