Poorer Caregiver Mental and Social Health Is Associated With Worse Respiratory Outcomes in Preschool Children With Recurrent Wheezing

被引:4
作者
Fitzpatrick, Anne M. [1 ,2 ,6 ]
Diani, Badiallo [3 ,4 ]
Kavalieratos, Dio [5 ]
Corace, E. Alison [2 ]
Mason, Carrie [2 ]
Van Dresser, Morgan [2 ]
Grunwell, Jocelyn R. Grunwell [1 ,2 ]
机构
[1] Emory Univ, Dept Pediat, Atlanta, GA USA
[2] Childrens Healthcare Atlanta, Atlanta, GA USA
[3] Emory Univ, Dept Biomed Engn, Atlanta, GA USA
[4] Georgia Inst Technol, Dept Biomed Engn, Atlanta, GA USA
[5] Emory Univ, Dept Family & Preventat Med, Atlanta, GA USA
[6] Emory Univ, Dept Pediat, 2015 Uppergate Dr, Atlanta, GA 30322 USA
基金
美国国家卫生研究院;
关键词
Anxiety; Asthma control; Caregiver burden; Depression; Disparity; Mental health; Patient-reported out-comes; Social determinants of health; Stress; Wheezing; MATERNAL STRESS; ASTHMA CONTROL; UNITED-STATES; KIDS TRACK; DETERMINANTS; DISPARITIES; DEPRESSION;
D O I
10.1016/j.jaip.2023.02.023
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Mental and social health in caregivers of preschool children has been inadequately studied, but it may influence respiratory symptom recognition and management. OBJECTIVE: To identify preschool caregivers at highest risk for poor mental and social health outcomes on the basis of patientreported outcome measures. METHODS: Female caregivers 18 to 50 years old (N = 129) with a preschool child aged 12 to 59 months with recurrent wheezing and at least 1 exacerbation in the previous year completed 8 validated patient-reported outcome measures of mental and social health. k-means cluster analysis was performed using the T score for each instrument. Caregiver/child dyads were followed for 6 months. Primary outcomes included caregiver quality of life and wheezing episodes in their preschool children.RESULTS: Three clusters of caregivers were identified: low risk (n = 38), moderate risk (n = 56), and high risk (n = 35). The high-risk cluster had the lowest life satisfaction, meaning and purpose, and emotional support and the highest social isolation, depression, anger, perceived stress, and anxiety that persisted for more than 6 months. This cluster had the poorest quality of life and marked disparities in social determinants of health. Preschool children from caregivers in the high-risk cluster had more frequent respiratory symptoms and a higher occurrence of any wheezing episode, but a lower outpatient physician utilization for wheezing management. CONCLUSIONS: Caregiver mental and social health is associated with respiratory outcomes in preschool children. Routine assessment of mental and social health in caregivers is warranted to promote health equity and improve wheezing outcomes in preschool children. & COPY; 2023 American Academy of
引用
收藏
页码:1814 / 1822
页数:9
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