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International Journal of Pediatrics
Volume 2010, Article ID 404687, 10 pages
Research Article

Interactions among Ecological Factors That Explain the Psychosocial Quality of Life of Children with Complex Needs

1Children's Treatment Network, Simcoe/York, ON, Canada L4M 2Y1
2System-Linked Research Unit on Health and Social Service Utilization, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada L8P 0A1
3Children's Health Research Institute, McMaster University, Hamilton, ON, Canada L8N 3Z5
4CanChild, McMaster University, Hamilton, ON, Canada L8S 1C7

Received 12 November 2009; Accepted 11 March 2010

Academic Editor: Praveen Kumar

Copyright © 2010 Sandy Thurston et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To explore the associations and interactions among ecological factors and explain the psychosocial quality of life of children with complex needs. Methods. In this cross-sectional survey consenting parents were identified by the Children's Treatment Network. Families were eligible if the child from 0 to 19 years, resided in Simcoe/York, and there were multiple family needs. Regression analysis was used to explore associations and interactions. 𝑛 = 4 2 9 . Results. Younger children, without conduct disorder, without hostile and punitive parenting and with low adverse family impact demonstrated the highest levels of psychosocial quality of life. Statistically significant interactions between processes of care and parent variables highlight the complexity of real life situations. Conclusions. It is not possible to fully understand the child's psychosocial quality of life in complex needs families by considering only simple associations between ecological factors. A multitude of factors and interactions between these factors are simultaneously present and the care of these families requires a holistic approach.