Search Results (58)

Background: Attention Deficit Hyperactivity Disorder (ADHD) is associated with executive function deficits—such as planning, organization, and prospective memory—that impair autonomy and daily functioning, increase family stress, and create challenges in educational contexts. These consequences underscore the need for accessible and ecologically valid interventions addressing the cognitive, familial, and educational dimensions. Traditional approaches often lack ecological validity, and pharmacological treatment shows a limited impact on functional cognition. Objectives: This protocol outlines a feasibility study of DiverAcción, a web-based telerehabilitation system designed to enhance functional cognition through interactive and gamified tasks integrated into a comprehensive healthcare programme. Methods: A quasi-experimental feasibility study before and after the study will recruit 30 participants aged 9 to 17 years with ADHD. The study comprises an initial face-to-face session for instructions and baseline assessment (T0), followed by twelve supervised online sessions over six weeks. Therapeutic support is provided via integrated chat, email, and two scheduled videoconference check-ins. Feasibility Outcomes: include recruitment, adherence, retention, usability (SUS), acceptability (TAM), satisfaction, user-friendly design, therapeutic alliance (WAI-I), and professionals’ attitudes toward technology (e-TAP-T). Exploratory Measures: include parental self-efficacy (BPSES), parenting stress (PSI-4-SF), ADHD symptomatology (SNAP-IV), executive functioning (BRIEF-2), time management (Time-S), emotional regulation (ERQ-CA), prospective memory (PRMQ-C), and health-related quality of life (KIDSCREEN-52). Analyses emphasize descriptive statistics for feasibility metrics (recruitment, adherence, retention, dropout and fidelity). Assessments are conducted post-intervention (T1) and at three-month follow-up (T2) and analyzed relative to baseline using repeated-measures ANOVA or Friedman tests, depending on data distribution. Conclusions: This feasibility protocol will provide preliminary evidence on the usability, acceptability, and implementation of DiverAcción. Findings will guide refinements and inform the design of a subsequent randomized controlled trial. Full article

Obesity is associated with multiple comorbidities and therefore requires a multidisciplinary approach. Particular attention is given to the role of visceral adiposity and its impact on quality of life. Childhood obesity, in particular, is a major global public health challenge with physical, psychological, and social consequences extending into adulthood. Within the framework of personalized medicine, assessing physical fitness and health-related quality of life (HRQoL) offers valuable insight for defining individualized therapeutic goals. Objective: To evaluate the relationship between physical fitness and HRQoL in children with simple obesity and to highlight the potential value of personalized approaches in pediatric obesity management. Methods: This study included 123 patients aged 8–16 years with simple obesity who were hospitalized at the Children’s Memorial Health Institute in Warsaw. Obesity was diagnosed according to CDC growth charts (OLAF study). Physical fitness was assessed using the EUROFIT test battery (8 trials), and HRQoL was measured with the Kidscreen-52 questionnaire (10 domains). Results: The overall EUROFIT test performance in the study group was significantly lower compared with population norms (p < 0.001). Similarly, HRQoL scores reported by both children and their parents were significantly below reference values (p < 0.001). Conclusions: Reduced physical fitness is strongly associated with impaired quality of life in children with obesity. Personalized interventions aimed at improving motor performance may represent an effective strategy in the prevention and treatment of pediatric obesity. Full article

Background: School bullying, be it in its traditional form or as cyberbullying, is a worldwide phenomenon, with significant impacts on schoolchildren’s wellbeing, and its accurate evaluation is thus key in prevention and intervention. The aim of the present study was to validate the Spanish version of the Zurich Brief Bullying Scales (ZBBS), a brief and effective instrument to measure school bullying victimisation and perpetration in different settings. Method: The sample comprised 2125 students of secondary education (11–17 years) in Spain. A confirmatory factor analysis (CFA) was performed to evaluate the structure of the scale. Results: We examined the scale’s reliability (α > 0.7 in all the subscales) and correlations to test its construct validity and its concurrent validity with the Kidscreen-52 victimisation and self-esteem scales, and with cyberbullying scales (European Cyberbullying Intervention Project Questionnaire). The confirmatory factor analysis confirmed two independent factors: victimisation and perpetration. Conclusions: The results supported the psychometric soundness of the ZBBS, evidencing its applicability in measuring school bullying and cyberbullying in different age groups and genders. We discuss the implications for its use in research and educational practice, underscoring its potential as a brief and valid instrument for monitoring school bullying and cyberbullying across early to late adolescence in Spanish-speaking educational contexts. Full article

