Health-related quality of life and its determinants in children with allergic rhinitis

Background Allergic rhinitis (AR) is highly prevalent in school-aged children and can substantially impair health-related quality of life (HRQoL). The modifiable determinants of HRQoL in this population remain incompletely understood. Methods In this cross-sectional study, 110 children aged 6–12 years with physician-diagnosed AR and 110 age- and sex-matched healthy controls were enrolled from a tertiary hospital (January–December 2023). HRQoL was assessed using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ). A visual analog scale (VAS) quantified four core nose symptoms, while a structured questionnaire captured household environmental exposures, allergen patterns, and treatment adherence. Anxiety and sleep quality were evaluated using HADS-A and PSQI, respectively. Independent-samples t tests, repeated-measures ANOVA with Bonferroni correction, and multiple linear regression were performed. Results The Chinese PRQLQ demonstrated good reliability, with an overall Cronbach's α of 0.891 and an overall test–retest correlation coefficient of 0.895. Children with AR had higher total and domain PRQLQ scores than controls (all P < 0.01). Core nose symptoms were comparably severe, while secondary symptoms were milder. Poor HRQoL was independently associated with pet ownership, secondhand smoke, high indoor humidity, frequent pollen-season outdoor activity, increased dust-mite exposure, poor medication adherence, absence of allergen immunotherapy, higher anxiety, and poor sleep (all P < 0.01). Conclusions AR markedly impairs HRQoL in school-aged children. Targeted management of nose symptoms, household exposures, adherence, and psychosocial factors, combined with timely allergen immunotherapy, may optimize quality of life.