Paper
Thursday, July 12, 2007
Health-Related Quality of Life: Differences Between Children Living With Asthma and Their Caregivers
Judith A. Harris, RN, MS, CPNP, Pediatric Pulmonary, Phoenix Children's Hospital, Phoenix, AZ, USA
Background: Childhood asthma management is a family affair. The health-related quality of life (HRQOL) of children living with asthma and their caregivers are affected. Clinicians treat children with asthma recognize HRQOL in both groups as critical to guiding symptom management. However, little is known about differences between reported HRQOL in children and caregivers and/or the effect of disease severity. Therefore, the aim was to examine between group differences (child and caregiver) in reports of activity limitations (functional health) and emotional function (quality of life) in asthma, and the effect of disease severity. Methods: This sample included 1025 pairs of children (age 7-17) and caregivers who use Breathmobile services. The Pediatric Asthma Quality of Life Questionnaire (children) and Pediatric Asthma Caregiver Quality of Life Questionnaire (caregivers) were completed using a 7-point scale (low scores correspond with increased activity limitations and decreased emotional function). Means were compared and the effect of severity analyzed. Results: Means in overall sample showed statistically significant differences on both activity limitation and emotional function between children and caregivers. Caregivers reported less activity limitation (caregivers = 5.49, children = 4.925; p=.000), and decreased emotional function (concern, worry, helplessness, frustration) (caregivers = 4.988, children = 5.239; p=.000). However, when the effect of severity was considered there was no statistical significance. For activity limitation the mean difference between the child with mild versus moderate to severe asthma and their caregivers (.5257; .3004) was not statistically significant (p= .467). For emotional function the mean difference between the child (mild versus moderate to severe asthma) and their caregivers (-.3247; -.4066) was also not statistically significant (p= .554). Conclusion: The successful management of childhood asthma involves a partnership between the child, caregiver and provider. Because differences exist between the child and caregiver clinicians should consider interventions that are specific to each group.