Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are they Comparable?
Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are they Comparable?
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DOI：
10.1007/s11482-017-9528-5
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发表时间：
2018-06-01
影响因子：
3.4
通讯作者：
Fiese, Barbara H.
中科院分区：
文献类型：
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作者：
Everhart, Robin S.;Greenlee, Jessica L.;Fiese, Barbara H.
本研究旨在比较哮喘儿童家庭中主要和次要照顾者的生活质量，并确定在临床和研究环境中纳入次要照顾者生活质量的潜在重要性。参与者包括118个有主要和次要照顾者的哮喘儿童家庭。家庭在一次研究会议上完成了测量。照顾者报告生活质量，心理功能和家庭负担;儿童完成生活质量的措施。通过客观肺量计测定儿童肺功能。在研究访视后6周测量处方控制药物的依从性。主要照顾者的生活质量显著低于次要照顾者（平均总体生活质量为5.85 vs 6.17，p <0.05）。更好的药物依从性与更高的主要照顾者QOL相关（rho = .22，p = .02）;次要照顾者QOL，而不是主要照顾者QOL，与儿童QOL呈正相关（rho = .20，p = .03）。照顾者之间生活质量评分差异（评分差异至少0.50）的家庭的特点是更多的家庭负担和主要照顾者的心理症状。照顾者之间生活质量评分的差异可能反映了主要照顾者在日常哮喘管理方面的更多投资。在报告主要照顾者负担较低且心理困难较少的家庭中，任何一位照顾者的QOL评估可能提供信息并代表父母如何适应儿童哮喘。在经历高水平的负担或更多的主要照顾者心理困难的家庭中，二级照顾者的QOL报告可能没有临床意义。
This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (rho = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (rho = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. Differences in QOL scores between caregivers may be a reflection of primary caregivers' greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.