Predictors of quality of life among children with thalassemia
Keywords:
Quality of life, Sick role perception, Self-care behavior, Children with thalassemiaAbstract
Thalassemia is a hereditary blood disorder that causes persistent anemia and impaired quality of life among pediatric patients. This predictive research aimed to examine the quality of life and identify its predictors among children with thalassemia at Phrachomklao Hospital, Phetchaburi Province. The participants comprised 90 children aged 8–18 years who were selected using purposive sampling. Data were collected using the Quality of Life Questionnaire, the Perceived Sick-Role Questionnaire, and the Self-Care Behavior Questionnaire, with Cronbach’s alpha coefficients of .89, .76, and .74, respectively. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and stepwise multiple regression analysis. The findings revealed that the overall quality of life among children with thalassemia had a mean score of 91.73 (SD= 12.14). Responsibility in illness situations, a dimension of patient role perception, and self-care behavior related to symptom monitoring and appropriate management of abnormal symptoms were positively correlated with quality of life (r=.230, p<.05 and r=.390, p<.01, respectively). Predictors of quality of life among children with thalassemia included self-care behavior related to symptom monitoring and management of abnormal symptoms, responsibility in illness situations, adherence to the treatment plan and scheduled follow-up visits, the perceived obligation to improve one’s health, and the perceived obligation to seek assistance and cooperate with healthcare professionals (Beta =.350, .329, -.258, -.356, and .209, respectively; p<.05) jointly explained 28.0% of the variance in quality of life (F(5,84) =7.915, p<.001). The findings provide baseline evidence for the development of interventions to enhance the quality of life for children with thalassemia by strengthening patient role perception and self-care behaviors through collaborative efforts among hospitals, families, and schools.
References
Bakar, S. F. N., Yudianto, K., & Eriyani, T. (2026). Management of dietary education for children with thalassemia at the thalassemia polyclinic. Journal of Nursing Care, 9(1), 21-27. https://doi.org/10.24198/jnc.v9i1.65090
Basu, S., Rahaman, M., Dolai, T. K., Shukla, P. C., & Chakravorty, N. (2023). Understanding the intricacies of iron overload associated with β-thalassemia: A comprehensive review. Thalassemia Reports, 13(3), 179–194. https://doi.org/10.3390/thalassrep13030017
Charoenkwan, P., Komvilaisak, P., Thepsuthummarat, K., Seksarn, P., & Torcharus, K. (2024). Causes of hospitalizations in pediatric patients with thalassemia under the National Health Coverage Scheme in Thailand. Thalassemia Reports, 14(1), Article 2. https://doi.org/10.3390/thalassrep14010002
Charoensatsiri, R. (2026). Influence of self-care knowledge and social support on quality of life in children with transfusion-dependent thalassemia at Phrapokklao Hospital. Journal of Phrapokklao Nursing College, Chanthaburi, 37(1), 274-285. https://he01.tci-thaijo.org/index.php/pnc/article/view/289315/192412 (in Thai)
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Compas, B. E., Jaser, S. S., Dunn, M. J., & Rodriguez, E. M. (2012). Coping with chronic illness in childhood and adolescence. Annual Review of Clinical Psychology, 8, 455–480. https://pubmed.ncbi.nlm.nih.gov/22224836/
Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.
