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Qual Life Res. 2012 Nov;21(9):1577-86. doi: 10.1007/s11136-011-0078-2. Epub 2011 Dec 14.

A comparison of health-related quality of life between children with versus without special health care needs, and children requiring versus not requiring psychiatric services.

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Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001, Zürich, Switzerland.



The purpose of the present study was to compare health-related quality of life (HRQoL) between children with special health care needs (CSHCN) and those without. In particular, CSHCN who require psychiatric services and those who do not were compared.


A representative community sample of 3,325 children (10-14 years old) was recruited from the Canton of Zurich. Via either computer-assisted telephone interviews or a written questionnaire, special health care needs were assessed using the five-item parent-reported CSHCN Screener. Subsequent to screening, a written questionnaire was sent to a sub-sample of 974 children to acquire more detailed information, both from the children and their parents, about their health and health care utilization, and to assess HRQoL (KIDSCREEN-27) and emotional and behavioral problems (SDQ). A total of 626 children responded to the questionnaire. Multiple linear regression models were used to examine the association between HRQoL and subject group, controlling for other covariates.


Among 2,586 children whose parents participated in the screening stage, roughly 18% were identified as CSHCN, with 6.2% requiring psychiatric services. The subsequent survey revealed that those CSHCN who required psychiatric services had the lowest HRQoL scores and highest SDQ scores. CSHCN who utilized psychiatric services were particularly prone to low HRQoL, especially among lower income families.


The influence of noticeable emotional and behavioral problems on HRQoL should be afforded more attention, both in clinical practice and empirical studies involving children with special health care needs.

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