Background/Objectives: Evidence links children’s health-related quality of life (HRQoL) to overall diet, but data on specific, actionable habits are limited. We tested whether vegetable intake ≥2 portions/day and fish intake ≥2–3 times/week were associated with risk of low HRQoL (KIDSCREEN-10 Index score <40) and assessed their joint effect and robustness to overall diet quality. Methods: In three waves (2020–2023) in Madrid (Spain), 1127 observations from 771 children (8–12 years) were analysed. Logistic Generalised Estimating Equations (GEE) adjusted for age, sex, socioeconomic status (four levels), moderate-to-vigorous physical activity (MVPA), screen time, body mass index (BMI) z-score, wave and school ownership. Marginal predicted probabilities were computed for four exposure combinations (neither, vegetables only, fish only, both). Sensitivity models added school area and the Mediterranean Diet Quality Index (KIDMED; KIDMED_wo_FV and total); hybrid within–between GEE and a linear mixed model for continuous KIDSCREEN-10 were also fitted. Results: Vegetables ≥2/day and fish ≥2–3/week were inversely associated with low HRQoL (odds ratio (OR) 0.49 (95% confidence interval (CI) 0.30–0.82) and 0.61 (0.43–0.87)). The interaction was positive (OR 2.50 (1.39–4.53)). Adjusted probabilities were 40.1% (neither), 25.8% (vegetables only; −14.3 percentage points (p.p.)), 29.7% (fish only; −10.5 p.p.), and 34.0% (both; −6.1 p.p.). Findings persisted with KIDMED_wo_FV and attenuated with total KIDMED. MVPA related inversely and screen time directly to risk. Conclusions: Vegetables ≥2/day and fish ≥2–3/week were associated with lower odds of low HRQoL, with non-additive combined effects. These simple targets may complement physical-activity promotion and reduced screen time; longitudinal/experimental studies should test causality and dose–response. Full article

Background/Objectives: Emotional and behavioral difficulties are common during adolescence and have lasting implications for well-being. Although several psychological resources—such as self-efficacy, mindfulness, and reflective functioning—have been individually linked to better adjustment, less is known about how these strengths jointly relate to perceived stress, difficulties, and health-related quality of life (HRQoL). This study aimed to develop and test an integrative structural model capturing the interplay of these factors during early and mid-adolescence. Methods: A cross-sectional online survey was conducted among 395 adolescents (222 girls, 173 boys; aged 10–16 years) who completed self-report questionnaires assessing HRQoL (KIDSCREEN-10), emotional–behavioral difficulties (SDQ), perceived stress (PSS), self-efficacy (GSE), mindfulness (CAMM), and reflective functioning (RFQY-5). After descriptive analyses and correlation testing, the structural path model using observed variables examined how these variables were interrelated. Multi-group analyses assessed whether structural pathways were invariant across gender and age groups. Results: Mindfulness, self-efficacy, and reflective functioning were each indirectly associated with better HRQoL, mainly through lower perceived stress and fewer emotional–behavioral difficulties. Perceived stress showed a strong positive association with difficulties, and both constructs uniquely predicted lower HRQoL. The overall pattern of associations was fully consistent across age and broadly comparable across gender. Conclusions: The findings highlight the interconnected role of psychological resources, stress, and emotional–behavioral difficulties in adolescents’ well-being. However, the cross-sectional design, convenience sampling, reliance on self-report measures, and single-country sample limit the generalizability and causal interpretation of the results. The robustness of these pathways across age and their broad comparability across gender underscore their developmental relevance and suggest that programs aimed at strengthening socio-emotional competences may be meaningfully applied to support adolescents’ well-being already from early adolescence. Full article

