Owotomo Olusegun, Riekert Kristin A, Rand Cynthia S, Eakin Michelle N
Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Asthma. 2025 Jun;62(6):1061-1069. doi: 10.1080/02770903.2025.2458516. Epub 2025 Feb 5.
Caregivers of children with asthma can become overwhelmed by the burden of care provision. Guided by the socioecological framework, we examined individual and system-level factors associated with caregiver health-related quality of life (HRQoL) among preschool children (aged two to six years) enrolled in a multilevel home- and school-based asthma educational intervention in Baltimore, Maryland.
The primary outcome was caregiver HRQoL measured at baseline and six months. Independent variables were baseline individual-level factors (caregiver's health literacy, self-efficacy to manage asthma, and depressive symptoms) and system-level factors (barriers to asthma care measured in five subdomains-pragmatics, health knowledge and beliefs, expectations, skills, and marginalization-and neighborhood social cohesion). Multiple regression models were used to assess the association between baseline individual and system-level factors and caregiver HRQoL at baseline and six-month follow-up adjusting for the child's asthma control, caregiver's age, household income, and study arm assignment/intervention.
398 caregivers completed the baseline survey and 328 (82%) completed the six-month follow-up survey. In the adjusted multiple regression model, lower caregiver's health literacy and higher barriers to asthma care related to pragmatics were significantly associated with lower caregiver HRQoL at baseline ( = 0.38, 95% CI, 0.15-0.61, = .002; and = 0.01, 95% CI, 0.004-0.02, < .001, respectively). The results were similar at the six-month follow-up.
Caregiver health literacy and barriers to asthma care related to pragmatics and skills were found to be important determinants of asthma caregiver HRQoL. Addressing these factors may improve the quality of life among caregivers of preschool children with asthma.
哮喘患儿的照料者可能会因护理负担而不堪重负。在社会生态框架的指导下，我们研究了马里兰州巴尔的摩市参与多层次家庭和学校哮喘教育干预项目的学龄前儿童（2至6岁）的照料者中，与照料者健康相关生活质量（HRQoL）相关的个体和系统层面因素。
主要结局指标是在基线和6个月时测量的照料者HRQoL。自变量为基线个体层面因素（照料者的健康素养、管理哮喘的自我效能感和抑郁症状）和系统层面因素（在五个子领域——语用学、健康知识与信念、期望、技能和边缘化——以及邻里社会凝聚力方面测量的哮喘护理障碍）。使用多元回归模型评估基线个体和系统层面因素与基线及6个月随访时照料者HRQoL之间的关联，并对儿童的哮喘控制情况、照料者年龄、家庭收入以及研究分组/干预进行调整。
398名照料者完成了基线调查，328名（82%）完成了6个月的随访调查。在调整后的多元回归模型中，较低的照料者健康素养以及与语用学相关的较高哮喘护理障碍，在基线时与较低的照料者HRQoL显著相关（β = 0.38，95%CI，0.15 - 0.61，P = 0.002；以及β = 0.01，95%CI，0.004 - 0.02，P < 0.001）。在6个月随访时结果相似。
发现照料者健康素养以及与语用学和技能相关的哮喘护理障碍是哮喘照料者HRQoL的重要决定因素。解决这些因素可能会改善学龄前哮喘患儿照料者的生活质量。
