School Absenteeism, Health Status, and Health Care Utilization Among Children With Asthma: Associations With Parental Chronic Disease
School Absenteeism, Health Status, and Health Care Utilization Among Children With Asthma: Associations With Parental Chronic Disease
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DOI：
10.1542/peds.2008-1890
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发表时间：
2009-01-01
期刊：
影响因子：
8
通讯作者：
Kuhlthau, Karen A.
中科院分区：
文献类型：
--
作者：
Lipstein, Ellen A.;Perrin, James M.;Kuhlthau, Karen A.
OBJECTIVE.患有慢性病的父母可能比健康的父母更有可能认为他们患有慢性病的孩子在医学上是脆弱的。我们这项研究的目的是确定父母患有慢性病的哮喘儿童与父母没有患有慢性病的哮喘儿童相比，在医疗保健利用、缺课和报告的儿童健康状况方面是否存在差异。患者和方法。我们从2003年全国健康访谈调查中选择了5至17岁的哮喘儿童及其父母。我们确定了父母是否患有慢性疾病，并检查了父母慢性疾病与儿童健康状况，学校缺勤和医疗保健利用的关系。我们在多变量回归中控制了已知影响因变量的因素，包括儿童疾病严重程度的指标。在561对父母-子女配对中，父母患有慢性病的哮喘儿童更有可能健康状况不佳，每年平均缺课时间比其他哮喘儿童多1.3天。在哮喘不太严重的儿童中，父母患有慢性疾病的儿童报告的健康状况较低，但与父母没有慢性疾病的儿童相比，没有更多的学校缺课（平均差异：0.39）。父母一方患有慢性病与医疗保健利用率的增加无关。与其他哮喘儿童相比，父母患有慢性病的儿童健康状况更差，缺课更多，特别是在哮喘更严重的儿童中。了解父母的健康如何影响儿童的健康护理和健康状况，可以帮助提供者与父母合作，更有效地管理儿童的哮喘护理，使他们能够更充分地参与学校和其他活动。儿科2009;123：e60-e66
OBJECTIVE. Parents with chronic disease may be more likely than healthy parents to perceive their children with chronic conditions as medically vulnerable. Our objective for this study was to determine if children with asthma whose parents have chronic disease differ in health care utilization, school absenteeism, and reported child health status compared with those whose parents do not have chronic disease.PATIENTS AND METHODS. We selected children with asthma, 5 to 17 years of age, and their parents from the 2003 National Health Interview Survey. We determined whether parents had chronic disease and examined associations of parental chronic disease with child health status, school absenteeism, and health care utilization. We controlled for factors known to influence our dependent variables, including an indicator of child disease severity, in multivariable regression.RESULTS. Among 561 parent-child dyads, children with asthma whose parents had chronic disease were more likely to have less than very good health and missed an average of 1.3 more school days annually than other children with asthma. Among children with less severe asthma, those whose parents had chronic disease had lower reported health status but did not miss more school (mean difference: 0.39) than children whose parents did not have chronic disease. Having a parent with chronic disease was not associated with increased health care utilization.CONCLUSIONS. Compared with other children with asthma, children whose parents have chronic disease have worse health status and miss more school, particularly among children with more severe asthma. Understanding how parents' health influences children's health care and health status may help providers work with parents to more effectively and efficiently manage their children's asthma care so they can more fully participate in school and other activities. Pediatrics 2009;123:e60-e66