Allen Clare W, Bidarkar Manasee S, vanNunen Sheryl A, Campbell Dianne E
Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2015 Jul;51(7):696-8. doi: 10.1111/jpc.12794. Epub 2015 Jan 15.
This study aims to determine factors impacting the parental burden in immunoglobulin E (IgE)-mediated food-allergic children (FAC), focusing on attitudes towards adrenaline autoinjectors (AAIs).
Questionnaires were sent to parents of diagnosed IgE-mediated FAC attending follow-up allergy clinic appointments at two Sydney hospitals in May-September 2013. The questionnaires ascertained parental attitudes, confidence and knowledge regarding AAIs and included the validated, Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire.
The response rate was 68%. Of FAC, 62% were male aged 1-17 years (median 6.0). There was a high proportion of children with multiple food allergies (52% allergic to >2 foods), coexistant eczema (85%) and asthma (54%). Sixty-three per cent reported a past history of anaphylaxis and 42% reported reactions in the last 6 months. AAI had been prescribed for 84%. FAC with a history of anaphylaxis were more likely to have had an AAI prescribed (P < 0.0001). There was no difference in FAQL-PB mean scores with age or AAI prescription status. The PB score was greater if the parent had administered the AAI (P = 0.02) and where the child was allergic to >2 foods (P < 0.0001).The Ninety per cent of parents reported that the AAI increased or did not change the child's quality of life, the family or FACs freedom. Three per cent of parents whose FAC children were prescribed an AAI reported increased stress related to AAI prescription.
Severity of food allergy, number of food allergens and past anaphylaxis rather than prescription of an AAI appear to be major influences on parental burden.
本研究旨在确定影响免疫球蛋白E(IgE)介导的食物过敏儿童(FAC)家长负担的因素,重点关注对肾上腺素自动注射器(AAI)的态度。
2013年5月至9月,向在悉尼两家医院过敏门诊接受随访的确诊IgE介导的FAC患儿家长发放问卷。问卷确定了家长对AAI的态度、信心和知识,并包括经过验证的食物过敏生活质量-家长负担(FAQL-PB)问卷。
回复率为68%。FAC患儿中,62%为1至17岁男性(中位数为6.0岁)。有多种食物过敏的儿童比例很高(52%对>2种食物过敏),同时患有湿疹(85%)和哮喘(54%)。63%的患儿有过敏反应病史,42%的患儿在过去6个月内有过敏反应。84%的患儿已开具AAI处方。有过敏反应病史的FAC患儿更有可能已开具AAI处方(P<0.0001)。FAQL-PB平均得分在年龄或AAI处方状态方面没有差异。如果家长曾使用过AAI(P=0.02)以及孩子对>2种食物过敏(P<0.0001),则家长负担得分更高。90%的家长报告称AAI提高或未改变孩子的生活质量、家庭或FAC的自由度。在FAC患儿已开具AAI处方的家长中,3%报告与AAI处方相关的压力增加。
食物过敏的严重程度、食物过敏原的数量和既往过敏反应而非AAI处方似乎是影响家长负担的主要因素。