title: Pain and hospital admissions are important factors associated with quality of life in nonambulatory children.
abstract: OBJECTIVE
  This was the first study to investigate the factors associated with health-related quality of life (HRQoL) in nonambulatory children with cerebral palsy (CP), based on a HRQoL measure specifically developed for this population.
  
  
  METHODS
  The Dutch version of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD-DV) was used to measure HRQoL. It was completed by 66 parents of 47 boys and 19 girls with nonambulatory CP aged between five and 18 years with gross motor function classification system (GMFCS) levels of IV and V. Factors measured were the child's motor and cognitive impairments, comorbidities, pain, parents' education and occupations and family structure. Multiple linear regression analyses were used to determine the significant factors and the relative contribution of these factors to the CPCHILD-DV scores.
  
  
  RESULTS
  The most important factors associated with poorer HRQoL scores were pain and hospital admissions in the previous six months. Other factors were as follows: increased GMFCS level, feeding by gastrostomy tube, inability to communicate verbally, cognitive impairment, poor seizure control and higher parents' educational qualifications.
  
  
  CONCLUSIONS
  Pain and hospital admissions were the most important factors that were negatively associated with HRQoL in nonambulatory children with CP between five to 18 years.
authors.affiliation: Department of Rehabilitation Medicine, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Agnes
authors.initials: A
authors.lastname: Elema
authors.affiliation: Stichting Omega, Amsterdam, The Netherlands.
authors.forename: Trees A L
authors.initials: TA
authors.lastname: Zalmstra
authors.affiliation: Rehabilitation Centre 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Boonstra
authors.affiliation: Division of Orthopedics & Child Health Evaluative Sciences, The Hospital for Sick Children and Bloorview Research Institute University of Toronto, Toronto, ON, Canada.
authors.forename: Unni G
authors.initials: UG
authors.lastname: Narayanan
authors.affiliation: Department of Rehabilitation Medicine, University Medical Centre Groningen, Groningen, The Netherlands.|Rehabilitation Centre 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.
authors.forename: Heleen A
authors.initials: HA
authors.lastname: Reinders-Messelink
authors.affiliation: Department of Special Needs Education and Child Care, University of Groningen, Groningen, The Netherlands.
authors.forename: Annette A J
authors.initials: AA
authors.lastname: V D Putten
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D011788:Quality of Life; D012600:Scoliosis
keywords: Cerebral palsy; Health-related quality of life; Hospital admission; Nonambulatory children; Pain