Evaluation of quality of life and its relation with multi-dimensional deprivation in 7th grade students in Bayrakli

Introduction and aim: Quality of life is individuals' 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. In children; in addition to basic features like age, sex and health status, individual lifestyle factors, family structure and socioeconomic status effect quality of life. The concept of "deprivation" has come to the forefront in socioeconomic evaluations in recent years. The study aims, to determine health related quality of life and the related factors, to evaluate the multidimensional deprivation and its relation to quality of life. Method: This cross-sectional study is conducted in the Bayraklı district of Izmir between January and December 2016. The sampling included 934, 7th grade middle school children (prevalence 50.9%, Cl 95%, SE %5, design effect 2.25 and with 20% replacement). By stratified clustered sampling from 24 schools 1090 students participated. Response rate was 84.9%. The KID-KINDL Health Related Quality of Life Scale was used. The independent variables were examined in four layers derived by using Dahlgren's Determinants of Health Model (basic characteristics of the child, lifestyle factors, family characteristics, life and school conditions). Deprivation status was evaluated through; clothing, nutrition, leisure activities, social facilities, educational resources, access to information, household deprivation and access to health care using the European Child Deprivation Index of UNICEF 2012. Student t, Mann-Whitney U, Kruskal Wallis H tests and multiple linear regression analyzes were used. Permissions were taken from Ege University Medical Faculty Hospital Ethics Committee and Izmir Provincial Directorate of National Education. Results: Mean age was 12.5±0.5, 51.5% were male. Parental educational status was high school or above in 51.6%. Among the households 17.8% had income lower than their expenditure and 7.5% of them had income below the poverty threshold. Deprivations were most prevalent at household level (38.0%), in health care access (24,9%) and for leisure time activities (11.4%). Among the children, 12.5% experienced two or more material deprivation. Mean quality of life score was 71.3±12.6 with the highest scores at family and friends and the lowest scores at school and self-esteem dimensions. According to linear regression results; the HRQoL scores decreased in girls (2.0 points), with lower health perception (6.9 p), with lower school achievement (3.5 p), with perceived owerweight (2.2 p), for those with sleep time <9 hours (2.4 p), with unemployed household head (7.8 p), with deficient pocket Money (2.9 p), for those lacking safe playground (1.8 p), with structural problems at house (5.0 p) and when there is inaccess to healthcare (5.2 p). Conclusion: Students HRQoL scores are mostly related with unemployment of household head, poor state of health perception and deprivation in access to health care. In the follow-up of school children, the role of primary health care should be promoted in all stages of prevention, early diagnosis, treatment and follow-up and oral and dental health centers offering public services should be expanded. Provision of public means for income security during unemployment periods will favor children's health.