Abstract
Background: The health-related quality of life (HRQoL) of adolescents with cerebral palsy (CP) in low and middle-income countries is often poor, as is the case in Bangladesh. This study examined what modifiable factors are predictors of HRQoL among adolescents with CP in rural Bangladesh, a typical low- and middle-income country (LMIC).
Methods: Adolescents with CP (10 to 18y) were identified using the Bangladesh Cerebral Palsy Register. HRQoL was assessed with the Cerebral Palsy Quality of Life-Teens questionnaire (CPQoL-Teens). Bivariate analysis and hierarchical multiple linear regression models related adolescent clinical characteristics and mental health, caregiver mental health and proxies of socioeconomic status to HRQoL outcomes.
Results: 154 adolescents with CP (mean age 15y 1mo SD 1y 8mo, female n =31.2%) participated in this study. Numerous characteristics correlated to HRQoL; strongest correlation was between ‘feelings about functioning’ and motor impairment ( r =0.545). Nine factors were predictive of CPQoL-Teens dimensions; adolescent sex, school attendance, severity of motor impairment, hearing and speech impairment, mother’s education, primary caregiver depression and stress, and having a sanitary latrine at home resulting in score changes of between 0.79 (95% CI 0.24 to 1.35) to 35.1 (95% CI 6.03 to 64.22).
Conclusions: Many of the factors predicting the HRQoL of adolescents with CP are amenable to intervention, and have the potential to improve adolescent wellbeing. Several determinants are priorities of the sustainable development goals (SDGs); these findings should inform resource prioritization to improve the wellbeing of adolescents with CP in Bangladesh and other LMICs.
Health-related quality of life in children with cerebral palsy in low- and middle-income countries: opportunities and next steps
