Wheelchairs for children with impaired mobility provide health, developmental and psycho-The sampling frame was children with impaired mobility (18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews con-
Wheelchairs for children with impaired mobility provide health, developmental and psycho-The sampling frame was children with impaired mobility (18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews con-
social benefits, however there is limited understanding of how mobility aids affect the health-
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related quality of life of children with impaired mobility. Preference-based health-related
quality of life outcome measures are used to calculate quality-adjusted life years; an impor-
tant concept in health economics. The aim of this research was to understand how young
wheelchair users and their parents define health-related quality of life in relation to mobility
impairment and wheelchair use.
Methods
The sampling frame was children with impaired mobility (18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews con-
ducted in participants’ homes. Qualitative framework analysis was used to analyse the inter-
view transcripts. An a priori thematic coding framework was developed. Emerging codes
were grouped into categories, and refined into analytical themes. The data were used to
build an understanding of how children with impaired mobility define health-related quality of
life in relation to mobility impairment, and to assess the applicability of two standard mea-
sures of health-related quality of life.
Results
Eleven children with impaired mobility and 24 parents were interviewed across 27 inter-
views. Participants defined mobility-related quality of life through three distinct but interre-
lated concepts: 1) participation and positive experiences; 2) self-worth and feeling fulfilled;
3) health and functioning. A good degree of consensus was found between child and parent
responses, although there was some evidence to suggest a shift in perception of mobility-
related quality of life with child age.
PLOS ONE | https://doi.org/10.1371/journal.pone.0179269 June 15, 2017 1 / 20
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OPENACCESS
Citation: Bray N, Noyes J, Harris N, Edwards RT (2017) Defining health-related quality of life for young wheelchair users: A qualitative health economics study. PLoS ONE 12(6): e0179269. https://doi.org/10.1371/journal.pone.0179269
Editor: Yih-Kuen Jan, University of Illinois at Urbana-Champaign, UNITED STATES
Received: February 24, 2017
Accepted: May 27, 2017
Published: June 15, 2017
Copyright: © 2017 Bray et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability Statement: Data are protected for patients’ confidentiality. Qualitative interview participants did not consent to have their full transcripts made publicly available. Anonymised data and interview transcripts are available from the Centre for Health Economics and Medicines Evaluation (CHEME, Ardudwy Hall, Bangor University, Bangor, Gwynedd, UK, LL57 2PZ; cheme@bangor.ac.uk; +44 1248 382153). Please contact Dr. Nathan Bray (n.bray@bangor.ac.uk) for access.
Conclusions
Young wheelchair users define health-related quality of life in a distinct way as a result of
their mobility impairment and adaptation use. Generic, preference-based measures of
health-related quality of life lack sensitivity in this population. Development of a mobility-
related quality of life outcome measure for children is recommended.
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