Asia Pac Allergy.  2016 Oct;6(4):213-219. 10.5415/apallergy.2016.6.4.213.

Family quality of life among families of children with atopic dermatitis

• Jang HJ
• Hwang S
• Ahn Y
• Lim DH
• Sohn M
• Kim JH

• KMID: 2397017
• DOI: http://doi.org/10.5415/apallergy.2016.6.4.213

Abstract

BACKGROUND
Atopic dermatitis (AD) may cause emotional distress and impairs the quality of life (QoL) in children and their families.
OBJECTIVE
We examined family QoL of children with AD and explored associated factors such as disease severity and psychosocial factors among parents of children with AD.
METHODS
Study participants were 78 children (1 month to 16 years old) diagnosed with AD and their parents visiting an outpatient clinic of the Department of Pediatrics in Inha University Hospital. Data were collected using structured questionnaires and medical record review. Parents completed the Dermatitis Family Impact questionnaire (DFI), the Positive Affect and Negative Affect Schedule, the Satisfaction with Life Scale, and the Korean Parenting Stress Index. For children aged below 6-year-old, parents were asked to complete the Infants' Dermatologic Quality of Life. SCOring Atopic Dermatitis (SCORAD), Children's Dermatology Life Quality Index, and the Pediatric Quality of Life Inventory version 4.0 Generic Core Scale were also completed.
RESULTS
The mean age of parents and children were 37.4 ± 5.3 years and 65.1 ± 45.7 months, respectively. Among them, 87.2% of parents were mothers and 60.3% of children were boys. The mean score of DFI was 11.2 ± 6.0. The mean SCORAD score was 28.3 ± 16.1. Family who experienced strong negative emotionality had a 3.8 times higher probability of experiencing a lower QoL than parents who did not (odds ratio [OR], 3.82; p = 0.041). Family of children with higher severity of AD had a 6.6 times (OR, 6.55; p = 0.018) higher probability of experiencing a low family QoL than their less-severe counterparts. Families of girls with AD had a lower QoL (OR, 8.40; p = 0.003) than families of boys.
CONCLUSION
Family QoL among parents of children with AD was low and associated with parent's psychosocial characteristics as well as disease severity of the children. Considering parental involvement in AD management for children, emotional support for parents can be helpful in long journey of disease management.

Keyword

Dermatitis, aopic; Quality of life; Stress, psychological

MeSH Terms

Ambulatory Care Facilities
Appointments and Schedules
Child*
Dermatitis
Dermatitis, Atopic*
Dermatology
Disease Management
Female
Humans
Medical Records
Mothers
Parenting
Parents
Pediatrics
Psychology
Quality of Life*
Stress, Psychological

Reference

1. Lee SC. Various diagnostic criteria for atopic dermatitis. J Korean Med Assoc. 2014; 57:212–217.

2. Jee HM, Kim KW, Kim CS, Sohn MH, Shin DC, Kim KE. Prevalence of asthma, rhinitis and eczema in Korea n children using the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaires. Pediatr Allergy Respir Dis. 2009; 19:165–172.

3. Ahn K, Kim J, Kwon HJ, Chae Y, Hahm MI, Lee KJ, Park YM, Lee SY, Han M, Kim WK. The prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in Korean children: nationwide cross-sectional survey using complex sampling design. J Korean Med Assoc. 2011; 54:769–778.

4. Lind N, Nordin M, Palmquist E, Nordin S. Psychological distress in asthma and allergy: the Västerbotten Environmental Health Study. Psychol Health Med. 2014; 19:316–323.

5. Cheng CM, Hsu JW, Huang KL, Bai YM, Su TP, Li CT, Yang AC, Chang WH, Chen TJ, Tsai SJ, Chen MH. Risk of developing major depressive disorder and anxiety disorders among adolescents and adults with atopic dermatitis: a nationwide longitudinal study. J Affect Disord. 2015; 178:60–65.

6. Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006; 155:145–151.

7. Choi JE, Lee KS, Park JA, Hong SJ, Chang HY, Kim KW, Shin YH, Ahn K. Relationship between parenting and mental health of mothers and behavioral problem of 24-month-old infant with atopic dermatitis. Korean J Woman Psychol. 2015; 20:1–23.

8. Kim DH, Li K, Seo SJ, Jo SJ, Yim HW, Kim CM, Kim KH, Kim DW, Kim MB, Kim JW, Ro YS, Park YL, Park CW, Lee SC, Cho SH. Quality of life and disease severity are correlated in patients with atopic dermatitis. J Korean Med Sci. 2012; 27:1327–1332.

