Li Z, Leite W L, Thompson L A, Gross H E, Shenkman E A, Reeve B B, DeWalt D A, Huang I-C
College of Nursing and Health Professions, Valparaiso University, Valparaiso, IN, USA.
School of Human Development and Organizational Studies in Education, College of Education, University of Florida, Gainesville, FL, USA.
Clin Exp Allergy. 2017 Mar;47(3):383-394. doi: 10.1111/cea.12827. Epub 2016 Oct 21.
How the longitudinal asthma control status and other socio-demographic factors influence the changes of health-related quality of life (HRQOL) among asthmatic children, especially from low-income families, has not been fully investigated.
This study aimed to describe the trajectories of asthma-specific HRQOL over 15 months and examine the effect of asthma control status on HRQOL by taking socio-demographic factors into consideration.
A total of 229 dyads of asthmatic children and their parents enroled in public insurance programs were recruited for assessing asthma control status and HRQOL over four time points of assessment. Asthma control status was measured using the Asthma Control and Communication Instrument, and asthma-specific HRQOL was assessed using the Patient-Reported Outcomes Measurement Information System's Pediatric Asthma Impact Scale. Latent growth models (LGMs) were applied to examine the trajectory of HRQOL and the factors contributing to the changes of HRQOL.
Unconditional LGM revealed that HRQOL was improved over time. Conditional LGM suggested that accounting for asthma control and participants' socio-demographic factors, the variation in the initial level of HRQOL was significant, yet the rate of change was not. Conditional LGM also revealed that poorly controlled asthma status was associated with poor HRQOL at each time point (P's < 0.05). Lower parental education was associated with lower baseline HRQOL (P < 0.05). Hispanic children had a larger increase in HRQOL over time (P < 0.01) than non-Hispanic White children.
Vulnerable socio-demographic characteristics and poorly controlled asthma status affect HRQOL in children. This finding encourages interventions to improve asthma control status and HRQOL in minority children.
纵向哮喘控制状况及其他社会人口学因素如何影响哮喘儿童，尤其是低收入家庭哮喘儿童的健康相关生活质量（HRQOL）变化，尚未得到充分研究。
本研究旨在描述15个月内哮喘特异性HRQOL的轨迹，并通过考虑社会人口学因素来检验哮喘控制状况对HRQOL的影响。
共招募了229对参加公共保险项目的哮喘儿童及其父母，在四个评估时间点评估哮喘控制状况和HRQOL。使用哮喘控制与沟通工具测量哮喘控制状况，使用患者报告结局测量信息系统的儿童哮喘影响量表评估哮喘特异性HRQOL。应用潜在增长模型（LGMs）来检验HRQOL的轨迹以及导致HRQOL变化的因素。
无条件LGM显示HRQOL随时间改善。条件LGM表明，在考虑哮喘控制和参与者的社会人口学因素后，HRQOL初始水平的差异显著，但变化率不显著。条件LGM还显示，哮喘控制不佳在每个时间点都与较差的HRQOL相关（P值<0.05）。父母教育程度较低与基线HRQOL较低相关（P<0.05）。随着时间的推移，西班牙裔儿童的HRQOL增幅（P<0.01）大于非西班牙裔白人儿童。
脆弱的社会人口学特征和哮喘控制不佳的状况会影响儿童的HRQOL。这一发现鼓励采取干预措施，以改善少数族裔儿童的哮喘控制状况和HRQOL。
