Pediatric Asthma Caregiver's Quality Of Life Questionnaire Research Articles

Quality of life and its relation to pediatric asthma severity

BackgroundBronchial asthma is a global health problem that negatively affects the quality of life (QOL) of both children and their caregivers. However, there is a paucity of data regarding the impact of QOL on asthma severity in the pediatric population. Therefore, we aimed to examine the effect of health-related QOL of children with asthma and their caregivers on the level of asthma control and the degree of asthma severity.ResultsAt enrollment, thirty asthmatic children and their caregivers completed the study. The standardized Arabic versions of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) were fulfilled by the asthmatic patients and their caregivers, respectively. Asthma control and severity were assessed using Global Initiative for Asthma guidelines and asthma severity scores. The relations between QOL and the other study parameters including asthma severity were examined which revealed that poor QOL of both asthmatic children and their caregivers was associated with frequent asthma-related hospital admissions (p = 0.046, 0.011). In addition, significant associations were found between symptoms, activity domains of PAQLQ score, and asthma control test score (p = 0.019,0.039). Furthermore, both QOL questionnaires’ total scores correlated strongly with asthma severity scores (p < 0.05 for all).ConclusionsIn this study, QOL appears to be strongly related to the level of asthma control and asthma severity in children. Therefore, improving QOL is recommended for proper management of patients with severe asthma. Moreover, QOL questionnaires can be used as useful tools for monitoring asthma severity in children.

Asthma control in normal weight and overweight/obese asthmatic children following adenotonsillectomy.

Childhood adenotonsillar hypertrophy (ATH) with sleep-disordered breathing (SDB) frequently occurs concomitant with asthma. Adenotonsillectomy and reduction in asthma severity association has been reported. We describe changes in asthma control in nonobese or normal weight and obese/overweight children undergoing adenotonsillectomy for SDB. This prospective, nonrandomized cohort trial with 6-month follow-up at a tertiary children's hospital enrolled 41 children with persistent asthma undergoing adenotonsillectomy for SDB. Children with significant chronic medical conditions, premature birth (< 28weeks), or recent respiratory infection were excluded. Patients were stratified by baseline BMI into nonobese or normal weight (BMI < 85 percentile) and obese/overweight (BMI > 85%). The primary outcome was change in Childhood Asthma Control Test (cACT) scores 3 and 6 months following adenotonsillectomy. Secondary outcome examined improvement in Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) 3 and 6months following adenotonsillectomy. Baseline characteristics were similar except for anthropometric measures and mean PACQLQ (P = .03). Children with nonobese or normal weight (n = 26) had statistically significant improvement in change in cACT at 3 (22.80 ± 2.33 vs. 17.86 ± 3.53, P < .001) and 6 (20.71±3.29 vs. 18.24 ± 4.16, P = .044) months compared with baseline. PACQLQ scores also improved at 3 (6.20 ± 0.87 vs. 4.56 ± 1.12, P < .001) and 6 (6.36 ± 0.72 vs. 4.93 ± 0.96, P < .001) months. Obese/overweight children (n = 10) had significant improvement in cACT scores at 6months (20.00 ± 3.90 vs. 15.00 ± 6.90, P = .048). Change of cACT scores at 3months (17.86 ± 3.53 vs. 14.86 ± 6.31, P = .272) was not significantly different. PACQLQ scores improved at 3 (5.47 ± 1.09 vs. 3.70 ± 0.85, P < .001) and 6 (5.75 ± 2.19 vs. 3.67 ± 1.04, P = .016) months. Nonobese or normal-weight children undergoing adenotonsillectomy demonstrated significant improvement in asthma control scores at 3 and 6 and obese/overweight children at 6 months. Using the PACQLQ, caregiver quality of life improved for all children at 3 and 6 months. Surgical management of ATH in children with comorbid SBD and asthma is a good treatment option.

