Yu Tak-Sun Ignatius, Wong Tze-Wai
Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
Pediatr Pulmonol. 2004 Jan;37(1):37-42. doi: 10.1002/ppul.10403.
To evaluate the relative validity of information on children's respiratory experience given by different informants, we examined and compared the relationship between low ventilatory function (defined as more than 1 standard deviation below the corresponding mean) and schoolchildren's respiratory symptoms or illnesses reported separately by the children and their parents, using a standard respiratory questionnaire. A total of 1,963 children aged 8-12 years from 12 primary schools in three districts of Hong Kong provided parent-completed and self-completed questionnaires, as well as acceptable spirometric measurements. Prevalence of low forced expiratory volume ratio (FEV1/FVC) and low forced expiratory flow rate between 25-75% of FVC (FEF25-75) were higher among those with either parent or child-reported symptoms/illnesses. Child-reported cough and phlegm performed better than the corresponding parent-reported symptoms in predicting low FEV1/FVC. The contrary was true for wheezing and bronchitis. For low FEF25-75, parent-reported wheezing, asthma, and bronchitis performed better, while the opposite was true for cough. Subgroup analysis by age showed that for older children (age 10 or above), child-reported symptoms/illnesses performed better in general in the prediction of low FEV1/FVC. On the other hand, parent-reported symptoms/illnesses seemed to have an advantage over child-reported ones in predicting low FEF25-75. Subgroup analysis by sex did not reveal any clear pattern. Overall, there was little difference between respiratory illness experiences reported by schoolchildren and their parents in terms of their associations with low ventilatory function. In a population-based study in which schoolchildren are subjects, it would be appropriate for respiratory questionnaires to be administered to the children themselves, especially if they have reached age 10. By doing so, higher response rates, and perhaps also better yields of correct information, may be obtained.
为评估不同信息提供者提供的儿童呼吸经历信息的相对有效性，我们使用标准呼吸问卷，检查并比较了低通气功能（定义为比相应平均值低超过1个标准差）与儿童及其父母分别报告的学童呼吸症状或疾病之间的关系。来自香港三个地区12所小学的1963名8至12岁儿童提供了家长填写和自我填写的问卷，以及可接受的肺功能测量结果。在有家长或儿童报告症状/疾病的人群中，低用力呼气量比值（FEV1/FVC）和用力呼气流量在FVC的25%-75%之间（FEF25-75）的患病率更高。在预测低FEV1/FVC方面，儿童报告的咳嗽和咳痰比相应的家长报告症状表现更好。喘息和支气管炎则相反。对于低FEF25-75，家长报告的喘息、哮喘和支气管炎表现更好，而咳嗽则相反。按年龄进行的亚组分析表明，对于年龄较大的儿童（10岁及以上），儿童报告的症状/疾病在预测低FEV1/FVC方面总体表现更好。另一方面，家长报告的症状/疾病在预测低FEF25-75方面似乎比儿童报告的更具优势。按性别进行的亚组分析未发现任何明显模式。总体而言，学童及其父母报告的呼吸疾病经历与低通气功能之间的关联差异不大。在以学童为研究对象的基于人群的研究中，对儿童本人进行呼吸问卷调查是合适的，特别是如果他们已年满10岁。这样做可能会获得更高的回应率，也许还能得到更好的正确信息产出。
