Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
Department of Paediatrcs, Cork University Hospital, Cork, Ireland.
Pediatr Allergy Immunol. 2023 Aug;34(8):e14006. doi: 10.1111/pai.14006.
Anaphylaxis is rising in prevalence among children. The current recommendations on the effective transition of anaphylaxis management to adolescents and young adults suggest preparation for the transition may be considered at 11-13 years of age in accordance with the patient's developmental stage. However, there has been limited research conducted on the perspective of caregivers regarding the transition of anaphylaxis management to their children. This study aims to determine the age caregivers feel it is appropriate to begin to teach their child to recognize anaphylaxis and use their adrenaline auto-injectors (AAI).
Caregivers of pediatric allergy patients who have been diagnosed with IgE-mediated food allergy and have an AAI prescription were contacted by phone and invited to complete a questionnaire about when they feel it is appropriate to begin to teach their child to recognize anaphylaxis and use their AAI.
Of the 123 responses to the questionnaire received, 44.7% indicated that 9-11 years was the appropriate time for teaching their children to self-inject an AAI. History of severe anaphylaxis (94.3%), child's ability to describe reasons to inject adrenaline (87.8%), and demonstrate AAI use (82.1%) were "very important" readiness factors identified. Almost half of caregivers were "not confident" (8.94%) or "somewhat confident" (40.65%) in training their child to use AAI. Caregivers with higher household incomes more frequently identified themselves as the party responsible for training their children to use AAI (p = .04).
Caregivers in this sample expressed different perspectives than the current guidelines regarding the timing to initiate the transition of anaphylaxis management to their child. Caregivers expressed suboptimal confidence in teaching their children to use AAI. Clinicians should be aware of the factors that may indicate caregivers' desire to initiate an earlier transition of anaphylaxis management to their child and ensure access to appropriate training, education and support is available.
儿童过敏的发病率呈上升趋势。目前关于过敏管理向青少年和年轻人有效过渡的建议建议，根据患者的发育阶段，11-13 岁时可以考虑开始为过渡做准备。然而，对于照顾者在将过敏管理过渡到其子女方面的观点，相关研究有限。本研究旨在确定照顾者认为开始教导子女识别过敏和使用肾上腺素自动注射器（AAI）的合适年龄。
通过电话联系已被诊断出患有 IgE 介导的食物过敏且有 AAI 处方的儿科过敏患者的照顾者，并邀请他们完成一份问卷，内容是他们认为何时开始教导子女识别过敏和使用 AAI。
在收到的 123 份问卷中，44.7%的人表示 9-11 岁是教导子女自我注射 AAI 的合适时间。严重过敏反应史（94.3%）、孩子描述注射肾上腺素原因的能力（87.8%）和演示 AAI 使用（82.1%）是确定的“非常重要”的准备因素。近一半的照顾者对培训子女使用 AAI“没有信心”（8.94%）或“有些信心”（40.65%）。家庭收入较高的照顾者更常认为自己有责任培训子女使用 AAI（p=0.04）。
本研究中的照顾者对开始将过敏管理过渡到子女的时间提出了与当前指南不同的观点。照顾者对教导子女使用 AAI 的信心不足。临床医生应注意可能表明照顾者希望更早开始将过敏管理过渡到子女的因素，并确保提供适当的培训、教育和支持。
