title: Health-related quality of life and its determinants in children with a congenital diaphragmatic hernia.
abstract: BACKGROUND
  The development of new therapeutics has led to progress in the early management of congenital diaphragmatic hernia (CDH) in pediatric intensive care units (PICU). Little is known about the impact on the quality of life (QoL) of children and their family. The aim of this study was to assess the impact of CDH treated according to the most recent concepts and methods outlined above on child survivors' QoL and their parents' QoL.
  
  
  METHODS
  This study incorporated a cross-sectional design performed in two PICU (Marseille, France). Families of CDH survivors born between 1999 and 2008 were eligible. The following data were recorded: socio-demographics, antenatal history and delivery, initial hospitalization history. Self-reported data were collected by mail, including current clinical problems of the children (13-symptom list), children's QoL (Kidscreen-27 questionnaire), and parents' QoL (Short-Form 36 questionnaire). Children's QoL score was compared with controls and QoL of survivors of childhood leukemia. Parent's QoL was compared with controls. Non-parametric statistics were employed.
  
  
  RESULTS
  Forty-two families agreed to participate and questionnaires were completed by 32 of them. Twenty-one children had a current clinical problems related to CDH. All the QoL scores of CHD survivors were significantly lower compared with controls. The physical well-being dimension was significantly higher for CHD survivors compared with survivors of childhood leukemia. Gastro-esophageal reflux at discharge, antenatal diagnosis, length of stay in the PICU, and neuropsychological and respiratory issues significantly impacted QoL scores of children. The parents of CHD survivors had significantly poorer score in emotional role dimension compared with controls.
  
  
  CONCLUSIONS
  The impact of CDH on QoL seems to be important and must be understood by clinicians who treat these children and their parents.
authors.affiliation: Espace Ethique Méditerranéen, ADES UMR 7268 ADES, Espace Ethique Méditerranéen Aix-Marseille Université, Marseille 13385, France. fabrice.michel@ap-hm.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Michel
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.forename: Agathe
authors.initials: A
authors.lastname: Gosselin
authors.forename: Pierre
authors.initials: P
authors.lastname: Le Coz
authors.forename: Thierry
authors.initials: T
authors.lastname: Merrot
authors.forename: Sophie
authors.initials: S
authors.lastname: Hassid
authors.forename: Kathia
authors.initials: K
authors.lastname: Chaumoître
authors.forename: Julie
authors.initials: J
authors.lastname: Berbis
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006304:Health Status; D006548:Hernia, Diaphragmatic / Q000503:physiopathology / Q000523:psychology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D010290:Parents / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*