Correlation between sleep quality and quality of life in asthmatic children and primary caregivers

Background: Asthma is a serious global health problem that often and adversely affects children. Between 20 and 30% of children in the pediatric population experience sleep problems. The responsibilities of providing nocturnal care and the stress that is directly tied to the illness affect caregiver sleep patterns in a similar way to how a chronic illness may have a direct impact on a child's sleep. Objective: To examine the relationship between an asthmatic child's quality of life and their primary caregivers sleep habits. Material & Method: According to inclusion and exclusion criteria, 50 patients with chronic asthma and their primary caregiver were recruited from the pediatric outpatient department of Civil Hospital Sec. 6, Panchkula, for cross-sectional correlational research. Children with asthma were given the Children Sleep Habit Questionnaire (CSHQ) and the Mini PAQLQ (mini pediatric asthma quality of life questionnaire), whereas primary caregivers were given the Pittsburgh Sleep Quality Index (PSQI) and the Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), respectively.Results: With a correlation value of r = -.768, this study demonstrated a strong association between asthmatic children's sleep quality and quality of life. With a connection value of r = -.765, main carers' sleep quality and quality of life were also shown to be significantly correlated.Conclusion: Based on findings of the study, there was a significant correlation between the sleep quality and quality of life in asthmatic children and primary caregiver.

A BRIEF OVERVIEW OF QUESTIONNAIRES ASSESSING THE QUALITY OF LIFE OF CHILDREN WITH BRONCHIAL ASTHMA

Our aim was to present the Qol Quality of Life Assessment (Qol) tools which are currently used in clinical practice, their role and importance in the classification and management of asthma. We reviewed 6 questionnaires: 1) Child Health Survey for Asthma (CHSA) -Developed by the American Academy of Pediatrics; 2) Child Health Survey for Asthma-Child Version (CHSA-C) -Developed by the American Academy of Pediatrics; 3) Pediatric Asthma Quality of Life Questionnaire (PAQLQ) - Developed by E.F. Juniper; 4) Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) - Developed by E.F. Juniper; 5) Pictorial Quality of Life Measure for Young Children With Asthma (Pictorial PAQLQ) -Developed by R.S. Everhart and B.H. Fiese; 6) Pediatric Quality of Life Inventory 3.0 Asthma Module (of the Pediatric Quality of Life Inventory) (Developed by J.W. Varni). Assessing health-related quality of life (HRQOL) can provide a significant and more comprehensive assessment of the impact of asthma on a child's quality of life. Its (QoL) study and correct evaluation can be very useful for the proper management and prognosis of asthma. The impact of asthma on quality of life is different in different countries, which is determined by the cultural, social, psychosomatic, nutritional characteristics of the nation, therefore, validation of the instruments for assessing the quality of life of children with asthma in Georgia is necessary and important.

The Buteyko breathing technique in children with asthma: a randomized controlled pilot study

BackgroundEvidence supports the Buteyko breathing technique (BBT) as reducing medication and improving control and quality of life in adults with asthma, but having minimal impact on spirometry. For children with asthma, evidence addressing the utility of BBT is sparse. We evaluated the effectiveness of BBT in managing various aspects of asthma in children. MethodsThirty-two children with partly controlled asthma (age 6-15 years, 66% male) were randomized to either Treatment as Usual (TAU) or TAU combined with Buteyko training (Buteyko group, BG). Children in the BG received an intensive five-day training followed by three months of home practice. Primary outcome was bronchodilator reduction. Secondary outcomes were changes in physiological parameters FEV1_AR (at rest), FEV1_ER (after ergometry), FEV1_BR (after bronchospasmolysis), corticosteroid use, FeNO, SpO2, breath-hold test and questionnaire data [Asthma Control Questionnaire and Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ)]. All measures were collected at Baseline and a three-month follow-up. ResultsFor the primary outcome, no significant between-group difference was found. Regarding the secondary outcomes, children receiving treatment augmented with BBT revealed significantly greater improvement at the follow-up than those receiving TAU for FEV1_AR (p = .04, d=-0.50), FEV1_ER (p = .02, d=-0.52), and the emotional function subscale of the PACQLQ (p < .01, d = 1.03). No between-group differences were found for the remaining secondary measures of outcome. ConclusionsOur preliminary findings suggest that the addition of BBT to treatment as usual for children with asthma enhances outcomes with respect to spirometry and parental emotional function but does not lead to reductions in medication, at least over the short term.

