Wrotek August, Wrotek Oliwia, Jackowska Teresa
Department of Pediatrics, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland.
Department of Pediatrics, Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland.
Diseases. 2023 Sep 24;11(4):126. doi: 10.3390/diseases11040126.
Respiratory syncytial virus (RSV) is one of the leading causes of pediatric hospitalizations, mainly in children under 2 years of age. Hospitalization affects the caregivers' quality of life (QoL). We assessed the caregivers' QoL during RSV-confirmed hospitalizations of children under 2 years old, identified the most affected QoL dimensions and calculated utilities focusing on the assessment methods and potential confounders.
The caregivers filled out the EQ-5D questionnaire, consisting of a descriptive system (assessing 5 QoL dimensions) and a visual analog scale (EQ VAS). Utility, utility loss and quality-adjusted life years (QALY) loss were calculated, and a concordance between the two systems was assessed.
A disturbance in any of the five assessed dimensions was reported by 42% (55 out of 132) of the caregivers, mostly anxiety/depression (37%) and pain/discomfort (17%). The utilities varied between 0.17 and 1 in the descriptive system and 0.33-1 (median 0.86) in the EQ VAS, with a utility loss of 0.14 (IQR: 0.1-0.2). The calculated QALY loss reached a median of 2.45 × 10 (IQR: 1.37 × 10-4.56 × 10) and was not influenced by the patient's age or the final clinical diagnosis (QALY loss for bronchiolitis: 2.74 × 10, pneumonia: 1.84 × 10, bronchitis: 1.78 × 10, differences statistically insignificant). Only a moderate concordance between the descriptive system and the EQ VAS was seen (Spearman's rank correlation coefficient = 0.437, < 0.05), with the latter revealing a higher degree of QoL disturbances.
RSV hospitalization influences parental QoL significantly, and anxiety/depression is the most commonly reported issue. Utility impairment scores depend on the assessment method but not on the patient's age or final diagnosis. Thus, the impact of RSV on caregivers' QoL cannot be underestimated.
呼吸道合胞病毒（RSV）是导致儿童住院的主要原因之一，主要影响2岁以下儿童。住院会影响照料者的生活质量（QoL）。我们评估了2岁以下确诊为RSV感染的儿童住院期间照料者的生活质量，确定了受影响最大的生活质量维度，并计算了效用，重点关注评估方法和潜在混杂因素。
照料者填写EQ-5D问卷，该问卷由一个描述性系统（评估5个生活质量维度）和一个视觉模拟量表（EQ VAS）组成。计算效用、效用损失和质量调整生命年（QALY）损失，并评估两个系统之间的一致性。
42%（132人中的55人）的照料者报告在五个评估维度中的任何一个存在干扰，主要是焦虑/抑郁（37%）和疼痛/不适（17%）。描述性系统中的效用值在0.17至1之间，EQ VAS中的效用值在0.33至1之间（中位数为0.86），效用损失为0.14（四分位间距：0.1 - 0.2）。计算出的QALY损失中位数达到2.45×10（四分位间距：1.37×10 - 4.56×10），且不受患者年龄或最终临床诊断的影响（毛细支气管炎的QALY损失：2.74×10，肺炎：1.84×10，支气管炎：1.78×10，差异无统计学意义）。描述性系统和EQ VAS之间仅显示出中等程度的一致性（Spearman等级相关系数 = 0.437，P < 0.05），后者显示出更高程度的生活质量干扰。
RSV感染住院显著影响父母的生活质量，焦虑/抑郁是最常报告的问题。效用损害评分取决于评估方法，而不取决于患者年龄或最终诊断。因此，RSV对照料者生活质量的影响不可低估。
