Measuring Health-Related Quality of Life in Children and Adolescents: Implications for Research and Practice

By Dennis Drotar | Go to book overview

PART II
POPULATION-BASED APPLICATIONS OF MEASURES OF HEALTH-RELATED QUALITY OF LIFE WITH CHILDREN AND ADOLESCENTS

The second major section of the book concerns applications of measures of health-related quality of life (HRQOL) with populations of children. Such applications are particularly useful because they provide a broad public-health perspective in which to conduct HRQOL research on outcomes of child and adolescent health. For example, in chapter 5, Kaplan presents an outcomes model for evaluating health that is applicable to policy issues related to investment of economic resources in adolescent health care. In contrast to the traditional medical model, which focuses on disease processes measured by physiologic measures and physician judgment, the outcomes model takes a broad perspective that is focused on early identification and prevention of health and mental health problems to reduce risk for subsequent morbidity. Kaplan describes an approach to outcomes assessment using the Quality of Well-Being Scale, which is a generic measurement approach that yields a measure of quality adjusted life years, which classifies individuals according to their level of functioning over time. Illustrations of this method with various adolescent physical and mental health problems are described. Applications of this method suggest several directions for future research, including assessment of adolescents' perceptions of current and future benefits of health and analyses of preventive health programs for adolescents.

Starfield & Riley (chap. 6) describe the purposes of health assessment and the development of the Child Health and Illness Profile (CHIP), an instrument that was developed specifically for norm-based interpretation of children's physical and emotional functional status and well-being. This measure provides a comprehensive assessment of adolescent health status across multiple domains, and has a wide range of clinical and policy applications. Studies are presented that support the validity of the CHIP. Moreover, new applications of this measure include the development of profiles that characterize individuals according to their patterns of functioning including strengths and weaknesses on a variety of heath characteristics. Such profiles provide a way to conduct a needs assessment and tailor interventions more specifically to the needs of individuals, especially children with chronic illness. The development of health profiles for the CHIP gives planners and health service providers a tool to assess the

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