Características, control de la enfermedad y calidad de vida de los pacientes asignados al ‹‹Programa de Atención al Niño Asmático›› de un centro de atención primaria.

Objetivos: Evaluar las características clínicas, el grado de control de la enfermedad y calidad de vida de cuidadores de pacientes y pacientes asignados al «Programa de Atención al Niño Asmático» en un centro de atención primaria. Métodos: Estudio descriptivo observacional, con recolección prospectiva de datos procedentes de 3 cuestionarios estandarizados, entregados al paciente o cuidadores: Asthma Control Questionnaire(ACQ)TM, Paediatric Asthma Quality of Life Questionnaire(PAQLQ)TM y Paediatric Asthma Caregivers Quality of Life Questionnaire(PACQLQ)TM y recolección retrospectiva de datos procedentes de la historia clínica. La muestra proviene del “Programa de Atención al Niño Asmático” de un centro de salud. Resultados: El 40% de los pacientes presentaban antecedente materno o paterno de asma y el 80% antecedente personal de dermatitis atópica, rinitis alérgica o alergia alimentaria. La media de los resultados de las escalas fue de ACQTM: 0.87 +/- 1.06 puntos (rango 0 – 3.6). Media de resultado PAQLQTM: 6.08 +/- 0.77 (rango 5 – 7). Media de PACQLQTM: 5.48 +/- 1.06 (rango 3 – 7). En pacientes con ACQTM &lt;0.5 puntos, la media de puntuación en PACQLQTM fue de: 6.30 +/- 0.83. En pacientes con ACQTM &gt;1 fue de: 4.66 +/- 0.72. Conclusiones: La presencia de atopia personal y el antecedente familiar de asma es el factor de riesgo más relacionado con el desarrollo de asma en nuestro estudio. El grado de control de asma en la muestra es mejorable, relacionándose un peor control de la enfermedad con peor puntuación en la escala de calidad de vida, siendo necesario implementar medidas de mejora en el ámbito educativo, clínico y asistencial.

Psychometric evaluation of the Brazilian version of the pediatric asthma control and communication instrument

There is a lack of questionnaires capable of evaluating the clinical control of Brazilian children and adolescents with asthma over a wide age range. The Pediatric Asthma Control and Communication Instrument (PACCI) has been validated, but only with English- and Spanish-speaking children in the United States. To evaluate the psychometric properties of the Brazilian version of the PACCI questionnaire. A cross-sectional psychometric study conducted with children and adolescents aged 01 to 19 years with a clinical diagnosis of asthma, and their respective parents/guardians. The following assessments were conducted: socioeconomic status; clinical control using the Childhood Asthma Control Test (c-ACT), Asthma Control Test (ACT); caregiver quality of life using the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ); and pulmonary function test (spirometry). Validity was evaluated as follows: exploratory and confirmatory factor analysis; Cronbach's alpha analysis (α); floor and ceiling effects; receiver operator characteristic curve analysis. A total of 128 participants were included, most of them male (54.7%). The Brazilian version of PACCI had adequate internal consistency (α = .76) and moderate floor and ceiling effects. The internal structure presented acceptable adjustment indices, considering the extraction of four factors. The factors presented adequate α values. Asthma control factor 1 correlated with c-ACT/ACT and PACQLQ. Control domain scores greater than four points (sum of score) and above 1 point (problem index) were indicative of uncontrolled asthma. The Brazilian version of PACCI was able to provide valid and reliable measures in evaluating the clinical control of asthma in Brazilian children and adolescents.

