Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Pediatr Pulmonol. 2010 Feb;45(2):141-8. doi: 10.1002/ppul.21157.
Children of parents who perceive their children have increased asthma severity use more medical services and reliever medication.
A randomized control trial of the Roaring Adventures of Puff (RAP) education program was completed among 287 grade 2-5 children with asthma. Parents and children completed a quality of life (QOL) questionnaire pre-intervention, 6 and 12 months post-intervention. We hypothesized that RAP altered how parent's assessed their child's QOL with a resultant change in asthma management.
Pre-intervention, parents rated their child's overall QOL higher than their child (parent 5.41 [95% CI 5.24, 5.58] vs. child 4.54 [95% CI 4.32, 4.75]; P < 0.001: paired t-test). For every point increase in the parent's overall QOL score, the child was 36% less likely to receive inhaled corticosteroids in the prior 2 weeks (OR 0.64, 95% CI 0.46, 0.88; P = 0.024) and 46% less likely to have missed school due to asthma in the prior 6 months (OR 0.54, 95% CI 0.36, 0.82; P = 0.016: logistic regression). The child's QOL assessment, beyond that provided by their parent, was not associated with the asthma management outcomes examined. The RAP program decreased parent's symptoms QOL assessment by an improvement of 0.45 on a 7-point scale greater than control at 6 months (95% CI -0.81, -0.09; P = 0.06). Moreover, the RAP interaction on parent symptoms rating was important in determining whether the child received a short-acting beta-agonist in the prior 2 weeks (P = 0.05).
Parent's QOL perception, and not the child's, is associated with asthma management. RAP decreased the parent's QOL symptoms assessment and was important in determining the child's asthma management.
父母认为孩子哮喘加重的情况下，孩子会使用更多的医疗服务和缓解药物。
一项针对罗林冒险的 Puff（RAP）教育计划的随机对照试验在 287 名 2-5 年级哮喘儿童中完成。父母和孩子在干预前、干预后 6 个月和 12 个月完成了一项生活质量（QOL）问卷。我们假设 RAP 改变了父母对孩子 QOL 的评估方式，从而改变了哮喘管理方式。
干预前，父母对孩子的整体 QOL 评分高于孩子（父母 5.41[95%CI 5.24,5.58] vs. 孩子 4.54[95%CI 4.32,4.75]；P<0.001：配对 t 检验）。父母的整体 QOL 评分每增加 1 分，孩子在前 2 周内使用吸入性皮质类固醇的可能性就降低 36%（OR 0.64,95%CI 0.46,0.88；P=0.024），在前 6 个月内因哮喘缺课的可能性降低 46%（OR 0.54,95%CI 0.36,0.82；P=0.016：逻辑回归）。孩子的 QOL 评估，除了父母提供的评估外，与所检查的哮喘管理结果无关。RAP 计划在 6 个月时将父母的症状 QOL 评估提高了 0.45 分（7 分制），比对照组高（95%CI -0.81，-0.09；P=0.06）。此外，RAP 对父母症状评分的影响在确定孩子在前 2 周内是否使用短效β-激动剂方面非常重要（P=0.05）。
父母的 QOL 感知，而不是孩子的，与哮喘管理有关。RAP 降低了父母的 QOL 症状评估，对确定孩子的哮喘管理很重要。
