Correlation Between Food Allergy Response Capabilities of Mothers Who Raise Children with Food Allergy and the Quality of Life

Purpose:

The objective of this study is to clarify the correlations among food allergy response capabilities of mothers, factors affecting it and quality of life (QOL).

Methods:

Subjects were mothers who raised children between the ages of 0-6 years (preschool age) who had been diagnosed by physicians as having a food allergy. A self-recorded questionnaire was distributed and collected via post. The evaluation period was from September 2010 to March 2011. A total of 650 self-recorded questionnaires were distributed to hospitals with a pediatric allergy outpatient clinic (8 institutions) and general clinics (11 institutions) or pediatricians specialized in allergy (2 institutions).

Questionnaire items included the subject’s background such as mother’s age, working condition, health condition, allergic disease, gender, health condition, removed items, number of removed items, consultation facilities, hospital transfer experience, number of hospital transfers, anaphylactic experience, allergic disease apart from food allergy, commuting to kindergarten, self-made lunch box for kindergarten, and the family health condition. In addition, in total 26 items of the Japanese version of the World Health Organization Quality of Life-26 (WHOQOL26) which composed of satisfaction on 4 domains and an added 2-item health condition and QOL subjective evaluation; food allergy response capability proposed by Aika et al., which consisted of 5 factors and 17 items (Cronbach’sα coefficient0.81); and the effects of food allergy on daily life, were used for evaluation.

All statistical analyses were conducted using statistical analysis software IBM SPSS ver.19.0. Pearson’s correlation was used to analyze the correlation between food allergy response capabilities and QOL. In addition, multiple regression analysis (stepwise method) was carried out with QOL as the dependent variable and food allergy response capabilities, the effect of food allergy on daily life, health condition, removed food items, anaphylactic experience, and hospital transfer experience as the independent variables.

Ethical considerations: A written explanation on the study objectives and significance, methods, voluntary based participation, anonymity, and privacy protection were enclosed in the survey, and the written consent was received via post. This study was proceeded following an approval from the Kawasaki University of Medical Welfare Ethics Committee.

Results:

The questionnaire response was obtained from 328 subjects, with a response rate of 50.5%. Among them, 23 subjects were excluded due to missing data. In addition, those with 0 number of removed items in food and those without the description of number of removed food (25 subjects) were excluded, resulting in 280 subjects to be included in the analysis (effective answer rate: 45.0%). Mean age of mothers was 33.6±4.6 years and mean age of children was 35.6±19.8 months. Ratio of male and female was 1.7:1. As for working status of the mother, those who answered full-timer were 74 subjects (26.4%), part-timer mothers were 44 subjects (15.7%), and unemployed mothers were 162 subjects (57.9%). Mean value of food allergy response capabilities was as follows: “Stress coping” 2.96±0.80, “skills in performing the elimination diet” 3.57±0.96, “gathering information from the healthcare professionals” 2.96±0.80, “knowledge on food allergies” 2.96±0.80, and “husband’s cooperation” 2.96±0.80.

WHOQOL26 score of the mother was 3.42±0.42. As for the score grouped by the domains, physical domain was 3.55±0.51, mental domain was 3.41±0.52, social relationships was 3.50±0.56, and environmental domain was 3.32±0.49. From a multivariate regression model (R²0.49,p<0.001), it was found that mother’s QOL consisted of food allergy response capabilities (β=0.31, p<0.001), mother’s health condition (β=0.29, p<0.001), feelings of stress, anxiety and difficulty in one’s overall life except child care (β=-0.24, p<0.001), and family health condition (β=0.13, p<0.05).

Conclusion:

In order to prevent reduction of mother’s QOL, it is important to improve food allergy response capabilities as early as possible following the diagnosis. It is important for nurses to have correct knowledge on food allergy, to understand the situation and feelings of mothers, to deliver appropriate information, to introduce individually-adjusted menus as well as possible eating-out places, to provide practical information supply in cooperation with the dietician, to draw mother’s stress coping capability, to ensure cooperation between the mother and the husband, to recommend the presence of the husband during consultation, and to introduce the importance of husband’s cooperation for child care with food allergy using pamphlets.