title: Child-related determinants of health-related quality of life in children with brain tumours 1 year after diagnosis.
abstract: OBJECTIVE
  Infratentorial tumour site and health-related quality of life (HRQL) 1 month after diagnosis have been shown to predict HRQL 1 year after diagnosis in children with brain tumours. This study aimed to identify additional early child-related determinants of parent- and child-report HRQL.
  
  
  METHODS
  Longitudinal prospective study. Semi-structured interviews took place approximately 1 and 12 months after diagnosis. HRQL was measured using the self- and parent-report Pediatric Quality of Life Scales (PedsQL 4.0) Total Scale Score and Health Utilities Index Mark 3 (HUI3) multi-attribute utility function. Child variables included performance and verbal IQ, general memory, selective attention executive function, behaviour problems, adaptive behaviour, symptoms of depression and anxiety and event related anxiety. Univariate analyses were used to identify potential early predictors of HRQL. Regression analysis was then used to identify the most important determinants of HRQL at 1 year.
  
  
  RESULTS
  Thirty-five patients completed the 12-month interviews. Multivariate analysis showed infratentorial tumour site remained an important determinant of HRQL 1 year after diagnosis. Infratentorial tumour site and selective attention at 1 month generally best predicted poor self- and parent-report HRQL at 12 months. Adaptive behaviour and performance IQ may be important.
  
  
  CONCLUSIONS
  Selective attention and infratentorial tumour site are most important in predicting both parent- and self-report HRQL at 1 year after diagnosis. Larger prospective studies are needed to confirm these findings. Cognitive remediation or/and pharmacological intervention, particularly aimed at children with infratentorial tumours may improve attention and subsequently HRQL and both merit further investigation.
authors.affiliation: Department of Paediatric Neurology, Frenchay Hospital, Bristol, UK. antpenn@doctors.org.uk
authors.forename: Anthony
authors.initials: A
authors.lastname: Penn
authors.forename: Robert I
authors.initials: RI
authors.lastname: Shortman
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Lowis
authors.forename: Michael C G
authors.initials: MC
authors.lastname: Stevens
authors.forename: Linda P
authors.initials: LP
authors.lastname: Hunt
authors.forename: Renee J
authors.initials: RJ
authors.lastname: McCarter
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Curran
authors.forename: Peta M
authors.initials: PM
authors.lastname: Sharples
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D015192:Infratentorial Neoplasms / Q000175:diagnosis / Q000628:therapy; D007360:Intelligence; D008297:Male; D008603:Mental Health; D011788:Quality of Life; D011795:Surveys and Questionnaires