Background: Cardiological conditions in adolescents can impair health-related quality of life (HRQoL), influencing physical, emotional, and social functioning. Identifying sociodemographic and psychosocial determinants is essential for targeted multidisciplinary interventions involving pediatric cardiologists, nurses, and psychologists. This study assessed HRQoL in hospitalized adolescents with cardiologic problems. Methods: A cross-sectional study was conducted among 100 adolescents aged 11–18 years hospitalized in a pediatric cardiology ward in Poland (June–December 2022). HRQoL was measured using the validated Polish version of the KIDSCREEN-52 questionnaire. Data on demographics, family and financial situation, and pain were collected. Non-parametric tests and Spearman’s correlations were applied; p < 0.05 was considered significant. Results: The highest HRQoL scores were observed in Social Acceptance (mean 86.3 ± 17.9), while the lowest scores were found in School Environment (49.2 ± 21.4). Boys had significantly higher Physical Well-being and Self-perception scores than girls (p = 0.019, p = 0.031). Older age correlated negatively with Moods and Emotions (r = −0.216, p = 0.031) and Peer Relationships (r = −0.300, p = 0.002). Rural residence was associated with stronger family relationships (p = 0.025). A better financial status correlated with higher family relationship and financial resource scores. Pain was linked to poorer physical and emotional well-being. Conclusions: The health-related quality of life (HRQoL) of adolescents hospitalized for cardiac conditions is mainly affected by socio-demographic factors, such as gender, age, place of residence, perceived socioeconomic status, and experiences of pain and discomfort. Girls, older adolescents, urban residents, and those reporting poorer socioeconomic conditions and pain had lower HRQoL scores in specific areas. Conversely, family structure and the presence of chronic diseases did not significantly influence HRQoL outcomes. Full article

Background: Adolescent cancer survivors constitute a clinically vulnerable population whose psychosocial adjustment following oncological treatment remains insufficiently characterized, particularly within Central and Eastern Europe. The present study aimed to evaluate health-related quality of life (HRQoL) and depressive symptomatology among Polish adolescent survivors, identify their psychological predictors, and determine age-related differences in these associations. Methods: A cross-sectional study was conducted among 165 survivors aged 11–18 years, recruited from four pediatric oncology centers. Participants completed the KIDSCREEN-10 (HRQoL) and the Children’s Depression Inventory-2™ (CDI-2™). Descriptive statistics, Spearman rank-order correlations, and multiple regression analyses were performed separately for younger (primary school) and older (secondary school) cohorts. Results: The findings demonstrated a pronounced polarization of HRQoL, with approximately one-third of participants (32.7%) scoring within the clinically low range. Depressive symptoms were prevalent, particularly in the domains of Negative Mood (M = 19.93) and Ineffectiveness (M = 15.45), while Negative Self-Esteem levels were comparatively low (M = 8.02). HRQoL correlated strongly and inversely with Interpersonal Problems (rs = −0.89, p < 0.001). Regression analyses indicated that Negative Self-Esteem (CDI-2D) was the strongest negative predictor of HRQoL in both age groups, whereas Ineffectiveness (CDI-2C) and Negative Mood (CDI-2A) emerged as significant positive predictors. Interpersonal Problems (CDI-2B) were predictive only in older adolescents, suggesting a developmental shift in determinants of well-being. Conclusions: Adolescent cancer survivors exhibit a distinctive psychological pattern characterized by pronounced emotional distress without pervasive self-devaluation. HRQoL appears highly polarized and primarily determined by self-esteem and interpersonal functioning. These findings underscore the necessity of developmentally tailored psychosocial interventions addressing self-worth, peer reintegration, and socio-economic stressors in survivorship care. Full article

Background: This study examined the relationship between screen time, body image satisfaction, body mass index (BMI), and quality of life among children and adolescents from two school clusters in Sesimbra, Portugal. Methods: The sample included 80 students aged 10 to 18 years, assessed using validated questionnaires (Collins’ Figure Rating Scale and KIDSCREEN-27). Results: Results indicated sex differences in electronic game use, with boys reporting higher usage. A negative association was found between time spent on social networks and perceived autonomy and parent–child relationship quality. A high prevalence of body image dissatisfaction was found, particularly among boys, which was significantly associated with BMI. Regarding quality of life, participants scored lower than the European average in the domains of physical and psychological well-being. Conclusions: Findings suggest that screen time, body image, and BMI interdependently affect quality of life, underscoring the need to promote digital literacy, self-esteem, body acceptance, and healthy lifestyles in both school and family settings. Full article

Background: Primary headaches in children and adolescents impose emotional, cognitive, and functional burdens beyond pain. This review synthesizes their psychopathological and neuropsychological dimensions and outlines implications for assessment and care. Methods: We performed a comprehensive review with systematic searches of PubMed, Scopus, and Embase (2015–2025). We included observational/experimental studies and evidence syntheses on 0–18-year-olds with migraine, tension-type, or cluster headache; treatment-only reports were excluded. Results: Across population and clinic samples, primary headaches co-occur with elevated anxiety/depression, frequent ADHD/learning problems, and pervasive sleep disturbances with likely bidirectionality. Interictally, small to moderate neurocognitive differences are most consistent in attention/executive control, processing speed, and verbal memory. Quality of life and school participation are reduced. Standardized tools (e.g., PedMIDAS, PedsQL/KIDSCREEN, SDQ/CBCL, SDSC±actigraphy, NEPSY-II/BRIEF) support multidisciplinary assessment. Conclusions: Care should look beyond pain counts, integrating routine screening of mood, sleep, and cognition; active family involvement; and school–healthcare coordination within stepped-care pathways (education and sleep hygiene for all; targeted CBT for catastrophizing/avoidance) with monitoring that pairs headache frequency with functional outcomes. Full article

