title: Parent perspectives of health related quality of life for adolescents with bladder exstrophy-epispadias as measured by the child health questionnaire-parent form 50.
abstract: OBJECTIVE
  Few groups have examined health related quality of life for adolescents with bladder exstrophy-epispadias. We studied parent reported health related quality of life for adolescents with bladder exstrophy-epispadias using the Child Health Questionnaire-Parent Form 50.
  
  
  METHODS
  We recruited 11 to 17-year-old participants with bladder exstrophy-epispadias and their parents. Parents served as proxy respondents for the adolescents by self-administering a validated generic health related quality of life instrument, the Child Health Questionnaire-Parent Form 50. We collected urinary incontinence, catheterization status, and medical and surgical history data. Mean questionnaire scores were compared to population based norms.
  
  
  RESULTS
  Median age of the 55 patients was 14 years, 69% were male and 84% were white. Diagnoses included bladder exstrophy in 48 cases and epispadias in 7. Of the participants 29 (53%) reported urinary incontinence. The median number of lifetime surgeries was 9. Although physical and psychosocial summary measure scores were comparable to norms, the mean general health perception score was significantly worse than that of a population based sample (65.8 points, 95% CI 61.4-70.2 vs 73, 95% CI 71.3-74.7, p = 0.004). Mean family activity and parent emotional impact scores were also significantly worse than in a population based sample (83.6 points, 95% CI 79.3-88.0 vs 89.7, 95% CI 87.9-91.5, p = 0.02 and 67.7, 95% CI 61.9-73.6 vs 80.3, 95% CI 78.4-82.2, p <0.0001, respectively). Comparison of incontinent to continent children revealed a lower mean score on the parent emotional impact scale (62.6 points, 95% CI 55.5-69.8 vs 73.4, 95% CI 63.9-82.9), which approached significance (p = 0.06).
  
  
  CONCLUSIONS
  Although overall adolescent quality of life was comparable to norms, parents reported significantly impaired adolescent general health and family activity as well as a negative parental emotional impact. Further research is needed to identify interventions that can decrease the adverse impact of bladder exstrophy-epispadias on family activity and parent emotional distress.
authors: Department of Urology, Johns Hopkins Medical Institutions, Marburg144, 600 North Wolfe St., Baltimore, Maryland 21287-2101, USA. jdodson@jhmi.edu
authors: Jennifer L
authors: JL
authors: Dodson
authors: Susan L
authors: SL
authors: Furth
authors: Gayane
authors: G
authors: Yenokyan
authors: Kaitlyn
authors: K
authors: Alcorn
authors: Marie
authors: M
authors: Diener-West
authors: Albert W
authors: AW
authors: Wu
authors: John P
authors: JP
authors: Gearhart
mesh_terms: D000293:Adolescent; D001290:Attitude; D001746:Bladder Exstrophy / Q000150:complications; D002648:Child; D004842:Epispadias / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D011788:Quality of Life; D011795:Surveys and Questionnaires