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International Journal of Pediatrics
Volume 2010, Article ID 570209, 12 pages
Clinical Study

System Integration and Its Influence on the Quality of Life of Children with Complex Needs

1Children's Treatment Network, Simcoe/York, ON, Canada L4M 2Y1
2Research Unit on Health and Social Service Utilization, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road. S., Suite 210A, Hamilton, ON, Canada L8P 0A1
3Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education of the University of Toronto, ON, Canada M5S 1V6
4Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada L8N 3Z5
5Children's Health Research Institute, McMaster University, Hamilton, ON, Canada L8N 3Z5
6CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada L8S 4L8

Received 8 June 2010; Accepted 11 August 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 interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; . Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years.