Knowledge, attitudes and quality of life of caregivers towards asthma in their children: a Nigerian perspective

Introduction: The burden of uncontrolled asthma is high and caregivers can offer support in the management of asthma. Asthma is one of the most common chronic diseases in children. The objective of this study was to assess the knowledge, attitudes, and quality of life (QoL) of caregivers toward asthma in their children.&#x0D; Methods: This cross-sectional study was conducted in the Paediatric Respiratory Unit of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State (July 2017-September 2017). We utilized a 46-item questionnaire comprising knowledge and attitude domains and the 13-item Pediatric Asthma Caregiver’s QoL Questionnaire (PACQLQ). Data were analyzed using the IBM SPSS Version 25.0. Statistical significance was set at p &lt; 0.05.&#x0D; Results: Fifty-one caregivers participated in the study. More than half (n = 36, 70.6%) of the caregivers were 40 years old and above, female (n = 37, 72.5%), graduates from higher institutions (n = 33, 64.7%), and self-employed (n = 27, 52.9%). About a quarter (n = 13, 25.5%) had a family history of asthma and a similar proportion (n = 14, 27.5%) knew the three main symptoms of asthma.&#x0D; Conclusion: Less than half (n = 24, 47.1%) of the caregivers had good asthma knowledge. Dust (n = 35, 68.6%) and smoke (n = 31, 60.8%) were identified as the most common asthma triggers in their children. The majority of the caregivers (n = 41, 80.3%) agreed that most people can have well-controlled asthma without seeing a doctor regularly. Overall, less than half of the caregivers (n = 24, 47.1%) showed positive attitudes toward their children’s asthma. The overall score for the PACQLQ was 3.91 (0.98) which implied a poor QoL. The caregivers had both impaired activity and emotional function from managing asthma in their children. More female caregivers had better knowledge about asthma than their male counterparts (t = −3.178; df = 49; p = 0.003). Less than half of the caregivers had good asthma knowledge and positive attitudes toward asthma in their children. They had an impaired QoL from managing asthma in their children.

Parental quality of life and self-efficacy in pediatric asthma

Objective: Self-efficacy is the personal belief that a behavior can produce a desired result; and in asthma, self-efficacy in asthma care has been related to improvements in asthma outcomes and children’s quality of life. To appreciate the full burden of asthma on families, the relationship between parental self-efficacy and quality of life also needs further study. We aim to characterize this relationship.Methods: Secondary analysis of measurements of parents of children with persistent asthma (n = 252; ages 4-17 years) from a large urban area were identified from a randomized trial; the association between baseline assessments of parental quality of life, measured by the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ), and parental self-efficacy, measured through the Parental Asthma Management Self-Efficacy Scale (PAMSES), were examined through multivariable linear regression.Results: Parental self-efficacy in asthma was positively associated with quality of life among parents of racially and ethnically diverse children (p = 0.01). Confidence in using medications correctly (p = 0.03), having inhalers during a child’s serious breathing problem (p = 0.02), and knowing which medications to use during a child’s serious breathing problem (p = 0.04) were associated with a clinically meaningful difference in parental quality of life. Other significant factors associated with parental quality of life included Hispanic/Latino ethnicity (p < 0.01) of the child and Asthma Control Test scores (p < 0.01).Conclusion: The findings suggest that improving parental confidence on when and how to use their child’s asthma medications, particularly during an asthma attack, might be clinically meaningful in enhancing parent’s quality of life.

A Prospective Study to Assess the Quality of Life in Children with Newly Diagnosed Asthma and Their Caregivers using the Pediatric Asthma Quality of Life Questionnaire.

Objectives:The study aims to assess the quality of life (QOL) in newly diagnosed asthmatic children and their caregivers before and after treatment using mini pediatric asthma quality of life questionnaire (PAQLQ) and pediatric asthma caregivers quality of life questionnaire (PACQLQ) and to compare their quality of life with ACS (asthma clinical severity score).Materials and Methods:This prospective study was done among 99 children and their caregivers, who were interviewed using mini PAQLQ and PACQLQ on 2 occasions: at the time of inclusion and 4 weeks after treatment. During their clinic visit, asthma clinical severity scoring was done, and children were treated according to GINA (Global Initiative for Asthma).Results:After 4 weeks of treatment, there was a significant change in all domains of mini PAQLQ (P < .001) and PACQLQ (P < .001). In children, the change in the emotional domain after treatment was minimal when compared to other domains. When ACS was compared with mini PAQLQ and PACQLQ, children with well-controlled asthma had a better quality of life than partially-controlled asthmatic children (P < .001) and there wasn’t a significant change in the quality of life of the caregivers after treatment (P = .321)Conclusion:During treatment, QOL of newly diagnosed asthmatic children and their caregivers showed significant improvement but children lagged in their emotional domain. Despite medical intervention, these children also require psychological support and counseling. Also, caregivers didn’t perceive a change in their QOL when compared with ACS and it indicates that parent’s and child health-related quality of life should be taken as independent dimensions.

