gms | German Medical Science

Objective: The aim of the study was to examine the association between pain and health-related quality of life (HRQOL ) measured with the KINDL-R questionnaire in a representative sample of children and adolescents in Germany.

Methods: As part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), data on pain were collected in 14,959 children and adolescents aged 3 to 17. We used the internationally employed KINDL-R generic HRQOL questionnaire, which consists of 24 items, which form a total score and six subscales (physical well-being, emotional well-being, self-esteem, family, friends and every day functioning, i.e. school or nursery school/kindergarten). Results are reported separately for 11-17 year olds, who filled in the questionnaire themselves, and 3-10 year olds, whose parents reported on their pain and HRQOL.

Results: The three-months prevalence of pain was 64.5% in 3-10 year olds and 64.5% in 11-17 year olds. Participants with pain in the last 3 months reported significantly lower HRQOL in all domains compared to those without pain. The greatest difference was found in the physical well being domain (scale of 65 versus 79in girls aged 11-17). HRQOL differed by gender in an age-dependent manner. Among children and adolescents without pain there were almost no HRQOL gender differences. In children with pain we found age-dependent gender differences in most KINDL-R subscales, with lower HRQOL in younger boys and adolescent girls with pain compared to their peers without pain. These gender differences were similar for repeated pain and remained significant after adjustment for social class.

Conclusions: The association of pain with a lower HRQOL confirms previous findings on the impact of pain in children and adolescents. The lower HRQOL in older girls with pain compared to boys with pain is in line with the results of previous pain studies in adults.