Association of academic performance, general health with health-related quality of life in primary and high school stude
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RESEARCH
Association of academic performance, general health with health‑related quality of life in primary and high school students in China Shengxiang Qi1†, Zhenzhen Qin1†, Na Wang1, Lap Ah Tse2, Huifen Qiao3* and Fei Xu1,4*
Abstract Purpose: To explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China. Methods: In this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health. Results: Totally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location. Conclusions: Both self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status. Keywords: Academic performance, General health, Health-related quality of life, Child Health Utility 9D, Students
*Correspondence: [email protected]; [email protected] † Shengxiang Qi and Zhenzhen Qin contributed equally to this work and they are co-first authors 1 Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing 210003, China 3 Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, Nanjing 210029, China Full list of author information is available at the end of the article
Background Health related quality of life (HRQoL) is a subjective concept frequently applied to describe people’s physical, mental, social, psychological and functional aspects of health [1, 2]. HRQoL is not only widely used for clinical purposes but also employed in public health fields [3]. It is documented that children and adolescents under the age of 18 could self-perceive the HRQoL stably in the absence of significant health/life events [4], and lifestyle and behavior f
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