Quality of Life of asthmatic children and their caregivers

Objectives:To assess Quality of Life (QOL), and its associated factors between asthmatic children and their caregivers, and determine the correlation between QOL of patients and caregivers, at King Abdulaziz University Hospital (KAUH), Jeddah.Methods:A cross-sectional study was conducted among eligible participants who attended Pediatric Pulmonology Outpatient Clinic of KAUH, during 2016/2017. A data collection sheet was used. The standardized Arabic version of Pediatric Asthma Quality of Life Questionnaire (PAQLQ) for children aged 7 - 17 years was completed. The caregiver who accompanied the child fulfilled the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ). Descriptive and inferential analyses were performed.Results:QOL scores were reduced among asthmatic children who had other type of allergy, or a family history of allergies. Uncontrolled management of asthma presented by frequent waking-up at night, frequent wheezes, visiting Emergency Rooms (ER), or hospital admission was associated with poor QOL of both asthmatic children and their caregivers. There is a positive correlation between child symptoms domain of PAQLQ and emotional domain of PACQLQ of their caregivers.Conclusion:Uncontrolled asthma was associated with poor QOL of asthmatic child and caregivers. Better management of asthma is recommended to improve their QOL.

Quality of life of children with bronchial asthma and their caregivers: A hospital-based study

Objectives: This study aims to describe the health-related quality of life (QOL) and their associated factors in children with bronchial asthma as well as their caregivers in Mansoura, Egypt. Methods: This cross-section hospital-based study included 171 dyad of children with physician diagnosed asthma and their caregivers attending the outpatients’ clinics of three hospitals. Data were collected using the Arabic versions of the pediatric asthma quality of life questionnaire (PAQLQ) and the pediatric asthma caregiver’s quality of life questionnaire (PACQLQ). Asthma severity was assessed using Global Initiative for Asthma guidelines. Results: The overall mean scores of the PAQLQ and its activity, emotion, and symptom domains were 4.7, 4.3, 4.9, and 4.7; respectively. The overall mean scores of the total PACQLQ and its activity and emotion domains were 4.2, 5.4, and 4.0; respectively. Children with low socioeconomic status (SES) had a significantly lower total, activity and emotion domains of PAQLQ scores. Low and very low SES of the family, uncontrolled, and severe asthma are associated with low QOL of both asthmatic child and his caregivers. Conclusions: Early control of severe asthma will contribute to a better QOL of affected children and their caregivers.

Quality of life of children with bronchial asthma and their care givers: A hospital-based study

Objectives:This study aims to describe the health related quality of life and their associated factors in children with bronchial asthma as well as their caregivers in Mansoura, Egypt. Methods:This cross-section hospital-based study included 171dyad ofchildren with physician diagnosed asthma and their caregivers attending the outpatients' clinics of three hospitals. Data were collected using the Arabic versions of the pediatric asthma quality of life questionnaire (PAQLQ) and the pediatric asthma caregiver’s quality of life questionnaire (PACQLQ). Asthma severity was assessed using GINA guidelines. Results:The overall mean scores of the PAQLQ and its activity, emotions and symptoms domains were 4.7, 4.3, 4.9 and 4.7; respectively. The overall mean scores of the total PACQLQ and its activity and emotions domains were 4.2, 5.4 and 4.0; respectively. Children with low had a significantly lower total, activity domain and emotions domain, domain PAQLQ scores. Low and very low socioeconomic status of the family, uncontrolled and severe asthma are associated with low quality of life of both asthmatic child and his care givers. Conclusions: Early control of severe asthma will contribute to a better quality of life of affected children and their caregivers.