9. Mitchell AE, Fraser JA, Ramsbotham J, Morawska A, Yates P. Childhood atopic dermatitis: a cross-sectional study of relationships between child and parent factors, atopic dermatitis management, and disease severity. Int J Nurs Stud. 2015; 52:216–228.

10. Olsen JR, Gallacher J, Finlay AY, Piguet V, Francis NA. Quality of life impact of childhood skin conditions measured using the Children's Dermatology Life Quality Index (CDLQI): a meta-analysis. Br J Dermatol. 2016; 174:853–861.

11. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980; 92:44–47.

12. Park GH, Park JH, Hwang YH, Sung MS, Kim SW. The correlation between the severity of atopic dermatitis classified by SCORing atopic dermatitis index and the laboratory tests. Allergy Asthma Respir Dis. 2013; 1:79–83.

13. Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG. The family impact of childhood atopic dermatitis: the Dermatitis Family Impact Questionnaire. Br J Dermatol. 1998; 138:107–113.

14. Cho J, Lee JH, Suh J, Yu JS, Lee H, Park E, Kim H, Chang EY, Kim J, Han Y, Ahn K. Change in quality of life according to the change in atopic dermatitis severity. Pediatr Allergy Respir Dis. 2012; 22:86–99.

15. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988; 54:1063–1070.

16. Lee HH, Kim EJ, Lee MK. A validation study of Korea positive and negative affect schedule: The PANAS scales. Korean J Clin Psychol. 2003; 22:935–946.

17. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985; 49:71–75.

18. Sohn M, Kim E, Lee JE, Kim K. Exploring positive psychology of children with type 1 diabetes focusing on subjective happiness and satisfaction with life. Child Health Nurs Res. 2015; 21:83–90.

19. Kim JH. The relationship between life satisfaction/life satisfaction expectancy and stress/well-being: an application of motivational states theory. Korean J Health Psychol. 2007; 12:325–345.

20. Abidin RR. Parenting stress index (PSI) manual. 3rd ed. Odessa (FL): Psychological Assessment Resources Inc.;1995.

21. Lee K, Chung KM, Park J, Kim HJ. Reliability and validity study for the Korean version of Parenting Stress Index Short Form (K-PSI-SF). Korean J Woman Psychol. 2008; 13:363–377.

22. Varni JW, Seid M, Kurtin PS. PedsQL.PedsQL™ 4.0: Reliability and Validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in Healthy and Patient Populations. Med Care. 2001; 39:800–812.

23. Chung KM, Yang SK. A study for the standardization of the Korean Version of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core Scales, self-report. Korean J Health Psychol. 2012; 17:677–695.

24. Lewis-Jones MS, Finlay AY, Dykes PJ. The Infants' Dermatitis Quality of Life Index. Br J Dermatol. 2001; 144:104–110.

25. Lewis-Jones MS, Finlay AY. The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol. 1995; 132:942–949.

26. Children's Dermatology Life Quality Index Questionnaire (2010 update) [Internet]. CDLQI Different Korean Versions;cited 2014 Oct 25. Available from: http://www.cardiff.ac.uk/dermatology/quality-of-life/childrens-dermatology-life-quality-index-cdlqi/cdlqidifferent-language-versions/.

27. Pucci N, Novembre E, Cammarata MG, Bernardini R, Monaco MG, Calogero C, Vierucci A. Scoring atopic dermatitis in infants and young children: distinctive features of the SCORAD index. Allergy. 2005; 60:113–116.

28. Shin N, Kim SH, Cho S, Whang KK, Hahm JH. The impact of childhood atopic dermatitis on their families. Korean J Dermatol. 2000; 38:494–499.

29. Kim SH, Han DH, Park HJ, Byun JY, Choi YW, Choi HY, Myung KB. The relationship between child and adolescent atopic dermatitis, attachment and the quality of parental life. Korean J Dermatol. 2008; 46:1457–1462.

30. Kwon IS, Seo YM. Home nursing and quality of life in parents of children with atopic dermatitis. J Korean Acad Child Health Nurs. 2009; 15:401–408.

31. Lee JH, Kim HY, Lee JH. A study on maternal stress in rearing children with disabilities and maternal quality of life. J Korean Acad Child Health Nurs. 2007; 13:5–12.

32. Park BK, Lee SJ, Kim HJ, Lee KA, Park NY, Yoo JH, Ju HO. Factors affecting the quality of life of parents who have children with diabetes. J Korean Soc Matern Child Health. 2015; 19:71–81.

33. Chernyshov PV. Gender differences in health-related and family quality of life in young children with atopic dermatitis. Int J Dermatol. 2012; 51:290–294.

34. Ballardini N, Östblom E, Wahlgren CF, Kull I. Mild eczema affects selfperceived health among pre-adolescent girls. Acta Derm Venereol. 2014; 94:312–316.