Allergy Asthma Immunol Res.  2018 Jul;10(4):379-386. 10.4168/aair.2018.10.4.379.

Factors Affecting Food Allergy-Related Quality of Life From Parents' Perception in Turkish Children

• Arik Yilmaz E
• Cavkaytar
• Buyuktiryaki B
• Soyer O
• Sahiner UM
• Sekerel BE
• DunnGalvin A
• Karabulut
• Sackesen C

• KMID: 2421672
• DOI: http://doi.org/10.4168/aair.2018.10.4.379

Abstract

PURPOSE
Food allergy (FA) affects the daily lives of children and parents in varying degrees. The Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) is a valid and reliable instrument to assess the quality of life (QoL) of children from parents' perception. The aim of this study was to validate and determine the reliability of the Turkish FAQLQ-PF and to assess QoL in food-allergic children.
METHODS
Children aged between 0 and 12 years and diagnosed with immunoglobulin E (IgE)-mediated FA for at least 1 month were enrolled. The English FAQLQ-PF was translated into Turkish according to the World Health Organization guidelines. The Food Allergy Independent Measure and the Turkish Child Health Questionnaire-Parent Form 50 were used for construct validity.
RESULTS
One hundred and fifty-seven patients participated. The median age of patients and FA duration were 2.4 years (1.2-5.2 years, interquartile-ranges) and 2 years (0.8-5.1), respectively. Ninety-six (61.1%) patients had anaphylaxis. The Cronbach's alpha coefficient and intra-class correlation coefficient for test-retest reliability was good for all age groups of children ( < 4, 4-6, and 7-12 years). Patients with either asthma or anaphylaxis had worse scores than others. Total scores of FAQLQ-PF tended to increase with age. Patients aged 7-12 had the highest total scores among all patients (2.2±0.1, 3.0±0.2, and 3.3±0.3 for < 4, 4-6, and 7-12 years, respectively, P < 0.001, P for trend < 0.001). Other factors causing the poor QoL were cow's milk allergy, sibling allergy, mother's age over 30 years, mother's high education level and lower number of persons in household.
CONCLUSIONS
The Turkish FAQLQ-PF is a valid and reliable scale. FA-related QoL was significantly worse with age. Coexistent asthma, anaphylaxis regardless of its severity, cow's milk allergy, sibling allergy and the older and educated mothers seem to poorly affect QoL.

Keyword

Age; children; food allergy; quality of life; validation

MeSH Terms

Anaphylaxis
Asthma
Child Health
Child*
Education
Family Characteristics
Food Hypersensitivity
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Milk Hypersensitivity
Mothers
Parents
Quality of Life*
Reproducibility of Results
Siblings
World Health Organization
Immunoglobulin E
Immunoglobulins

Figure

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  Figure Flowchart of participants.

Reference

1. Muraro A, Dubois AE, DunnGalvin A, Hourihane JO, de Jong NW, Meyer R, et al. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures. Allergy. 2014; 69:845–853. PMID: 24785644.

2. DunnGalvin A, Dubois AE, Flokstra-de Blok BM, Hourihane JO. The effects of food allergy on quality of life. Chem Immunol Allergy. 2015; 101:235–252. PMID: 26022884.

3. Flokstra-de Blok BM, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ, Hourihane JO, et al. Development and validation of a self-administered Food Allergy Quality of Life Questionnaire for children. Clin Exp Allergy. 2009; 39:127–137. PMID: 19016799.

4. Flokstra-de Blok BM, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ, Hourihane JO, et al. Development and validation of the self-administered Food Allergy Quality of Life Questionnaire for adolescents. J Allergy Clin Immunol. 2008; 122:139–144. PMID: 18602570.

5. DunnGalvin A, de BlokFlokstra BM, Burks AW, Dubois AE, Hourihane JO. Food allergy QoL questionnaire for children aged 0–12 years: content, construct, and cross-cultural validity. Clin Exp Allergy. 2008; 38:977–986. PMID: 18435800.

6. Wassenberg J, Cochard MM, DunnGalvin A, Ballabeni P, Flokstra-de Blok BM, Newman CJ, et al. Parent perceived quality of life is age-dependent in children with food allergy. Pediatr Allergy Immunol. 2012; 23:412–419. PMID: 22554401.

7. Couto M, Silva D, Piedade S, Borrego L, Flokstra-de Blok B, Dunn Galvin A, et al. Translation to Portuguese and cultural adaptation of Food Allergy Quality of Life Questionnaire - Parent Form (FAQLQ-PF). Eur Ann Allergy Clin Immunol. 2016; 48:82–87. PMID: 27152603.

8. Mizuno Y, Ohya Y, Nagao M, DunnGalvin A, Fujisawa T. Validation and reliability of the Japanese version of the Food Allergy Quality of Life Questionnaire-Parent Form. Allergol Int. 2017; 66:290–295. PMID: 27599914.

9. Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013; 162:193–204. PMID: 24008815.

10. Ozdogan H, Ruperto N, Kasapçopur O, Bakkaloglu A, Arisoy N, Ozen S, et al. The Turkish version of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ). Clin Exp Rheumatol. 2001; 19(Suppl 23):S158–S162. PMID: 11510322.

11. Dunn Galvin A, Hourihane JO. Health-related quality of life in food allergy : Impact, correlates, and predictors. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016; 59:841–848. PMID: 27329076.

12. DunnGalvin A, Koman E, Raver E, Frome H, Adams M, Keena A, et al. An examination of the Food Allergy Quality of Life Questionnaire Performance in a countrywide American sample of children: cross-cultural differences in age and impact in the United States and Europe. J Allergy Clin Immunol Pract. 2017; 5:363–368.e2. PMID: 28017626.

13. Knibb RC, Barnes C, Stalker C. Parental self-efficacy in managing food allergy and mental health predicts food allergy-related quality of life. Pediatr Allergy Immunol. 2016; 27:459–464. PMID: 27019307.

14. Sicherer SH, Noone SA, Muñoz-Furlong A. The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol. 2001; 87:461–464. PMID: 11770692.

15. Leung TF, Yung E, Wong YS, Li CY, Wong GW. Quality-of-life assessment in Chinese families with food-allergic children. Clin Exp Allergy. 2009; 39:890–896. PMID: 19226279.

16. Saleh-Langenberg J, Goossens NJ, Flokstra-de Blok BM, Kollen BJ, van der Meulen GN, Le TM, et al. Predictors of health-related quality of life of European food-allergic patients. Allergy. 2015; 70:616–624. PMID: 25627424.

17. Protudjer JL, Jansson SA, Middelveld R, Östblom E, Dahlén SE, Arnlind MH, et al. Impaired health-related quality of life in adolescents with allergy to staple foods. Clin Transl Allergy. 2016; 6:37. PMID: 27733903.

18. Marklund B, Ahlstedt S, Nordström G. Health-related quality of life in food hypersensitive schoolchildren and their families: parents’ perceptions. Health Qual Life Outcomes. 2006; 4:48. PMID: 16901348.

19. Polloni L, Toniolo A, Lazzarotto F, Baldi I, Foltran F, Gregori D, et al. Nutritional behavior and attitudes in food allergic children and their mothers. Clin Transl Allergy. 2013; 3:41. PMID: 24325875.