Inta, T., Mesukko, J., Niyomkar, S. (2024). Effect of the individual and family self-management program on iron chelation adherence among school-aged children with thalassemia. Journal of Nursing and Health Science Research, 16(2), e270432. https://he01.tci-thaijo.org/index.php/unc/article/view/e270432/e270432 (in Thai)
Li, Y. L., Wei, W. S., Gan, Y., Xie, X. M., Qin, P. T., Teng, L. S., & Jiang, L. H. (2024). Global, regional, and national epidemiology of thalassemia in childhood from 1990 to 2021. Journal of Biosciences and Medicines, 12(12), 361–379. https://www.scirp.org/journal/paperinformation?paperid=138299
Mankhemthong, K., Singharach, J., Uchukosolkarn, C., Bussabongthong, B., Wongiaruwat, P., & Thenurak, S. (2025). Quality of life and associated factors in transfusion-dependent thalassemia children in Nakornping Hospital. Journal of Nakornping Hospital, 16(1), 145–157. https://he01.tci-thaijo.org/index.php/jnkp/article/view/275008/186557 (in Thai)
Mardhiyah, A., Panduragan, S. L., Mediani, H. S., & Yosep, I. (2023). Nursing interventions to improve quality of life among children and adolescents with thalassemia: A scoping review. Journal of Multidisciplinary Healthcare, 16, 1749–1762. https://doi.org/10.2147/JMDH.S415314
Mungsrakhu, S., & Tarakham, A. (2025). Development of care model for children with thalassemia at suwannaphum hospital's outpatient department. Journal of Environmental and Community Health, 10(5), 316–325. https://he03.tci-thaijo.org/index.php/ech/article/view/4901/3650 (in Thai)
Orem, D. E. (1995). Nursing: Concepts of practice (5th ed.). McGraw-Hill.
Parsons, T. (1951). The social system. Routledge.
Plevinsky, J. M., Carmody, J. K., & Young, M. A. (2022). Introduction to the special issue on pediatric adherence and self-management: Topical reviews and clinical applications of evidence-based assessment and intervention. Clinical Practice in Pediatric Psychology, 10(4), 357–361. https://doi.org/10.1037/cpp0000469
Puinukroh, R. (2022). Quality of life in children with thalassemia and associated factors in Nong Khai Hospital. Mahasarakham Hospital Journal, 19(2), 113–126. https://he02.tci-thaijo.org/index.php/MKHJ/article/view/258809/176669 (in Thai)
Puntuwong, P. (2023). Quality of life in children with transfusion-dependent thalassemia among network in Thungsong Hospital. Maharat Nakhon Si Thammarat Medical Journal, 6(2), 90–101. https://he01.tci-thaijo.org/index.php/MNSTMedJ/article/view/260900/176177 (in Thai)
Purnamasari, I., Rahayu, C. D., Susanto, T., Peperawati, P. R., & Supriyati, A. (2025). Factors affecting the quality of life of children with transfusion-dependent thalassemia: A cross-sectional study. Acta Medica Academica, 54(2), 100–111. https://doi.org/10.5644/ama2006-124.486
Rachawat, P., & Pulom, N. (2022). Factors influencing quality of life in children with thalassemia. Research and Development Health System Journal, 15(1), 334–349. https://he02.tci-thaijo.org/index.php/RDHSJ/article/view/256883/175508 (in Thai)
Sangartit, S. (2007). Predictors of cigarette, alcohol, and substance abuse among adolescents. [Master of Nursing Science (Child Health Nursing)]. Khon Kaen University. (in Thai)
Sinpupanuruk, S. (2023). Effect of the self-care ability development program on self-care behavior of school-age children with thalassemia in pediatric ward at Phetchabun hospital. Phetchabun Medical Journal, 3(2), 149–163. https://he03.tci-thaijo.org/index.php/PMJ/article/view/2993/2185 (in Thai)
Sritipsukho, P., Wisai, M., & Thavorncharoensap, M. (2013). Reliability and validity of the Thai version of the Pediatric Quality of Life Inventory 4.0. Quality of Life Research, 22(3), 551–557. https://pubmed.ncbi.nlm.nih.gov/22552603/
Sunsalah, N., & Ua-kit, N. (2016). The effects of perceived self-efficacy promoting program on self-care behaviors among school-age children with thalassemia. Journal of Nursing Science Chulalongkorn University, 28(1), 103–112. https://he01.tci-thaijo.org/index.php/CUNS/article/view/74822/60373 (in Thai)
Varni, J. W., Seid, M., & Rode, C. A. (1999). The PedsQL™: Measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126–139. https://doi.org/10.1097/00005650-199902000-00003
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