The Society for Social Work and Research

2014 Annual Conference

January 15-19, 2014 I Grand Hyatt San Antonio I San Antonio, TX

Health-Related Quality of Life Among Youth in Residential Care

Friday, January 17, 2014
HBG Convention Center, Bridge Hall Street Level (San Antonio, TX)
* noted as presenting author
Steven Hoffman, PhD, Assistant Professor, University of Texas at San Antonio, San Antonio, TX
Timothy Nelson, PhD, Assistant Professor, University of Nebraska, Lincoln, Lincoln, NE
Katherine Kidwell, Graduate Assistant, University of Nebraska, Lincoln, Lincoln, NE
Alexandra Trout, PhD, Associate Research Professor, University of Nebraska, Lincoln, Lincoln, NE
Michael Epstein, PhD, Professor, University of Nebraska, Lincoln, Lincoln, NE
Ronald W. Thompson, PhD, Director, Father Flanagan's Boys Home (Boys Town), Boys Town, NE
Background and Purpose: Health-related quality of life (HRQoL) has been recognized for years as an important construct in health and well-being. Going beyond symptoms and diagnoses, HRQoL deals with the impact of health issues on daily functioning and the day-to-day impairment associated with these problems. Recent research points to the possibility of compromised HRQoL among youth in residential settings. Nelson and colleagues found that approximately one-third of youth entering a residential care setting had at least one diagnosed medical condition, and this high rate of health problems could contribute to lower HRQoL. Further, a substantial body of research has documented the psychosocial and educational status of youth in residential care, finding evidence for considerable difficulties which could impact HRQoL. Emerging research also suggests an interplay between physical and mental health issues for these youth. In light of the dearth of existing HRQol research among this population, the current study was designed to describe HRQoL in a sample of adolescents in residential care. Specifically, the study focused on three main goals: 1) we aimed to describe the HRQoL of adolescents in residential care by presenting mean scores for the major summary scales on the PedsQLTM, including Total HRQoL, Physical HRQoL, and Psychosocial HRQoL; 2) we examined the demographic correlates of HRQoL in this population in order to better understand factors associated with greater risk of poor HRQoL; and 3) we examined the association between psychotropic medication prescriptions and quality of life among adolescents in residential care.

Methods: A sample of 229 adolescents (mean age = 17 years) living in a residential care setting completed a validated measure of HRQoL (PedsQLTM 4.0 Generic Scales). Mean-level scores for Total HRQoL, Physical HRQoL, and Psychosocial HRQoL were examined and compared to published HRQoL data for healthy and clinical samples. Demographic and psychotropic medication data for each youth were accessed from an electronic database maintained by the residential care program and used to examine correlates of HRQoL.

Results: Overall, youth in residential care reported lower HRQoL than youth in a healthy comparison sample; however, youth in residential care had higher HRQoL than those in a psychiatric disorders comparison sample. Younger age and female gender were associated with poorer HRQoL. Psychotropic medication prescriptions, particularly antidepressant and antipsychotic medications, were associated with poorer HRQoL.

Conclusions and Implications: The findings of this study have important clinical and research implications. Residential settings could assess HRQoL at intake using a well-validated measure and then use this information in developing tailored service plans focused on supporting areas of sub-optimal functioning. Regular follow-up assessments could then be used to evaluate progress with regard to HRQoL and make modifications in services as needed. The results also point to individual-level factors – age, gender, and medication status – that could help identify youth most in need of HRQoL-focused assessment and intervention. Such screening, intervention, and evaluation would be consistent with the emerging emphasis on promoting HRQoL among vulnerable populations, rather than merely focusing on symptom reduction.