title: Determinants of health-related quality of life in children newly diagnosed with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To examine the degree to which nonmedical factors explain additional variance in parent proxy report and child self-report of health-related quality of life (HRQOL) among newly diagnosed children with juvenile idiopathic arthritis (JIA) after accounting for medical factors.
  
  
  METHODS
  Parents (of children ages 2-16 years; n = 230) and patients (ages >5 years; n = 180) diagnosed within the previous 6 months completed surveys to assess medical (clinical parameters and functional status) and nonmedical (self-efficacy, coping, barriers to adherence, social support, parental distress, and access to care) factors and HRQOL (Pediatric Quality of Life Inventory Generic Core Scales). Physician-rated global assessment of disease activity, active joint count, and select laboratory variables (rheumatoid factor, antinuclear antibodies, and erythrocyte sedimentation rate) were recorded.
  
  
  RESULTS
  Nonmedical factors, including self-efficacy, coping with pain, barriers to adherence, social support, and parental distress, explained additional variance in HRQOL total, physical functioning, and psychosocial functioning scales (R(2) increases of 6%, 1%, and 13% for parent proxy report and 16%, 7%, and 30% for self-report, respectively). Parental distress was uniquely associated with parent proxy-report HRQOL, while child self-efficacy and social support were uniquely associated with self-report HRQOL.
  
  
  CONCLUSIONS
  Nonmedical factors are associated with HRQOL in newly diagnosed patients with JIA after accounting for medical variables, particularly for psychosocial functioning.
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Michael
authors: M
authors: Seid
authors: Bin
authors: B
authors: Huang
authors: Stacey
authors: S
authors: Niehaus
authors: Hermine I
authors: HI
authors: Brunner
authors: Daniel J
authors: DJ
authors: Lovell
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D017281:Cost of Illness; D004185:Disability Evaluation; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007629:Kentucky; D016014:Linear Models; D008297:Male; D009820:Ohio; D010147:Pain Measurement; D010290:Parents / Q000523:psychology; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D020377:Self Efficacy; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires
references: J Rheumatol. 2004 Feb;31(2):390-2
references: 14760812
references: MMWR Surveill Summ. 2005 Oct 28;54(4):1-35
references: 16251867
references: JAMA. 1995 Jan 4;273(1):59-65
references: 7996652
references: Pain. 1996 Sep;67(1):141-150
references: 8895242
references: Arthritis Rheum. 2006 Jun 15;55(3):378-84
references: 16739206
references: AIDS. 2002 Jan 25;16(2):269-77
references: 11807312
references: Health Psychol. 1988;7(5):421-31
references: 3215154
references: Arthritis Rheum. 2009 Mar 15;61(3):393-9
references: 19248113
references: J Rheumatol. 2005 Jan;32(1):150-61
references: 15630741
references: J Clin Rheumatol. 2005 Aug;11(4):194-204
references: 16357756
references: Ambul Pediatr. 2003 Nov-Dec;3(6):329-41
references: 14616041
references: Arthritis Rheum. 2007 Feb 15;57(1):35-43
references: 17266064
references: Health Qual Life Outcomes. 2006 Oct 11;4:79
references: 17034633
references: Med Care. 2001 Aug;39(8):800-12
references: 11468499
references: Arthritis Rheum. 1994 Dec;37(12):1761-9
references: 7986222
references: Arthritis Rheum. 2002 Mar;46(3):714-25
references: 11920407
references: Arthritis Rheum. 1978 Mar;21(2):229-33
references: 637889
references: FDA Consum. 2006 Nov-Dec;40(6):26-32
references: 17333563
references: Arthritis Rheum. 2007 Aug 15;57(6):1000-6
references: 17665465
references: Arthritis Care Res (Hoboken). 2012 May;64(5):694-703
references: 22238240
references: Rheumatology (Oxford). 2007 Feb;46(2):314-20
references: 16877459
references: Assessment. 2000 Jun;7(2):103-11
references: 10868247
references: Arthritis Rheum. 2001 Apr;45(2):159-66
references: 11324780
references: JAMA. 1999 Dec 15;282(23):2227-34
references: 10605974
references: J Pediatr Psychol. 2002 Mar;27(2):155-65
references: 11821499