Recurrent pain and health related quality of life in young schoolchildren
Abstract: The objectives of this thesis were 1) to describe the occurrence and co-occurrence of recurrent pain (headache, stomach-ache, and backache) in young school children; 2) to describe Health Related Quality of Life (HRQoL) in these children, from the perspective of the child, 3) to examine the psychometric properties of the PedsQL, a pediatric HRQoL instrument.Three data collections were performed, two in Umeå, Sweden, and one in a nearby smaller municipality, Lycksele. In Umeå, the first survey included schoolchildren from grades 0-6 and three years later all schoolchildren attending grade three and six were approached. In Lycksele all school children attending grades three through six and grade nine were invited to participate. Pain and quality of life were measured by questionnaires.The main findings of the thesis were that 2/3 of the children experienced pain from the head, stomach or back recurrently (at least monthly) and 1/3 experienced weekly pain. Weekly headache was reported by 23% of the children, 19 % reported weekly stomach-ache and 7% weekly backache. Half of the children with recurrent pain conditions reported pain from several body sites, and, in children with weekly pain, 2/3 reported multi-site pain. HRQoL in children with recurrent pain problems was markedly impaired, especially in children with multi-site pain and in children with weekly pain. Finally, The Swedish PedsQL self-report forms showed acceptable psychometric properties.In conclusion, in young schoolchildren, headache, stomach-ache and backache are common conditions associated with a clearly reduced HRQoL. The results show an urgent need for early preventive and curative programs targeting HRQoL domains such as physical, emotional, social and school areas. The results also indicate that recurrent pain should be regarded a potential general pain disorder rather than merely a local disorder. The PedsQL was found to be a reliable and valid measure of HRQoL in young Swedish school-aged children.
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