Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Former Assaf Harofeh) Medical Center, Zerifin, Israel.
Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatr Allergy Immunol. 2021 Jul;32(5):1029-1037. doi: 10.1111/pai.13445. Epub 2021 Mar 9.
The start of oral immunotherapy (OIT) for food allergy is a critical period in the treatment process, with a potential to influence patient quality of life (QOL) and subsequently treatment outcome. The association of medical clowning with QOL at OIT initiation was examined.
Children aged 4-12 years supported by a medical clown (MC) during the induction week of OIT for food allergy were studied. Children in the same age range starting OIT without the support of a MC served as controls. Parents of all children completed the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF), and children aged 8-12 years completed the Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF). QOL scores of parents and children with and without a MC support were compared.
Children with (n = 88) and without (n = 212) the support of a MC were comparable in demographics and clinical characteristics. The study group had a significantly lower single highest tolerated dose compared to controls (57 ± 83 vs 162 ± 274 mg protein, respectively, P < .001). Parental perception of the QOL of children was not associated with a MC support (P = .81) but rather with previous reaction severity (P < .01). In contrast, the QOL of children aged 8-12 years (n = 119) was positively associated primarily with a MC support, total score 3.7 ± 1.1 vs 4.6 ± 1.3 (P < .001).
While the perception of QOL of parents of children with food allergy at OIT initiation is mainly associated with previous reaction severity, the QOL of the children themselves is primarily positively associated with MC support.
食物过敏的口服免疫治疗（OIT）起始阶段是治疗过程中的一个关键时期，可能会影响患者的生活质量（QOL），进而影响治疗结果。本研究旨在探讨医学小丑在 OIT 起始阶段与 QOL 之间的关联。
研究纳入了在食物过敏 OIT 诱导周期间接受医学小丑（MC）支持的 4-12 岁儿童。同时纳入了年龄匹配但未接受 MC 支持的 OIT 起始患儿作为对照组。所有儿童的家长均完成了食物过敏生活质量问卷-家长版（FAQLQ-PF），8-12 岁的儿童完成了食物过敏生活质量问卷-儿童版（FAQLQ-CF）。比较了有和没有 MC 支持患儿的 QOL 评分。
有（n=88）和没有（n=212）MC 支持的患儿在人口统计学和临床特征方面具有可比性。研究组的单次最高耐受剂量明显低于对照组（分别为 57±83 与 162±274 mg 蛋白，P<0.001）。家长对患儿 QOL 的感知与 MC 支持无关（P=0.81），但与既往过敏反应严重程度有关（P<0.01）。相反，8-12 岁患儿的 QOL（n=119）与 MC 支持呈显著正相关，总分分别为 3.7±1.1 与 4.6±1.3（P<0.001）。
尽管食物过敏 OIT 起始阶段患儿家长对 QOL 的感知主要与既往过敏反应严重程度有关，但患儿自身的 QOL 主要与 MC 支持呈正相关。
