Quality of life and its determinants in pediatric burn survivors attending a tertiary hospital in Nepal

• Pediatric burn survivors report moderate QoL, with school functioning impaired. • Lower QoL is associated with deeper burns, multiple sites, and ≤1 year post-injury. • Strong agreement between child and parent reports supports dual QoL assessment. Pediatric burn survivors may experience persistent impairments in quality of life (QoL), yet evidence from Nepal remains limited. This study assessed child- and parent-reported QoL among pediatric burn survivors and identified factors associated with poorer outcomes. A hospital-based cross-sectional study was conducted among 190 children aged 5–18 years attending a tertiary burn outpatient clinic in Nepal. QoL was assessed using the Nepali-validated Pediatric Quality of Life Inventory (PedsQL™ 4.0). Associations between socio-demographic and clinical characteristics and child-reported QoL were examined using non-parametric tests and multivariable linear regression. The median child-reported total QoL score was 68.5 (IQR 54.3–84.8), indicating an overall moderate level of quality of life. Social functioning showed the highest scores, while school functioning was consistently the most impaired domain. Parent proxy-reports closely aligned with child self-reports (p = 0.762), with high agreement across domains. Lower education level and post-burn period ≤1 year, were independently associated with poorer child-reported QoL. Pediatric burn survivors in Nepal demonstrate moderate QoL, with persistent challenges in school participation despite relatively preserved social functioning. Identifying children at higher risk of poorer QoL may help guide targeted educational, psychosocial, and rehabilitative interventions during follow-up care.