Impact of Age of the Child on Quality of Life of Families of Children With Asthma

SESSION TITLE: Pediatrics SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Measuring quality of life in families is a useful tool in monitoring asthma in children. Currently Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) is recommended only to be used in families with children ages 7-17 years even though younger children (ages 2-6 years) have more morbidity. It is not used in younger age group as it was assumed that parents of younger children may experience different issues then parents of older age. Aim: To identify usefulness of PACQLQ among parents of younger children (ages 2-6 years) with asthma by comparing their responses with responses of parents of older children (ages 7-17 years) with asthma over time once asthma is managed as per NAEPP (EPR-3) guidelines. METHODS: This was a 4 year prospective cohort study. After IRB approval, children were enrolled in our pediatric asthma center since 2011 (n= 868), and were provided asthma care as per NAEPP guidelines. A validated survey (PACQLQ) was used to evaluate the impact of asthma on families. Children (> 2 years of age) and caregivers who were seen in clinic at enrollment, and after every 3-6 months were included in this study (n=364). At each visit, the parents completed PACQLQ, ACT and symptom score since last visit. Results were compared over time between two age groups namely younger children ages 2-6 years old (n=213) and older children ages 7-17 years (n=151). RESULTS: The sample included 364 children. Male to female ratio was 61%:39%. Among younger children, mean age was 3.7±1.5 compared to 10.6±2.9 among older children. At initial visit, mean PACQLQ total, activity limitation, and emotions scores in families of younger children with asthma were not significantly different from responses of families of older children (4.1±2.1, 4.6±2.1 and 5.2±2.1 compared to 4.3±2.1, 4.7±2.2 and 5.2±2 respectively, p=.0.8, 0.8, 0.77 respectively). At three month follw-up, mean scores improved to 5.8 ±1.5, 5.9±1.5 and 6.3±1.2 compared to 5.9±1.3, 6.2±1.2 and 6.2±1.2 respectively in both groups. Linear mixed model analysis indicated significant overall improvement in PACQLQ total, Emotional Function, and Activity Limitation scores over the 4-year time period (all p<.001), but no significant differences were noted between groups with respect to overall PACQLQ total (F=.110, p=.732), Emotional Function (F= .172, p=.612), or Activity Limitation scores (F=.066, p=.820). At initial visit mean ACT scores were 15.6±6.1 and 16.2±5.5 respectively and median days/month with wheezing were 9 and 10. Both groups significantly improved over time without any significant difference between the groups. Improvement in PACQLQ total, emotion and activity in both groups over time correlated with improvement in ACT scores and decrease in number of days with wheezing. CONCLUSIONS: PACQLQ responses at baseline and changes over time in families of children with asthma ages 7-17 were similar to responses in families of younger children with asthma ages 2-6 years and changes correlated with changes in asthma symptoms and ACT over time. CLINICAL IMPLICATIONS: Age of the child has no significant impact on patterns of improvement in QOL in families of children with asthma over time thus PACQLQ can be used in families of younger children with asthma. DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Judy Pitts, Mehek Sheikh, Nancy Ryan-Wenger No Product/Research Disclosure Information

Improved quality-of-life of caregivers of children with asthma through guideline-based management

