Reporting About Asthma: Whom to Ask, Children or Parents?

Lynn M Olson ¹, Linda Radecki ¹, Kevin B Weiss ² and Robert Siegel ³. ¹Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL; ²Feinberg School of Medicine, Northwestern University, Chicago, IL and ³Cincinnati Pediatric Research Group, Cincinnati Children s Hospital, Cincinnati, OH. Poster presentation to the Pediatric Academic Societies, 2004.

 

Background: The capacity of children to report on their own health status is a key issue for both clinical care and valid research.

 

Objective: To compare child and parent reports of asthma symptoms and impact.

 

Design/Methods: In the Child Health Information Reporting Project (CHIRP) children (7-16 years) and parents both (n=213 pairs) answered the same questions about activities and impact of asthma, including 5-point Likert scale items from the Childrens Health Survey for Asthma (CHSA) regarding: a) physical symptoms and b) emotional impact of asthma in the past 2 weeks. Percent agreement within pairs was calculated to describe magnitude of agreement (for scale items within 1-point); paired t-tests were calculated to assess significance of difference between parent and child report.

 

Results: Children were a mean age of 10.7 years (range = 7-16) and were 49% African American, 35% Caucasian, and 12% Hispanic. Fifty-three percent of households had incomes below 30K. Fifty-six percent of parents reported their childs asthma as moderate or severe. Parent-child agreement was: 78% for whether someone in household smokes (t-test of difference, p <.001), 72% ever taken to ER for asthma ( p <.001), and 80% whether pet in home (t-test of difference, ns). Regarding physical symptoms, agreement included: Short of breath (81%, ns), tight chest (83%, ns), cough (71%, ns), wheezing (81%, ns), and sleep problems (68%, ns). Regarding emotional impact agreement was: Frustrated about having asthma (70%, ns), frustrated w/asthma treatments (65%, p<.001), frustrated w/activity limitations (67%, ns), upset about having asthma (71%, p<.09), and upset about asthma treatments (68%, p<.001). As comparison, for a non-asthma item - how often child takes bus to school - agreement between parents and children was 87% (ns).

 

Conclusions: Parents and children will never all agree (!), however, parents and children generally gave similar responses to observable physical symptoms, while agreement on emotional impact of asthma tended to be lower. Knowledge of the best source (child vs parent) of information on asthma impact may lead to improvements in clinical assessment of asthma. Future research in the CHIRP project with a larger sample will assess correlates of parent-child agreement, including child age and severity of disease.