Parental Distress and Quality of Life in Pediatric Inflammatory Bowel Disease: Implications for the Outpatient Clinic

The interrelation between the course of Inflammatory Bowel Disease (IBD) in children and parent's distress, and the subsequent impact this may have on Health-Related Quality Of Life (HRQOL) of the child is unclear. Therefore, we investigated (I) patient's HRQOL and parental distress, and (II) the association between the course of IBD, parental distress, and HRQOL of pediatric IBD patients. Pediatric IBD patients (8-18 years) and parents were invited. Patients completed the Pediatric Quality of Life Inventory, and parents the Distress Thermometer for Parents, simultaneously. Disease course was expressed as current clinical disease activity or months since last IBD flare. Patient's HRQOL and parental distress were compared to healthy controls. In total, 87 patients (71% response rate, 59% male, median age 15.2 years) and parents were included. Patients had an impaired total HRQOL (β = 0.125, p = 0.010), driven by lower physical ( = 0.196, p = 0.001) and school (β = 0.232, p < 0.001) functioning. Parents of children with IBD exhibited comparable levels of distress to parents of healthy children on the total problem and most subdomain problem scores (practical, social, emotional, physical and cognitive), yet experienced more frequent parenting problems (p = 0.025).More severe disease course (months since last IBD flare) was indirectly associated, through parental distress, with decreased HRQOL of patients. Worse disease course is directly associated with increased distress of parents and indirectly with lower HRQOL of children and adolescents with IBD. Distress of parents may be considered in management of pediatric IBD to improve HRQOL of childre