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Measuring Disease Burden:

Asthma caregiver quality of life


Ana Kobayashi
Maternal and Child Health Program
June 7, 2006

Background
Asthma

is a major public health problem


facing children and families.

Asthma

is a common chronic childhood


illness, leading to 14 million missed
school days each year.

Childrens

asthma also affects the well being


of
parents
and
caregivers.
(National Center for Environmental Health of the Centers of Disease Control
and Prevention, 2005) (Institute of Medicine, 2000)

Asthma Caregiver Quality of Life


The

Pediatric Asthma Caregiver Quality


of Life Questionnaire (PACQLQ)
measures how a childs asthma affects
caregivers.

13

item questionnaire asking caregivers


about their activities and feelings.

(Juniper et al., 1996b)

Literature Review
Patient

QOL studies find that AQLQ


scores are related to:
Asthma severity
Environmental tobacco smoke (ETS)
Education and income
Female gender (inconsistently)
Hispanic race/ethnicity

(Leidy et al., 1998a, Leidy et al., 1998b;Eisner et al, 2002;Sippel et al., 1999) (Adams
et al., 2004; Apter et al, 1999; von Rueden et al., 2006)

Literature Review

Few studies have investigated predictors of


caregiver QOL, and indicate caregiver QOL is
associated with:

Child symptom free days and symptom frequency


Caregivers perception of disease control
Use of maintenance medication
Smoking household
Hispanic ethnicity

(Halterman et al., 2004; Levy et al., 2004)

Study Objective
To evaluate

relationships between caregiver


QOL and health utilization, asthma
management, and other variables in a
community sample.

Setting: Clean Air for Kids

Clean Air for Kids Partnership (CAFK) is a


program designed to help caregivers of children
with asthma learn how to manage asthma at home
and how to reduce environmental exposures.

Caregivers of children with asthma who live in


Pierce County, Washington reach the program
through community-, physician-, school-, and self
- referral.

(Primomo, Johnston, DiBiase, Nodolf & Noren, 2006)

Methods

Secondary data analysis

Data was collected during CAFK program


evaluation, consisting of baseline caregiver
survey responses.

Linear regression was used to evaluate


associations between independent and outcome
variables and to generate three linear regression
models.

Results
Found:

Associations between independent


variables and PACQLQ, Emotional function,
and Activity limitation scores.
Three stepwise linear regression models for
each: PACQLQ, Emotional function, and
Activity limitation scores.

Results
Emotional
Function
Score

PACQLQ
Score
Perceived
Asthma Severity
Missed School
Days
ER visits
Caregiver
Education

Perceived
Asthma Severity
Missed School
Days
ER visits
Caregiver
Education

Activity
Limitation
Score
Perceived

Asthma Severity
Missed School
Days
ER Visits
Child Age

TABLE 3: Stepwise regression models predicting baseline PACQLQ scores.


Quality of Life Emotional Function Activity Limitation
Summary Score Subscale score ( )
subscale score ( )
()
Model 1
Perceived asthma
severity
Overall Model R2
Model 2
Perceived asthma
severity
ER Visits
Overall Model R2
Model 3
Perceived asthma
severity
ER visits
Caregiver education
Overall Model R2
* = p < 0.05
** = p < 0.01
*** = p < 0.001

- 0.48*

- 0.42*

- 0.61**

0.05*

0.05*

0.07**

- 0.30

- 0.26

- 0.37

- 0.12**
0.13**

- 0.10
0.10**

- 0.16**
0.15***

- 0.29

- 0.26

- 0.37

- 0.12**
0.34**
0.19**

- 0.99*
0.38
0.17***

- 0.16**
Not included
0.15***

Implications for practice

Interventions proven to reduce emergency


health services utilization should be used to
support increased caregiver quality of life.

Future studies should further investigate


relationships between demographic
characteristics of families and caregiver
quality of life.

Acknowledgements

Clean Air for Kids Partnership


Janet Primomo RN, PhD.
Marcia Williams PhD., MPH.
Supported in part by Project #T76 MC 00011
from the Maternal and Child Health Bureau
(Title V, Social Security Act),
Health Resources and Services Administration,
U.S. Department of Health and Human Services.

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