Abstract
The first crisis a child may encounter in life is acquiring a disease and hospitalisation. When the child leaves home, their siblings and their caregivers, it interrupts their daily routines and activities. In addition to the illness and injury, hospitalisation can cause physical discomfort and loss of autonomy, medication prescribed may have unpleasant side-effects, it may lead to absence from the school and changes in family interactions. Additionally, children often express a fear of pain, medical examination and uncertainty. Thus, both hospitalised children and their caregivers face various challenges during hospitalisation (Delvecchio et al., 2019). Due to these factors and that, children may have less well-developed coping mechanisms; they are more vulnerable to crisis from disease and hospitalisation (Bsiri-Moghaddam et al., 2011).
Disease and hospitalisation affect the quality of life of children in their physical, mental and social functioning (Karimi and Brazier, 2016). In the literature, quality of life is often interchangeably used with health-related quality of life. The World Health Organization defines quality of life as ‘an individual’s perception of their position in life in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’. Poor quality of life has been reported in hospitalised children (Hordijk et al., 2020; WHO, 2012). Various measurement tools are available to measure the quality of life of children. However, no specific instrument is available to measure the quality of life of hospitalised children in hospital.
As a member of a paediatric-nursing faculty, I have published manuscripts related to quality of life in children and adults (BNP et al., 2022; Jayabharathi & Judie, 2014; Kangeswari and Arulappan, 2022; Pandarakutty et al., 2020; Renford et al., 2020; Shaji Thomas et al., 2021; Thomas et al., 2017) and I have two more quality-of-life research studies in children in the pipeline therefore I feel well equipped to offer a commentary on this paper. During my publication journey, I learnt about various quality-of-life measurement instruments across different populations from various ethnic and linguistic backgrounds. The authors of this manuscript have developed a Hospital Quality of Life for Children Scale (HQL-children) through literature reviews and interviews. This is a well-suited tool to measure the quality of life of hospitalised children aged 7–18 years, as other hospital quality-of-life measurement instruments are unavailable. Moreover, an acceptable Cronbach’s alpha coefficient is reported in this study.
The other available paediatric quality-of-life instruments measure physical, emotional, social and school functioning. However, the HQL-children exclusively measures the illness, fear, activity, hospital and perception, which are not available in the other quality-of-life measures. Thus, this instrument is a stand-alone tool to measure the hospital quality of life of hospitalised children. However, as this instrument is developed in a Turkish setting, it may be limited in its applicability in other settings. Moreover, it may answer the hospital quality of life of children only in the Turkish culture and the value systems within it. However, this could be a baseline instrument, which might assist in developing a global hospital quality of life instrument. Determining the transferability of the instrument for a global application will be valuable.
Furthermore, the HQL-children scale is a promising instrument in measuring the perception of hospitalisation experiences from the perspectives of children. However, quality of life of children could also be measured from the perspectives of caregivers as well. Gaining a cumulative understanding of the hospitalisation experience from the perspectives of both the caregivers and children will yield a better understanding of the quality of life of hospitalised children. Thus, this study calls for further studies to explore the perception of hospitalisation experiences of hospitalised children and their caregivers. Lastly, further understandings of wider healthcare experiences, care and treatment processes could be collected alongside developing a global hospital quality-of-life instrument, doing this may make the final instrument more comprehensive.