title: Health-related quality of life of the rural-China left-behind children or adolescents and influential factors: a cross-sectional study.
abstract: BACKGROUND
  Due to sustained export of labor service, the left-behind children/ adolescents in rural areas of China have become a group that can no longer be neglected. However, even up to this day, little is known about the health-related quality of life (HRQoL) of the left-behind children/adolescents, particularly in Midwest China. This study aims at investigating their living condition and analyzing the influential factors of their HRQoL.
  
  
  METHODS
  A cross-sectional study based on households was conducted and 1363 children or adolescents from rural areas of 6 provinces in China, among whom 608 were left-behind and 755 were non-left-behind, were enrolled in a multistage sampling. HRQoL was revealed using the Pediatric Quality of Life Inventory (PedsQL). Differences in scores were analyzed using rank sum tests, and multivariate analyses were conducted with multiple linear regression.
  
  
  RESULTS
  There was a total of 608 (44.61%) left-behind children or adolescents, and they scored significantly lower in terms of the HRQoL synthesis scores (F = 6.14, P < 0.05), Physical Functioning (H = 33.18, P < 0.05), Emotional Functioning (H = 24.99, P < 0.05) and Social Functioning (H = 12.24, P < 0.05), compared with the non-left-behind. Multiple linear regressions indicated that age and mother's final academic qualification were in positive correlation with the HRQoL of the left-behind children, while mother's longer migrant working time and less frequent visits, and being reared by uncle/aunt etc., were potential risk factors for the left-behind children.
  
  
  CONCLUSIONS
  The HRQoL scores of left-behind children or adolescents were significantly lower than those of their counterparts both in the physical and the psychological domains. Influential factors should be considered when relevant policies are being made and intervening practices are being undertaken in the future, so as to improve the HRQoL of the left-behind children or adolescents.
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. iamhuangyun@sina.cn.
authors.forename: Yun
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. zxn66@vip.sina.com.
authors.forename: Xiao-Ni
authors.initials: XN
authors.lastname: Zhong
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. qingaza@126.com.
authors.forename: Qing-Ying
authors.initials: QY
authors.lastname: Li
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. 429291879@qq.com.
authors.forename: Dan
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. 562583714@qq.com.
authors.forename: Xuan-Lin
authors.initials: XL
authors.lastname: Zhang
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. 454866373@qq.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Feng
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. yguoxiu@qq.com.
authors.forename: Guo-Xiu
authors.initials: GX
authors.lastname: Yang
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. boyunyun@126.com.
authors.forename: Yun-Yun
authors.initials: YY
authors.lastname: Bo
authors.affiliation: Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China. 347324064@qq.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Deng
mesh_terms: D000293:Adolescent; D001010:Anxiety, Separation / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008426:Maternal Deprivation; D011788:Quality of Life / Q000523:psychology*; D012424:Rural Population / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000523:psychology* / Q000706:statistics & numerical data