Asthma

Asthma

Introduction

Asthma is a common chronic illness in children and adolescents, affecting 14% of American children (Centers for Disease Control and Prevention [CDC], 2009) and 9% of Icelandic children. Among high school students in Australia, 19% reported they had ever been diagnosed with asthma, 16% currently had asthma, and 38% of those with current asthma had experienced an asthma episode during the previous 12 months. In a longitudinal study of 179 Icelandic children who were followed for 20 years starting at age 18 to 23 months, 29% reported having been diagnosed with asthma by age 21, and 13% had experienced asthma symptoms in the 12 months prior to this time.

Given the chronic nature of asthma, it is important to assess how asthma affects the daily lives of adolescents who have this disease. Pediatric health-related quality of life (HRQL) for children with chronic illness has been the focus of a variety of recent studies worldwide. These research studies and clinical trials have centered on families of children and adolescents with chronic illnesses, with HRQL measured as an overall assessment of disease control, treatment, care delivery outcomes, changes in functioning, and well-being (Irwin et al, 1990).

Impact of the Disease on Patients' Life

The HRQL construct involves one's perception of how health status affects different domains of daily functioning. Therefore, some researchers have underscored the importance of obtaining HRQL assessments from the child's or adolescent's own perspective. However, to obtain a more holistic view of HRQL among children or adolescents with chronic illnesses, other researchers have stressed the need to collect information from both the adolescent's and parent's perspective as a mechanism for gaining information about the family as a unit, sometimes using either qualitative research methods or systematic reviews. Still other researchers and clinicians have assessed perception of the child's or adolescent's HRQL from the point of view of both members of the parent-child dyad to determine whether the proxy report of the parent can substitute for the child or adolescent response when it is not possible to obtain self-report data from the child or adolescent (Smith et al, 1992).

Though there are mixed results reported in the literature regarding the usefulness of parent proxy report for HRQL, information gathered from adolescents with asthma and their parents may play a key role in determining the impact of asthma on quality of life (QOL). Dyadic information may provide meaningful understanding of how asthma symptoms and health status influence each other and may uncover problems regarding asthma treatments, worrying, and communication concerns regarding the child's health condition. In addition, comparing responses between dyad members will determine the aspects of HRQL upon which children and parents agree, and those on which they do not (Enright et al, 1994).

Analysis

Results from this study add to the research on the agreement between parents' perception and adolescents' own perspective of their asthma QOL (Greenley et al., 2008). The study suggests that the directional differences between adolescent and parent perception of HRQL for the total PedsQLTM score and for each of the four ...