Quality of life and associated factors in transfusion-dependent thalassemia children in Nakornping hospital
Keywords:
quality of life, transfusion dependent thalassemia, depression, PEDsQL, CES-DAbstract
Introduction: Thalassemia is a chronic hemolytic anemia caused by abnormalities of hemoglobin production. The severity varies depending on the type of the disease. In severe cases, patients require regular blood transfusions to alleviate symptoms such as severe anemia, enlarged liver and spleen and growth retardation. These can affect daily life and impact physical, mental, and social well-being.
Objectives: To study quality of life and associated factors in pediatric patients with transfusion-dependent thalassemia at Nakornping Hospital.
Methodology: A cross-sectional analytical study collected data from 70 children diagnosed with transfusion-dependent thalassemia, aged 2-15 years, and their caregivers, who attended the one-day blood transfusion service at the Pediatrics Department, Nakornping Hospital, between March 2-24, 2023. Data were collected using a general characteristics questionnaire and the Thai version of the Pediatric Quality of Life Inventory™ (PedsQL™) to assess quality of life across four domains. Patients over 4 years old completed the questionnaire themselves, while caregivers answered for those under 4. A depression screening tool was used for both patients and caregivers. Descriptive statistics were used for data analysis, and factors related to quality of life were analyzed using multivariable linear regression.
Results: The pediatric patients with transfusion-dependent thalassemia were mostly male (51.43%) and aged 8–12 years, with β-thalassemia/E disease being the most prevalent (55.7%). Most required blood transfusions every < 4 weeks (80%), had iron levels ≥ 2,500 ng/ml (44.29%), and received iron chelation therapy (94.29%). The average quality of life score across all 4 domains was 89.24±11.84, indicating a good quality of life. The highest score was in the social domain (93.43±13.15), followed by emotional (91.57±14.20), physical (89.51±13.30), and the lowest in the school domain (79.00±14.82). Depression was the only factor significantly associated with quality of life.
Conclusion: The overall quality of life score was high but the school domain had the lowest score. Depression was a significantly factor related to the quality of life. Developing the blood transfusion service during holidays to reduce school absences, assessing mental health, and school support systems for sick children will help improve quality of life.
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