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      Health-related quality of life and psychological wellbeing are poor in children with bronchiectasis and their parents

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          Abstract

          Bronchiectasis is characterised by chronic wet cough, a cycle of inflammation, impaired mucociliary clearance, bacterial colonisation and infection [1]. People with bronchiectasis experience substantial disease burden, including recurrent hospitalisations and impaired quality of life (QoL) [2]. The prevalence and burden of bronchiectasis is increasingly appreciated worldwide [3].

          Abstract

          Children with bronchiectasis in a stable state have poor HRQoL and their parents report higher levels of anxiety and depression. Parental perception of HRQoL is associated with poorer parental psychological wellbeing. http://bit.ly/2lcf3uB

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          Maternal depressive symptoms and adherence to therapy in inner-city children with asthma.

          Floyd Malveaux, M Butz, Kristin Riekert … (2004)
          Little is known about how depressive symptoms in mothers affects illness management in inner-city children with asthma. Our goal was to determine how maternal depressive symptoms influence child medication adherence, impact of the child's asthma on the mother, and maternal attitudes and beliefs. Baseline and 6-month surveys were administered to 177 mothers of young minority children with asthma in inner-city Baltimore, MD and Washington, DC. Medication adherence, disruptiveness of asthma, and select attitudes toward illness and asthma therapy were measured. Six-month data (N = 158) were used to prospectively evaluate long-term symptom control and emergency department use. Independent variables included asthma morbidity, age, depressive symptoms, and other psychosocial data. No difference in child asthma morbidity was observed between mothers high and low in depressive symptoms. However, mothers with high depressive symptoms reported significantly more problems with their child using inhalers properly (odds ratio [OR]: 5.0; 95% confidence interval [CI]: 1.3-18.9) and forgetting doses (OR: 4.2; 95% CI: 1.4-12.4). Depressive symptoms were also associated with greater emotional distress and interference with daily activities caused by the child's asthma, along with less confidence in asthma medications, ability to control asthma symptoms, and self-efficacy to cope with acute asthma episodes. In addition, depressed mothers reported less understanding about their child's medications and use (OR: 7.7; 95% CI: 1.7-35.9). Baseline asthma morbidity, maternal depression scores, and family income were independently associated with asthma symptoms 6 months later, whereas medication adherence was not predictive of subsequent asthma morbidity or emergency department use. Maternal depressive symptoms were not associated with child asthma morbidity but were associated with a constellation of beliefs and attitudes that may significantly influence adherence to asthma medications and illness management. Identifying and addressing poor psychological adjustment in mothers is important when developing a child's asthma treatment and may facilitate parent-provider communication, medication adherence, and asthma management among inner-city children.
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            The burden of disease in pediatric non-cystic fibrosis bronchiectasis.

            Nitin Kapur, I Masters, Peter Newcombe … (2012)
            The burden of disease in children with non-cystic fibrosis (non-CF) bronchiectasis is unknown. Our study aimed to identify the determinants of quality of life (QOL) and parental mental health in this group of patients and their parents and to evaluate the effect of exacerbations on these parameters. Parents of 69 children (median age 7 years) with non-CF bronchiectasis prospectively completed two questionnaires (parent-proxy cough-specific quality of life [PC-QOL] and the Depression, Anxiety, and Stress Scale [DASS]) at stable and exacerbation states. Data on clinical, investigational, and lung function parameters were also collected. During the stable state, the median interquartile range (IQR) PC-QOL score was 6.5 (5.3-6.9) and the DASS 21-item questionnaire score was 6 (0-20). Being of a young age correlated with a worse QOL (r(5) = 0.242, P = .04) but radiologic extent, lung function, underlying cause, environmental tobacco smoke exposure, and chronic upper-airway disease did not influence these scores. Exacerbations caused significant worsening in the PC-QOL scores (median [IQR], 4.6 [3.8-5.4]; P = .001) and DASS scores (median [IQR], 22 [9-42]; P < .001; 38% with elevated anxiety, 54% with abnormal depression/stress scores during exacerbation). The presence of viral infection, hypoxia, and hospitalization did not influence the exacerbation PC-QOL and DASS scores. There is a significant burden of disease, especially during exacerbation, on parents of children with bronchiectasis. Prevention, early detection, and appropriate treatment of exacerbations are likely to reduce psychologic morbidity in this group.
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              Role strain in couples with and without a child with a chronic illness: associations with marital satisfaction, intimacy, and daily mood.

              Alexandra L Quittner, Dorothy L Espelage, Lisa C. Opipari … (1998)
              This study examined marital role strain in 33 couples caring for a child with cystic fibrosis (CF) and 33 couples with a healthy child. The relationship between role strain, marital satisfaction, and psychological distress was tested. Couples completed a structured interview, questionnaires, a card sort procedure, and 4 daily diaries assessing activities and mood. Couples in the CF versus comparison group reported greater role strain on measures of role conflict, child-care tasks, and exchanges of affection. They also spent less time in recreational activities, but no reliable group differences were found in marital satisfaction or depression. Regression analyses indicated that role strain was related to marital satisfaction and depression and that recreation time accounted for additional variance. Path analysis suggested that recreation mediated the negative relationship between role strain and distress. The importance of using a contextual, process-oriented approach is discussed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ERJ Open Res
                Journal ID (iso-abbrev): ERJ Open Res
                Journal ID (publisher-id): ERJOR
                Journal ID (hwp): erjor
                Title: ERJ Open Research
                Publisher: European Respiratory Society
                ISSN (Electronic): 2312-0541
                Publication date Collection: July 2019
                Publication date (Electronic): 10 September 2019
                Volume: 5
                Issue: 3
                Electronic Location Identifier: 00063-2019
                Affiliations
                [1 ]Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
                [2 ]Institute for Breathing and Sleep, Melbourne, Australia
                [3 ]Physiotherapy, Queensland Children's Hospital, Brisbane, Australia
                [4 ]Physiotherapy, Royal Children's Hospital, Melbourne, Australia
                [5 ]School of Health Sciences, University of SA, Adelaide, Australia
                [6 ]Physiotherapy, Women's and Children's Hospital, Adelaide, Australia
                [7 ]Dept of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Australia
                [8 ]Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
                [9 ]Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
                [10 ]Centre for Allied Health Research and Education, Cabrini Health, Melbourne, Australia
                [11 ]Dept of Physiotherapy, Monash University, Melbourne, Australia
                Author notes
                Annemarie L. Lee, Dept of Physiotherapy, Monash University, McMahons Road, Frankston, Vic 3199, Australia. E-mail: Annemarie.Lee@ 123456monash.edu
                Article
                Publisher ID: 00063-2019
                DOI: 10.1183/23120541.00063-2019
                PMC ID: 6734007
                SO-VID: 4f3600c9-eebf-4fc2-931c-7b0ecbec0684
                Copyright © Copyright ©ERS 2019
                License:

                This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                Date received : 07 March 2019
                Date accepted : 09 July 2019
                Categories
                Subject: Original Research Letters
                Subject: 3

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