title: Low impact of congenital hand differences on health-related quality of life.
abstract: OBJECTIVE
  To evaluate health-related quality of life (HRQoL) and its determinants in children with congenital hand differences (CHDs).
  
  
  METHODS
  Survey.
  
  
  METHODS
  Outpatient clinic of a university hospital.
  
  
  METHODS
  Children (N=116; age range, 10-14 y) with CHDs.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  HRQoL evaluated by child self-reports of the Pediatric Quality of Life Inventory and compared with reference values of healthy peers. Multivariable regression analysis was performed to investigate determinants of HRQoL.
  
  
  RESULTS
  All children with CHDs had scores similar to those of healthy peers, except for a lower score on social functioning in children aged 13 to 14 years. Higher ease of activity performance was related to higher HRQoL scores, and presence of comorbidity was related to lower scores on all HRQoL subdomains except for school functioning. Additionally, physical health was influenced by ethnicity, bilateral involvement, and previous surgery; emotional functioning by the number of affected digits; school functioning by age; and total HRQoL by bilateral involvement.
  
  
  CONCLUSIONS
  Children with CHDs report similar HRQoL as healthy peers. HRQoL decreased in the presence of comorbidity but increased with higher ease of activity performance. Scores on some subdomains were improved by the number of affected digits, but were reduced by age, ethnicity, bilateral involvement, and surgery. Although HRQoL is an important health outcome, it may not be sensitive to detect changes over time or changes after treatment in children with CHDs.
authors.affiliation: Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. m.ardon@erasmusmc.nl
authors.forename: Monique S
authors.initials: MS
authors.lastname: Ardon
authors.forename: Wim G
authors.initials: WG
authors.lastname: Janssen
authors.forename: Steven E
authors.initials: SE
authors.lastname: Hovius
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D015897:Comorbidity; D005006:Ethnicity; D005260:Female; D006228:Hand Deformities, Congenital / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009048:Motor Skills; D010379:Peer Group; D011788:Quality of Life; D012044:Regression Analysis