Department of Pediatrics, Emory University, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
Department of Biomedical Engineering, Emory University, Atlanta, Ga; Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga.
J Allergy Clin Immunol Pract. 2023 Jun;11(6):1814-1822. doi: 10.1016/j.jaip.2023.02.023. Epub 2023 Mar 1.
Mental and social health in caregivers of preschool children has been inadequately studied, but it may influence respiratory symptom recognition and management.
To identify preschool caregivers at highest risk for poor mental and social health outcomes on the basis of patient-reported outcome measures.
Female caregivers 18 to 50 years old (N = 129) with a preschool child aged 12 to 59 months with recurrent wheezing and at least 1 exacerbation in the previous year completed 8 validated patient-reported outcome measures of mental and social health. k-means cluster analysis was performed using the T score for each instrument. Caregiver/child dyads were followed for 6 months. Primary outcomes included caregiver quality of life and wheezing episodes in their preschool children.
Three clusters of caregivers were identified: low risk (n = 38), moderate risk (n = 56), and high risk (n = 35). The high-risk cluster had the lowest life satisfaction, meaning and purpose, and emotional support and the highest social isolation, depression, anger, perceived stress, and anxiety that persisted for more than 6 months. This cluster had the poorest quality of life and marked disparities in social determinants of health. Preschool children from caregivers in the high-risk cluster had more frequent respiratory symptoms and a higher occurrence of any wheezing episode, but a lower outpatient physician utilization for wheezing management.
Caregiver mental and social health is associated with respiratory outcomes in preschool children. Routine assessment of mental and social health in caregivers is warranted to promote health equity and improve wheezing outcomes in preschool children.
对学龄前儿童照顾者的心理和社会健康的研究还不够充分，但它可能会影响呼吸道症状的识别和管理。
根据患者报告的结果测量指标，确定学龄前儿童照顾者中心理健康和社会健康结果较差的高风险人群。
18 至 50 岁的女性照顾者（N=129），其照顾的学龄前儿童年龄为 12 至 59 个月，有反复发作的喘息，且在过去一年中有至少 1 次加重，完成了 8 项关于心理和社会健康的经过验证的患者报告结果测量指标。使用每个工具的 T 分数进行 k-均值聚类分析。对照顾者/儿童对进行了 6 个月的随访。主要结局包括照顾者的生活质量和学龄前儿童的喘息发作。
确定了 3 组照顾者：低风险（n=38）、中风险（n=56）和高风险（n=35）。高风险组的生活满意度最低，意味着目的和情感支持最低，社会孤立、抑郁、愤怒、感知压力和焦虑最高，且持续时间超过 6 个月。该组的生活质量最差，社会健康决定因素存在显著差异。来自高风险组照顾者的学龄前儿童呼吸症状更频繁，任何喘息发作的发生率更高，但门诊医生对喘息管理的利用率较低。
照顾者的心理和社会健康与学龄前儿童的呼吸道结局有关。应常规评估照顾者的心理和社会健康，以促进健康公平并改善学龄前儿童的喘息结局。