Background: It is important to investigate the combination of 24 h movement behaviors (24 h MB)—such as physical activity, screen time, and sleep—as children’s daily habitual behaviors significantly influence their health-related quality of life (HRQoL). However, such studies remain extremely limited in East Asia. This study aimed to examine whether adherence to the 24 h MB is associated with HRQoL among children from three East Asian countries. Methods: In this cross-sectional study, data were collected from primary school children aged 7–12 years in Japan (n = 786), China (n = 1246), and South Korea (n = 1011). HRQoL was assessed using the KIDSCREEN-27 questionnaire, while physical activity, screen time, and sleep duration were measured through a self-reported questionnaire survey. Results: Logistic regression analyses, adjusted for relevant covariates, confirmed significant associations with HRQoL subfactors including physical well-being, psychological well-being, social support, and peer relationships. Conclusions: Our findings highlight the critical relationship between adherence to 24 h MB and HRQoL in East Asian children, contributing valuable evidence to support integrated health promotion strategies in this region. Full article

Objective: To analyze the association between physical activity, health-related quality of life (HRQoL), and perceived barriers to physical activity with the risk of symptoms of depression, anxiety, and stress in Chilean adolescents. Method: A quantitative, cross-sectional, descriptive-correlational study was conducted with a sample of 351 secondary school students (mean age = 15.75 ± 1.47 years) from several educational institutions in the south-central region of Chile. Validated instruments were used to assess physical activity (PAQ-A), symptoms of mental health (DASS-21), HRQoL (Kidscreen-52), and the short scale of barriers to physical activity. For exploratory purposes, mental health outcomes were dichotomized based on standard cut-off scores, and binary logistic regression models were estimated to identify associated factors. Results: Based on the binary categorization, a substantial proportion of students exceeded the risk thresholds for depressive (54.4%), anxiety (63%), and stress symptoms (42.2%). Across models, lower physical activity levels, reduced autonomy and weaker relationships with parents, and barriers related to self-concept and motivation were consistently associated with higher mental health risk. Additionally, passive commuting and the perceived school environment emerged as specific predictors of stress and depression risk, respectively. Conclusions: These findings suggest that individual and contextual factors linked to lifestyle behaviors and perceived social support may play a critical role in adolescent mental health, and could represent key targets for school-based interventions. Full article

Health-related quality of life (HRQoL) is a multidimensional construct that encompasses physical, emotional, psychological, and social domains, according to an individual’s perception. Studies have indicated that lifestyle-related factors, such as engaging in physical activity (PA), reducing screen time (ST), and maintaining adequate sleep duration, may contribute to improved HRQoL in adolescents. The present study aimed to examine the associations of the 24 h movement behaviors (PA, ST, and sleep duration) with physical and psychological well-being, and HRQoL in adolescents. This study included 746 adolescents of both sexes, aged 11 to 15 years, enrolled in public schools. Sleep duration was assessed through a specific question related to habitual bedtime and wake-up time. ST was evaluated using a question regarding the daily time spent using recreational electronic devices. PA was measured using accelerometers (ActiGraph GT3X-BT). The KIDSCREEN questionnaire was used to assess physical and psychological well-being and HRQoL. Generalized linear models were used for statistical analysis. Significant associations were observed between meeting sleep duration recommendations and higher HRQoL scores (β = 1.05, 95% CI: 1.01–1.08), as well as psychological well-being (β = 1.07, 95% CI: 1.03–1.11). Additionally, adherence to ST recommendations was significantly associated with higher physical well-being scores (β = 1.07, 95% CI: 1.01–1.14). Concerning the combination of adherence to guidelines, meeting both sleep duration and ST recommendations was significantly associated with higher HRQoL scores (β = 1.08, 95% CI: 1.02–1.15), physical well-being (β = 1.11, 95% CI: 1.03–1.21), and psychological well-being (β = 1.09, 95% CI: 1.01–1.18). The findings of this study highlight the importance of adhering to the 24 h movement guidelines, which may contribute to improved adolescent well-being. Full article

