Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2533, USA.
Pediatr Pulmonol. 2013 Jun;48(6):579-86. doi: 10.1002/ppul.22687. Epub 2012 Nov 5.
Preterm children with bronchopulmonary dysplasia (BPD) frequently require complex home medical regimens and re-hospitalization during the first 2 years of life. The burden of caring for these medically complex children may negatively affect caregiver health related quality of life (HRQoL). The objectives of this study were to measure caregiver HRQoL of children with BPD and to identify factors that impact caregiver HRQoL during the first 2 years of life.
Children (n = 186) were recruited from the Johns Hopkins BPD Outpatient Clinic between January 2008 and July 2011. Caregiver HRQoL was measured using The PedsQL(TM) Family Impact Module. Respiratory symptoms and morbidities were assessed using questionnaires.
Among caregivers of BPD children, significant improvement in physical, worry, and daily domains improved longitudinally as children aged. An association was found between lower total HRQoL scores and caregivers of BPD children who reported more respiratory symptoms and acute care usage. No difference in total HRQoL scores was found between caregivers of BPD children requiring respiratory/enteral support and caregivers of children who did not. Caregiver income and educational level did not predict total HRQoL score, but Non-White race and public insurance was associated with a higher total HRQoL score at the first outpatient visit.
An association was found between lower HRQoL scores and caregivers of BPD children with frequent respiratory symptoms and acute care usage. Screening for low HRQoL in caregivers of BPD children with frequent respiratory illnesses should be considered to identify those who may benefit from additional support and intervention.
患有支气管肺发育不良(BPD)的早产儿在生命的头 2 年中经常需要复杂的家庭医疗方案和再次住院治疗。照顾这些医疗复杂的儿童的负担可能会对照顾者的健康相关生活质量(HRQoL)产生负面影响。本研究的目的是测量患有 BPD 的儿童的照顾者 HRQoL,并确定在生命的头 2 年中影响照顾者 HRQoL 的因素。
2008 年 1 月至 2011 年 7 月期间,从约翰霍普金斯 BPD 门诊诊所招募了 186 名儿童。使用 PedsQL(TM)家庭影响模块测量照顾者的 HRQoL。使用问卷评估呼吸症状和发病率。
在 BPD 儿童的照顾者中,随着儿童年龄的增长,身体、担忧和日常领域的 HRQoL 显著改善。发现 BPD 儿童的照顾者报告的呼吸症状和急性护理使用越多,总 HRQoL 评分越低。需要呼吸/肠内支持的 BPD 儿童的照顾者和不需要的儿童的总 HRQoL 评分之间没有差异。照顾者的收入和教育水平并未预测总 HRQoL 评分,但非白人种族和公共保险与首次门诊就诊时的总 HRQoL 评分较高相关。
发现 BPD 儿童的照顾者 HRQoL 评分较低与频繁出现呼吸症状和急性护理使用有关。应考虑对频繁出现呼吸疾病的 BPD 儿童的照顾者进行低 HRQoL 筛查,以确定那些可能受益于额外支持和干预的人。