Investigating the Inclusion of the Pediatric Quality of Life Inventory E-application Within Pediatric Outpatient Rehabilitation

Research Objectives: To investigate the inclusion of an electronic version of a health related quality of life measure as an adjunctive measure within pediatric outpatient rehabilitation

Design: This study used an exploratory design in the form of survey and retrospective medical records review over 12 weeks. The survey was administered at two points using open and close-ended questions including a questionnaire about the feasibility of an electronic Quality of Life (QoL) measure to gauge the attitudes and beliefs of the therapists prior to and following the implementation of the measure. This study also utilized a comprehensive review of pediatric occupational (OT), physical (PT), and speech (ST) therapy medical records to probe the inclusion of the electronic QoL tool as an outcome measure in pediatric outpatient rehabilitation.

Setting: Pediatric outpatient rehabilitation in a hospital-based setting

Participants: A convenience sample of 6 pediatric clinicians (OT, PT, ST) at a specific clinic were chosen by the organization.

All medical records for patients who attended therapy during one selected week of each month for two consecutive months were included (n = 280).

Interventions: The electronic version of the PedsQL (ePedsQL) was piloted over 12 weeks on clinic iPads. Administration of the ePedsQL was to be conducted by all clinicians during routine therapy visits.

Main Outcome Measures: Measures included pre-post survey of clinicians including open-ended questions and the Usage Rating Profile-Assessment questionnaire as well as number of unique patients who completed the ePedsQL.

Results: There was a decline in administration of the ePedsQL over time (31.9% in Month 1 vs. 21.7% in Month 2). Clinicians perceptions of the feasibility of the inclusion of the ePedsQL remained in the "agree" range, however declined slightly over time (mean = 4.9/6.0 Month 1 vs. mean = 4.5/6.0 Month 2). Clinicians expressed the PedsQL "added insight into how therapy can impact quality of life for patients" yet "some of the parents thought the questions were too vague".

Conclusions: Clinicians overall favored including a QoL measure to support the therapeutic process, however expressed concern with the time required to administer and technology inconsistencies as barriers to successful implementation. Additionally, clinicians indicated the generic version of the PedsQL is not applicable to all patients and the questions lacked clarity. Future study of more specific PedsQL modules as well as other methods for electronic implementation are warranted.

Author(s) Disclosures: None of the authors have any conflicts of interests.