Background/Objectives: In research on the relationship between pubertal timing and adolescent health, more attention is typically given to early rather than late maturation, as well as the associated risk of engaging in health-compromising behaviors. The aim of this study was to assess changes in HRQL (health-related quality of life) depending on subjectively perceived pubertal timing, measured in five categories. Methods: A cross-sectional online survey was conducted in spring 2024 in a western region of Poland (N = 9411; mean age 15.15 ± 1.56 years). Mean KIDSCREEN-27 index scores were compared according to self-reported pubertal timing, and five relevant general linear models were estimated, adjusting analyses for respondents’ age, sex, and the remaining four HRQL scores. Results: In the study group, 49.0% of students assessed their pubertal timing as typical, 28.5% as earlier, and 22.5% as later compared to peers of the same sex. For all five KIDSCREEN-27 dimensions, adolescents who matured at a pace perceived as typical achieved the highest quality-of-life index scores. Significantly earlier or significantly later pubertal timing was associated with a notable decrease in these indices. Some significant interactions were identified between sex or age and pubertal timing as predictors of HRQL. The strongest association with pubertal timing was observed for the Psychological Well-being dimension, where differences unfavorable to older age groups were additionally linked to delayed pubertal timing. Conclusions: Greater awareness of the relationship between perceived pubertal timing and adolescents’ well-being is warranted among preventive care physicians, parents, and school psychologists and educators. Full article

The decline in quality of life in recent decades in Spain and how it is related to health factors highlight the importance of considering health-related quality of life (HRQOL) as a key indicator in the assessment of well-being. Marked by physical, hormonal and social changes, adolescence is a critical period when lifestyle habits are consolidated, including physical activity and diet, which affect HRQOL. There are growing concerns that body image, especially in a context of increased sedentarism and screen use, is associated with low self-esteem and mental health problems. The promotion of healthy habits and a positive body image during this age is essential to improve overall well-being and prevent psychological disorders. This study examines differences in screen time, Mediterranean diet adherence, health-related quality of life and body image self-concept in children and adolescents, considering gender and educational level. A cross-sectional analysis was conducted with 305 students (ages 11–14) from primary and secondary schools. The instruments used to measure the different variables were the KIDMED questionnaire for adherence to the Mediterranean diet, the Screen-time Sedentary Behaviour Questionnaire (SSBQ) for screen time, the KIDSCREEN for health-related quality of life and the Body Size Guides (BSGs) for body image perception. The results showed significant differences by educational stage in screen time, health-related quality of life and body image, with secondary school students reporting higher values. No significant differences were found based on sex. The originality of this study lies in its holistic approach to identify patterns of behaviour and well-being, influenced by sociocultural and demographic factors, and in the detailed analysis of variations by age and gender that affect physical and mental health during critical stages of development. The findings highlight the need for educational strategies to promote healthy lifestyles, involving students, families and their environments, to enhance well-being and self-esteem. Full article

Background/Objectives: Decreased well-being may be a precursor to mental health challenges. Mental health visits for 5–11-year-old children increased by 24% from 2019 to 2020. COVID-19 led to record high levels of anxiety and depression in young children. This highlights the need for early identification and intervention of decreased well-being to prevent progression to potential mental health issues. The purpose of our research was to develop the Pediatric Well-Being Picture Scale© (PWBPS©), the first picture-based screening tool for ages 8–11 years, accessible to children regardless of their literacy, language skill, and developmental levels, allowing for quick screening for early referral and intervention. Methods: The mixed-methods research design included focus groups and one-on-one interviews for content and face validity, test/retest reliability, convergent validity, and exploratory factor analysis. Subjects were recruited from public elementary schools. Results: The numbers of participating subjects were as follows: N = 17 for focus groups; N = 12 for one-on-one interviews; N = 50 for test/retest reliability; and N = 237 for convergent validity. Thematic analysis resulted in a 10-item, 3-point picture-based Likert scale. The test/retest reliability demonstrated strong correlations, with an ICC of 0.823 (95% CI [0.690, 0.905]). The Cronbach’s alpha for all the administrations was 0.74, 0.74, 0.84, and 0.89. The convergent validity demonstrated correlation with the validated KIDSCREEN-10. The Spearman’s correlation was 0.64 (95% CI as [0.55, 0.71]). The cutoff for the PWBPS© was 18.5, which correlated to a score of 22 on the KIDSCREEN-10. All the items loaded on one component. Conclusions: These findings demonstrate that the PWBPS© is valid and reliable, allowing for quick and accurate assessments of children’s well-being and allowing for early intervention, which is key to reducing the negative effects of poor mental well-being. Full article