Purpose: To estimate the prevalence of children in rural China without constant parental guardians (i.e., "left-behind"), to examine whether left-behind children were associated with lower health-related quality of life (HRQOL) than their counterparts ("non-left-behind").
Methods: A stratified two-stage cluster survey was conducted among 640 children aged between 8 and 14 in a county of Shandong province. HRQOL was assessed in 606 participants using the Pediatric Quality of Life Inventory (PedsQL).
Results: The estimated prevalence of left-behind children in the area was estimated at 53.5% (324/606). The mean PedsQL total scores were lower in the left-behind children than the non-left-behind (84.1 vs. 88.4; P < 0.01), as were psychosocial summary, emotional functioning, social functioning and school performance scores, while mean physical subscale scores did not differ significantly (85.4 vs. 86.2; P = 0.31). As age, education level and economic status increased, HRQOL of the children was significantly improved.
Conclusions: Left-behind children report poorer HRQOL than non-left-behind children due to psychosocial dysfunction. An assessment of such problems is essential to estimate the need of rural children, for the identification of those at particular risk for lower quality of life, and for planning and implementation of appropriate health interventions.