Pediatric Chronic Diseases and Health Related Quality of Life

Health Related Quality of Life and Chronic Liver Diseases

Chronic liver diseases include a wide variety of disorders that may be infectious, metabolic, genetic, iatrogenic, idiopathic, structural, and autoimmune in origin. The clinical manifestations and the results of the initial laboratory investigations of many of them are similar. Accordingly, the final diagnosis depends on the results of specialized laboratory tests and histopathological findings of liver biopsies.

A challenging wide spectrum of medical and psychosocial problems may face the health care providers for children suffering from end-stage liver diseases. So, Health Related Quality of Life (HRQoL) is a marker of disease severity. It has been proven that psychiatric and active medical comorbidities Commentary and not the severity of the chronic liver disease determine the effects of such disease on HRQoL of the sufferers [2]. Hassan and Zaky [3] reported significantly poorer parental and sufferer perception of HRQoL total summary score as well as its physical, emotional, and scholastic subscores.

On the other hand, in many end-stage hepatic disorders, liver transplantation is considered as the definitive life-saving therapeutic surgical intervention. The recipient quality of life improves dramatically after such a procedure and it prolongs his expected survival. Liver transplantation is a complicated surgical intervention that needs collaboration of many specialties in a devoted experienced multidisciplinary team. A psychiatrist plays a crucial role in such a team to provide the necessary pre and post-operative thorough assessment and management of both the recipient and the donor.

Many comorbid mental disorders may stand behind the decision of choosing liver transplantation as a necessity for some cases. During the post transplantation stage, psychiatric problems may arise as a critical issue requiring prompt bio psychosocial intervention for both the recipient and the donor.

Health Related Quality of Life and Pediatric Malignancies

For the sufferers as well as their families, the management of pediatric malignancies represents a remarkable stressful event with significant biopsychosocial percussions. Because of the tremendous advances in cancer management, more therapeutic options are available nowadays for all pediatric malignancies with Higher expected survival rates. Accordingly, more attention has been directed recently towards improving the HRQoL of children diagnosed with different types of pediatric malignancies and their families.

Zaky, et al. [4] showed significantly higher mean values of depression score among children with newly diagnosed pediatric malignancies as well as survivors compared to controls while corresponding mean values of anxiety score were only significantly higher among those with newly diagnosed different pediatric malignancies with significantly more prevalent psychosocial dysfunction compared to controls. On the other hand, parental and children perception of HRQoL total summary score and all its sub scores were significantly poorer in those with newly diagnosed pediatric malignancies as well as survivors compared to controls with the former poorer than the later. In sibs of the newly diagnosed sufferers, significantly higher mean values of anxiety scores were recorded with more prevalent psychosocial dysfunction compared to controls and sibs of survivors and poorer perception of social subscore of HRQoL.

Health Related Quality of Life and Pediatric Bronchial Asthma

Bronchial asthma represents one of the most prevalent chronic pediatric diseases and is considered as an important public health problem with frequent hospitalization and impairment of normal activities and poorer quality of life in affected children and their caregivers [5].

Zaky, et al. [6] reported that childhood asthma lowered significantly the perception of the total HRQoL score and all its sub scores in their studied sample of Egyptian asthmatic children and their caregivers compared to controls with even poorer perception in caregivers compared to sufferers.