Klatte, E.M. (Elzien) (2015) Determinants of quality of life in children referred for asthma to secondary and tertiary line health care. thesis, Medicine.
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Abstract
Background: Asthma in children has a known impact on Quality of life (QoL). Measures like QoL are useful indicators to understand the impact of asthma on functional status and wellbeing. Little is known about independent determinants of QoL in children with asthma. Methods: Children referred for asthma were selected from the Electronic Portal for children. Children from the WHeezing Illnesses LEidsche Rijn (WHISTLER) cohort were approached to participate in the EP as healthy controls. All children completed questionnaires about general health and allergic and respiratory symptoms in the EP. General health was measured using the Dutch version on the RAND questionnaire, asthma related quality of life was measure using the Dutch version of the pediatric asthma quality of life (PAQLQ). RAND score in children referred for asthma was compared to controls. RAND score and PAQLQ score were compared for children referred for asthma, between children without a diagnosis, diagnosed by a general practitioner (GP) and diagnosed by a pediatrician. Determinants of QoL were identified with univariable and multivariable regression analysis. Results: In total, we included 612 children of whom 359 children were referred for asthma and 253 children were healthy controls. Median RAND score for children referred for asthma (Median 21, IQR 18-24) was significant lower as compared to healthy controls (Median 29, IQR 26-31). No significant difference was found for children referred for asthma without or with a diagnosis made by either a GP or pediatrician either in RAND score (p=0.06) or PAQLQ score (p=0.84). Independent determinants of the RAND for children referred for asthma were paternal education, wheezing, cough, recurrent infections, school absence more than five days and eczema. Among children diagnosed for asthma, asthma control and school absence were independent determinants. Independent determinants of the RAND in the control group were recurrent infections, restricted diet for food allergy and eczema. Conclusion: Referral for asthma has a significantly impact on QoL. Results of this study underline that asthma should not be seen as one entity only. Treatment of asthma needs a multidisciplinary approach and special attention must be paid not only to asthma related symptoms but also on the impact of comorbidities on QoL.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor and Koppelman, G.H. MD/PhD and University Medical Center Groningen, Beatrix Children’s Hosp |
| Supervisor name: | Erp, F.C. van der MD/PhD student and Wilhelmina Children’s Hospital Utrecht, department of pediat and External Supervisor and Ent, C.K. van der MD/PhD and Wilhelmina Children’s Hospital Utrecht, department of pediat |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1078 |
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