Use of health diaries in pediatric research*1

Abstract

Most health behavior information concerning children has been collected using consecutive parent interviews on questionnaires. However, there is a growing interest in using health diaries to record health events in children, including such areas as severity of chronic pain, symptoms associated with chronic illnesses, medication use, parent experiences post surgery of their child, and daily food intake. This interest in the diary instrument as a data collection tool is due primarily to reducing recall bias of health events associated with questionnaire data. Most questionnaire data is subject to some recall bias because respondents are asked to recall a health event over time (e.g., a six-month period), resulting in recall of major health events such as a hospitalization or surgery. Although this recall bias depends on the length of recall period, recall of many “minor health events,” such as less severe asthma symptoms or date of administration by a parent of an antipyretic, is subject to memory lapse even after a two-to-three week recall period. The type of questionnaire data collected during parental interviews can result in either over- or under-reporting of specific health events. For example, recall of a child's pain events by a parent during an interview may result in under-reporting of the child's pain experience if the pain is intermittent or not significant enough for the parent to accurately remember. Inaccurate reports of pain obtained from parents or children by using questionnaire data from a parent interview may influence pain management, prescription of analgesics, and quality of care if the parent inaccurately recalls the level and frequency of the child's pain ( Dampier et al., 2002 Dampier C. Ely E. Brodecki D. O'Neal P. Home management of pain in sickle cell disease: a daily diary study in children and adolescents. Journal of Pediatric Hematology/Oncology. 2002; 24: 610-612 Crossref PubMed Scopus (104) Google Scholar ).