Among children diagnosed with MS, parental HRQOL mediates the relationship between that diagnosis and the child’s HRQOL, underscoring the importance of family-centered care, according to findings published in Multiple Sclerosis Journal.

For the prospective, multi-site study, Julia O’Mahony (Department of Internal Medicine, University of Manitoba) and colleagues compared children with MS and those with monophasic acquired demyelinating syndromes (monoADS) to determine the impact of an MS diagnosis. Parent–child dyads completed HRQOL questionnaires, and random effects models were used to examine if parental HRQOL mediated the relationship between the diagnosis of MS and the HRQOL of children with the condition. Models were adjusted for child and family characteristics.

From September 2004 through January 2018, the study team enrolled 207 eligible parent–child dyads, including 65 with MS and 142 with monoADS. Children with MS were more likely to be female than children with monoADS (66% vs 45%) and tended to be older at the time of neurological onset (14.49 years vs 8.67 years).

MS Diagnosis Tied to Decreased HRQOL

When the investigators modeled the child’s HRQOL with adjustments for covariates, but not the parent’s HRQOL, the MS diagnosis was associated with decreased HRQOL for the child (P=0.004). However, when parental HRQOL was included in the model, the associations between the MS diagnosis and the child’s HRQOL decreased. Covariates included time-invariant factors, such as sex, age, number of siblings, and more, and time-variant factors, such as the child’s age, as measured in years at the time of HRQOL evaluation, and the occurrence of functional neurological impairments.

Consider Parental HRQOL

The findings indicate that children with MS may have HRQOL scores similar to those of children with monoADS or even healthy children if their parents achieve, and maintain, a sufficiently high HRQOL, according to the study results. The study also underscores the importance of considering parents’ HRQOL when examining the HRQOL of children with MS. Further, targeting parental HRQOL may be a way to improve HRQOL for both sides of this parent–child dyad, the researchers noted, and identifying factors that impact the link between parent psychological distress and children’s HRQOL may help inform for the creation of targeted psychosocial interventions.