Assessing quality of life in displaced children on Lesvos using PROMIS: a mixed methods study.

INTRODUCTION: Due to the ongoing global refugee crisis, around 400 million children are currently displaced. We investigate domains of quality of life (QoL) in two groups of displaced children; children living with their caregivers in Closed Control Access Centre (CCAC) Mavrovouni and unaccompanied minors (UAMs) in designated shelters on Lesvos, Greece. METHODS: A mixed-methods study using PROMIS® to quantitatively assess domains of QoL compared to a reference group by using a one-sample Wilcoxon sign-rank test. Associated variables were identified by multivariable linear regression analyses. Open questions were added to UAMs to qualitatively identify elements influencing QoL. RESULTS: A total of 111 children (N = 94) and UAMs (N = 17) participated. Children across all age groups showed significantly worse scores in various domains compared to the reference group. The youngest group (1-4 years) report more Depressive symptoms but better peer relationships, while the 5-18 year groups reported higher levels of anger, anxiety, depressive symptoms, and pain behavior. Adolescents (8-18 years) reported higher scores on meaning and purpose. A longer duration in camp was associated with higher scores on anxiety and depressive symptoms. UAMs mention separation from family as negatively influencing their mental health. They mention future goals, hope and social support as central to their sense of meaning and purpose. CONCLUSION: Displaced children report high levels of anger, anxiety, pain behavior, and depressive symptoms, a prolonged stay in the camps even worsens these outcomes. This underscores the need for tailored interventions to enhance the overall well-being of this vulnerable population.