Determinants of longitudinal health-related quality-of-life change in children with asthma from low-income families: a report from the PROMIS® Pediatric Asthma Study.
Determinants of longitudinal health-related quality-of-life change in children with asthma from low-income families: a report from the PROMIS® Pediatric Asthma Study.
复制标题
低收入家庭哮喘儿童与健康相关的生活质量纵向变化的决定因素：PROMIS® 小儿哮喘研究的报告。
DOI：
10.1111/cea.12827
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Huang,I-C
中科院分区：
文献类型：
--
作者：
Li,Z;Leite,WL;Thompson,LA;Gross,HE;Shenkman,EA;Reeve,BB;DeWalt,DA;Huang,I-C
背景 纵向哮喘控制状态和其他社会人口因素如何影响哮喘儿童（尤其是低收入家庭的哮喘儿童）健康相关生活质量（HRQOL）的变化尚未得到充分研究。 目的本研究旨在描述 15 个月内哮喘特异性 HRQOL 的轨迹，并考虑社会人口因素来考察哮喘控制状态对 HRQOL 的影响。 方法 共有 229 名哮喘儿童及其家长参与研究招募了公共保险计划中的参与者来评估四个评估时间点的哮喘控制状况和 HRQOL。使用哮喘控制和通信仪器测量哮喘控制状态，并使用患者报告结果测量信息系统的小儿哮喘影响量表评估哮喘特异性 HRQOL。应用潜在增长模型（LGM）来检查HRQOL的轨迹以及导致HRQOL变化的因素。结果无条件LGM显示HRQOL随着时间的推移而改善。有条件的 LGM 表明，考虑到哮喘控制和参与者的社会人口因素，HRQOL 的初始水平变化显着，但变化率却并不显着。有条件的 LGM 还显示，哮喘状态控制不佳与每个时间点的 HRQOL 较差相关（P < 0.05）。较低的父母教育程度与较低的 HRQOL 基线相关（P<0.05）。随着时间的推移，西班牙裔儿童的 HRQOL 比非西班牙裔白人儿童的 HRQOL 增幅更大（P < 0.01）。 结论 弱势社会人口特征和控制不佳的哮喘状况影响儿童的 HRQOL。这一发现鼓励采取干预措施来改善少数民族儿童的哮喘控制状况和 HRQOL。
BackgroundHow the longitudinal asthma control status and other socio‐demographic factors influence the changes of health‐related quality of life (HRQOL) among asthmatic children, especially from low‐income families, has not been fully investigated.ObjectivesThis study aimed to describe the trajectories of asthma‐specific HRQOL over 15 months and examine the effect of asthma control status on HRQOL by taking socio‐demographic factors into consideration.MethodsA total of 229 dyads of asthmatic children and their parents enroled in public insurance programs were recruited for assessing asthma control status and HRQOL over four time points of assessment. Asthma control status was measured using the Asthma Control and Communication Instrument, and asthma‐specific HRQOL was assessed using the Patient‐Reported Outcomes Measurement Information System's Pediatric Asthma Impact Scale. Latent growth models (LGMs) were applied to examine the trajectory of HRQOL and the factors contributing to the changes of HRQOL.ResultsUnconditional LGM revealed that HRQOL was improved over time. Conditional LGM suggested that accounting for asthma control and participants' socio‐demographic factors, the variation in the initial level of HRQOL was significant, yet the rate of change was not. Conditional LGM also revealed that poorly controlled asthma status was associated with poor HRQOL at each time point (P's < 0.05). Lower parental education was associated with lower baseline HRQOL (P< 0.05). Hispanic children had a larger increase in HRQOL over time (P< 0.01) than non‐Hispanic White children.ConclusionsVulnerable socio‐demographic characteristics and poorly controlled asthma status affect HRQOL in children. This finding encourages interventions to improve asthma control status and HRQOL in minority children.