Marklund Birgitta, Ahlstedt Staffan, Nordström Gun
Centre for Allergy Research, Karolinska Institutet, S-171 77 Solna, Sweden.
Health Qual Life Outcomes. 2006 Aug 10;4:48. doi: 10.1186/1477-7525-4-48.
About 20% of schoolchildren and adolescents in Sweden suffer from perceived food hypersensitivity (e.g. allergy or intolerance). Our knowledge of how child food hypersensitivity affects parents HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family is limited. Thus the aim of this study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The allergy-associated parameters we operated with were number of offending food items, adverse food reactions, additional hypersensitivity, allergic diseases and additional family members with food hypersensitivity. These parameters, along with age and gender were assessed in relation to child, parent and family HRQL.
In May 2004, a postal questionnaire was distributed to parents of 220 schoolchildren with parent-reported food hypersensitivity (response rate 74%). Two questionnaires were used: CHQ-PF28 and a study-specific questionnaire including questions on allergy-associated parameters. In order to find factors that predict impact on HRQL, stepwise multiple linear regression analyses were carried out.
An important predictor of low HRQL was allergic disease (i.e. asthma, eczema, rhino conjunctivitis) in addition to food hypersensitivity. The higher the number of allergic diseases, the lower the physical HRQL for the child, the lower the parental HRQL and the more disruption in family activities. Male gender predicted lower physical HRQL than female gender. If the child had sibling(s) with food hypersensitivity this predicted lower psychosocial HRQL for the child and lower parental HRQL. Food-induced gastro-intestinal symptoms predicted lower parental HRQL while food-induced breathing difficulties predicted higher psychosocial HRQL for the child and enhanced HRQL with regards to the family's ability to get along.
The variance in the child's physical HRQL was to a considerable extent explained by the presence of allergic disease. However, food hypersensitivity by itself was associated with deterioration of child's psychosocial HRQL, regardless of additional allergic disease. The results suggest that it is rather the risk of food reactions and measures to avoid them that are associated with lower HRQL than the clinical reactivity induced by food intake. Therefore, food hypersensitivity must be considered to have a strong psychosocial impact.
瑞典约20%的学童和青少年存在感知到的食物过敏（如过敏或不耐受）。我们对于儿童食物过敏如何影响父母的健康相关生活质量（HRQL）以及过敏状况的哪些方面与家庭中HRQL的恶化相关的了解有限。因此，本研究的目的是调查有一名被认为食物过敏的学童的家庭中，父母报告的HRQL情况。我们所涉及的与过敏相关的参数包括引起问题的食物种类数量、食物不良反应、其他过敏情况、过敏性疾病以及其他患有食物过敏的家庭成员。这些参数，连同年龄和性别，针对儿童、父母和家庭的HRQL进行了评估。
2004年5月，向220名有父母报告食物过敏的学童的家长发放了邮寄问卷（回复率74%）。使用了两份问卷：儿童健康问卷-家长版28项（CHQ-PF28）和一份包含与过敏相关参数问题的特定研究问卷。为了找出预测对HRQL影响的因素，进行了逐步多元线性回归分析。
除食物过敏外，过敏性疾病（如哮喘、湿疹、鼻结膜炎）是HRQL低的一个重要预测因素。过敏性疾病的数量越多，儿童的身体HRQL越低，父母的HRQL越低，家庭活动受到的干扰越大。男性的身体HRQL预测值低于女性。如果孩子有患有食物过敏的兄弟姐妹，则预测该儿童的心理社会HRQL较低，父母的HRQL也较低。食物引起的胃肠道症状预测父母的HRQL较低，而食物引起的呼吸困难预测儿童的心理社会HRQL较高，且在家庭相处能力方面HRQL有所提高。
过敏性疾病的存在在很大程度上解释了儿童身体HRQL的差异。然而，无论是否存在其他过敏性疾病，食物过敏本身都与儿童心理社会HRQL的恶化有关。结果表明，与食物摄入引起的临床反应性相比，与较低HRQL相关的更可能是食物反应的风险以及避免这些反应的措施。因此，必须认为食物过敏具有很强的心理社会影响。
