Quality of life of pediatric patients with transfusion-dependent thalassemia (TDT) receiving blood transfusions at Mae Sot Hospital
Keywords:
Quality of life, Thalassemia, Pediatric patientAbstract
Background: In Thailand, the incidence of newly diagnosed thalassemic disease case is approximately 12 per 1,000 live births, with the prevalence of about 1% in the population. Affected children frequently exhibit growth retardation, recurrent illness, and require periodic blood transfusions, resulting in frequent school absenteeism and a diminished overall quality of life.
Objectives: To investigate the quality of life (QOL) and its associations with baseline characteristics and clinical parameters among children with transfusion-dependent thalassemia (TDT) attending Mae Sot Hospital.
Methods: The descriptive cross-sectional study was conducted. The Pediatric Quality of Life Inventory (PedsQL™) Generic Core Scales version 4.0, developed by James W. Varni and administered under license from Mapi Research Trust, was utilized to assess QOL. Descriptive statistics and correlation analyses were performed.
Results: A total of 26 children with TDT were enrolled. Overall, 53.9% demonstrated low total QOL scores, while only 11.5% reported good QOL. Domain-specific analyses revealed that 46–50% had low physical QOL, 42–46% had low emotional QOL, and 40–45% experienced impaired social functioning. School functioning was the most affected domain, with 70–77% reporting low QOL. Age was moderately and positively correlated with overall QOL (r =0.3921, p value 0.0476), whereas foreign nationality was negatively correlated with physical QOL (rpb = 0.3892, p value 0.0494). Educational attainment was positively associated with overall QOL (rs =0.5423, p value 0.0042), particularly within the emotional domain (rs = 0.4615, p value 0.0176). Pre-transfusion hemoglobin levels were positively correlated with overall QOL (rs = 0.4670, p value 0.0162), as well as with physical (rs = 0.4895, p value 0.0112), emotional (rs = 0.3999, p value 0.0430), and social domains (rs = 0.4070, p value 0.0391). Strong interrelationships were observed among QOL dimensions. Physical health was significantly associated with emotional well-being (r = 0.7624, p value <0.0001), social functioning (r = 0.7720, p value <0.0001), and school performance (r = 0.6906, p value 0.0001). Emotional well-being was strongly correlated with both social functioning (r = 0.8872, p value <0.0001) and school QOL (r = 0.6817, p value 0.0001). Social functioning itself was highly associated with school performance (r = 0.7697, p value <0.0001).
Conclusions: Approximately 50% of pediatric patients with TDT experienced a low level of quality of life. The domains of physical, emotional, social, and school functioning were strongly and positively interrelated, indicating that improvement in one domain might contribute to enhancement in the others in the same direction.
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