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. 2014 Feb 20;9(2):e89222.
doi: 10.1371/journal.pone.0089222. eCollection 2014.

Measuring and valuing health-related quality of life among children and adolescents in mainland China--a pilot study

Fei Xu  1 , Gang Chen  2 , Katherine Stevens  3 , HaiRong Zhou  4 , ShengXiang Qi  4 , ZhiYong Wang  4 , Xin Hong  4 , XuPeng Chen  4 , HuaFeng Yang  4 , ChenChen Wang  4 , Julie Ratcliffe  2
Affiliations

Measuring and valuing health-related quality of life among children and adolescents in mainland China--a pilot study

Fei Xu et al. PLoS One. .

Abstract

Background: The Child Health Utility 9D (CHU9D), a new generic preference-based health-related quality of life (HRQoL) instrument, has been validated for use in young people in both the UK and Australia. The main objectives of this study were to examine the feasibility of using a Chinese version of the CHU9D (CHU9D-CHN) to assess HRQoL and to investigate the association of physical activity, homework hours and sleep duration with HRQoL in children and adolescents in Mainland China.

Methods: Data were collected using a multi-stage sampling method from grades 4-12 students in May 2013 in Nanjing, China. Consenting participants (N = 815) completed a self-administered questionnaire including the CHU9D-CHN instrument and information on physical activity, homework and sleep duration, self-reported health status, and socio-demographic characteristics. Descriptive and multivariate linear regression analyses were undertaken. CHU9D-CHN utility scores were generated by employing two scoring algorithms currently available for the instrument, the first derived from UK adults utilising the standard gamble (SG) valuation method and the second derived from Australian adolescents utilising the best-worst scaling (BWS) method.

Results: It was found that CHU9D utility scores discriminated well in relation to self-reported health status and that better health status was significantly associated with higher utility scores regardless of which scoring algorithm was employed (both p<0.001). The adjusted mean utilities were significantly higher for physically active than inactive students (0.023 by SG, 0.029 by BWS scoring methods, p<0.05). An additional hour of doing homework and sleep duration were, separately, associated with mean utilities of -0.019 and 0.032 based on SG, and -0.021 and 0.040 according to BWS scoring algorithms (p<0.01).

Conclusion: The CHU9D-CHN shows promise for measuring and valuing the HRQoL of children and adolescents in China. Levels of self-reported physical activity, homework and sleep time were important influencers of utility scores.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distributions of Child Health Utility 9D (CHU9D) utilities.
Figure 2
Figure 2. Bland-Altman plot of differences in Child Health Utility 9D (CHU9D) utilities from two scoring methods.
See this image and copyright information in PMC

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Publication types

Grants and funding

The study was supported by the Nanjing Municipal Science and Technique Foundation (ZDX12019) and the Young Medical Experts Project of Nanjing Medical Science and Technique Development Foundation (QRX11038), China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.