ABSTRACTObjective: The quality of life (QOL) of caregivers of children with asthma may be related to children's responses to asthma management. Aim: To evaluate change in QOL over time of caregivers of children with asthma through guideline-based management. Design: This was a 3-year prospective cohort study of children with asthma referred to our pediatric asthma center. Families completed Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), the Asthma Control Test™ (ACT), and reported the number of days/month of albuterol use and wheezing at each clinic visit. Results: We enrolled 143 children, ages 7–17 years (mean = 10.6 ± 2.9), 56.6% male, 70.6% Caucasian. Patients were managed by the same MD (n = 65,45.5%) or APN (n = 78,54.5%) over time. The mean total PACQLQ significantly increased over the 3-year period (F = 67.418, p < .001). Total scores at the first visit were 4.8 ± 1.6, which improved to 6.1 ± 1 at the 3-month follow-up visit. This improvement was sustained at the 1, 2, and 3-year clinic visits. PACQLQ emotional function (F = 60.798, p < .001) and activity limitation (F = 41.517, p < .001) domains significantly improved as well. PACQLQ scores were significantly associated with improved ACT scores (r = .37 to .47, p < .05), fewer days/month of albuterol use (r = −.25 to −.36., p < .05), and wheezing (r = −.28 to −.33, p < .05). There were no significant differences in PACQLQ, or asthma clinical outcome measures between MD and APN providers. Conclusion: Use of National Asthma Education and Prevention Program (NAEPP) guidelines significantly improved QOL of caregivers of children with asthma and in asthma-related symptoms. Improvements over time were independent of type of providers.

Quality of life in asthmatic children and their caregivers after two-year treatment with omalizumab, a real-life study

IntroductionOmalizumab, a monoclonal anti-immunoglobulin E antibody, has been successfully used as a supplementary therapy to improve asthma control in children aged ≥ 6 years with severe persistent allergic asthma.AimTo demonstrate the quality of life in children with severe asthma and their caregivers, and changes from baseline in forced expiratory volume in 1 s (FEV1) and daily inhaled corticosteroids (ICS) dose after 2-year treatment with omalizumab.Material and methodsParticipants were seen in the clinic at enrollment (visit 1), after 16 weeks (visit 2), after 52 weeks (visit 3) and after 104 weeks (visit 4) of treatment with omalizumab. We evaluated lung function, ICS use and the quality of life with the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ).ResultsNineteen children and caregivers were enrolled. Significant improvement was observed in PAQLQ and PACQLQ scores, both in all domains and in total scores. Significant differences were found between the first and the other visits. A positive correlation between PAQLQ and PACQLQ at the first and at the second visit was found, 63.3% of patients achieved reduction in ICS doses. We did not notice any significant improvement in FEV1.ConclusionsThe improvement in quality of life in asthmatic children and adolescents observed after omalizumab correlates with the improvement of quality of life in caregivers, reduction in ICS use but not with FEV1.

Acculturation and quality of life in urban, African American caregivers of children with asthma

Objective: Racial/ethnic minority caregivers of children with asthma are at risk for low levels of quality of life (QOL). Limited research has identified factors that contribute to lower QOL among African American caregivers. This study examined associations between acculturation (e.g., engaging in values/beliefs traditional of one's culture versus adopting mainstream cultural views) and caregiver QOL in low-income, urban African American families of children (7–12 years) with persistent asthma. We also investigated the association between caregiver QOL and child emergency department (ED) use. Methods: Fifty-five caregivers and their children completed interview-based questionnaires in a single research session. Caregivers completed the Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ), the African American Acculturation Scale-Revised (AAAS-R), and reported on child asthma variables. Children completed items assessing asthma control. Results: Higher overall QOL and emotional function subscale scores were associated with more traditional African American religious beliefs/practices (r = .288, p = .033; r = .333, p = .013). Higher emotional function subscale scores were associated with more traditional values of African American families (r = .306, p = .023). Lower QOL was found among caregivers of children who had visited the ED three or more times in the last year. Conclusions: Less acculturation tied to religious beliefs/practices and family values (as measured by the AAAS-R) may serve a protective role in reducing the burden low-income, urban African American caregivers experience in managing child asthma. This study is the first of its kind to study acculturation in African American caregivers of children with asthma.

The Effect of Family-Centered Empowerment Model on Quality of Life Among Mothers of Asthmatic Children

Background: Asthma causes different physical, emotional, and social limitations for the afflicted children and their families and reduces their quality of life. Therefore, the quality of life in families, particularly in mothers, needs to be enhanced through strategies such as empowerment. Objectives: The aim of this study was to assess the effect of the Family-Centered Empowerment Model on quality of life among the mothers of asthmatic children. Methods: A convenience sample of 172 mothers was recruited for this quasi-experimental study. Mothers were alternately allocated either to a control group or an experimental group based on the day in which they referred to the study setting. Accordingly, mothers who referred to the setting in odd and even days of a weak were allocated respectively to the control and experimental groups. A demographic questionnaire and the pediatric asthma caregiver’s quality of life questionnaire (PACQLQ) were used for data collection. The validity of the questionnaire was confirmed by a panel of experts (relevance: 0.98; clarity: 0.96; and simplicity: 0.94) while its reliability was confirmed by a Cronbach’s alpha of 0.88. A four-step empowerment program was implemented for the mothers in the experimental group based on the Family-Centered Empowerment Model. The four steps included knowledge improvement, self-efficacy, self-esteem, and evaluation. Mothers in the control group received no intervention during the study. Before and after the intervention, the mothers in both groups were asked to complete the study questionnaires. The data were described and analyzed by using descriptive and inferential statistics. Results: There were no significant between-group differences regarding the mothers’ demographic characteristics and their baseline quality of life scores. However, after the intervention, the scores of quality of life and its physical limitation and emotional function domains were significantly lower in the experimental group, denoting higher quality of life (P < 0.001). Conclusions: The Family-Centered Empowerment Model significantly improves quality of life among the mothers of children who suffer from asthma. Given the important role of mothers in giving care to their ill children, nurses are recommended to use the model to encourage mothers’ active participation in care giving to their children.

The burden of severe asthma in childhood and adolescence: results from the paediatric U-BIOPRED cohorts.

U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 preschoolers with mild/moderate wheeze in a cross-sectional study. Despite high-dose treatment, the severe cohorts had more severe exacerbations compared with the mild/moderate ones (annual medians: school-aged 3.0 versus 1.1, preschool 3.9 versus 1.8; p<0.001). Exhaled tobacco exposure was common in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse in the severe cohorts (mean±se school-age PAQLQ: 4.77±0.15 versus 5.80±0.19; preschool PACQLQ: 4.27±0.18 versus 6.04±0.18; both p≤0.001); however, mild/moderate cohorts also had significant morbidity. Impaired quality of life was associated with poor control and airway obstruction. Otherwise, the severe and mild/moderate cohorts were clinically very similar. Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping of these children, integrating clinical data with high-dimensional biomarkers, may help to improve and tailor their clinical management.

Validation of the Spanish version of the Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) in a population of Hispanic children

Objective: The Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) is intended to measure the impact of children's asthma on their parents/caregiver's QoL. However, there are no formal validation studies of the Spanish version of PACQLQ. Methods: In a prospective cohort validation study, asthmatic children aged between 7 and 17 years and their parents, attended both a baseline and a follow-up visit 2–6 weeks later. In these two visits, we gathered the necessary data for assessing the criterion validity, construct validity, test–retest reliability, sensitivity to change, internal consistency and usability of the PACQLQ. Results: At baseline, PACQLQ scores were significantly different between patients with controlled, partly controlled and uncontrolled asthma (median [IQR] 78.0 [61.0–85.0], 71.0 [37.0–76.0] and 48.0 [40.7–55.0], respectively, p < 0.001), and also between patients for whom this visit resulted in a step-up versus no change or a step-down in therapy (50.0 [40.0–60.0] versus 78.0 [61.0–85.0]; p < 0.001). PACQLQ scores at baseline were significantly lower than those obtained in the follow-up visit in patients with change for the better in the global rating of change questionnaire (median [IQR] 50.0 [42.5–56.0] versus 80.0 [78.5–85.0]; p < 0.001). The intraclass correlation coefficient of the measurements was 0.839 (95%CI: 0.735–0.902). The Cronbach α was 0.914 for the questionnaire as a whole. Conclusions: The Spanish version of the PACQLQ has adequate construct validity, adequate sensitivity to change, good internal consistency, excellent test–retest reliability and good usability when employed in children aged between 7 and 17 years with physician-diagnosed asthma.