CHILDREN AND PARENTS: HOW DO THEIR RATINGS OF ASTHMA HEALTH COMPARE?

Lynn M. Olson, Linda Radecki, Mary Pat Frintner.. Research, Amer Academy of Pediatrics, Elk Grove Village, IL.

Poster presentation at the Pediatric Academic Societies 2006 meeting.

 

BACKGROUND: In research and in patient care it is often not clear whom to ask: parent or child?

 

OBJECTIVE: Compare child and parent reports of asthma health status. Examine reports by child age and physical versus emotional health.

 

DESIGN/METHODS: Parents and children in separate interviews answered equivalent questions about activities and impact of asthma in the past 2 weeks, including 5-point Likert scale items from the Children's Health Survey for Asthma (CHSA). Scales were examined for: a) physical symptoms and b) emotional impact of asthma. Scale scores could range from 0-100; higher scores = better health. Paired t-tests compared parent ? child mean scores. Results were examined by child age groups: 7-9, 10-12, 13-16.

 

RESULTS: 414 parent/child pairs completed the study. 59% of children were male; mean age = 10.9 years; 46% African American; 42% family yearly income <$30,000. 41% of children had ever been hospitalized overnight for asthma, and 53% currently had moderate to sever asthma, as rated by parents. Overall children rated their physical health (eg, wheezing, sleep disturbance) worse than did their parents (71.2 vs. 84.4, p <.001), and this pattern was the same in each age group.

 

Child vs. Parent Mean Scores on Asthma Health Status
CHSA Scale	Child Score	Parent Score	Significance
PHYSICAL HEALTH
age 7-9	79.5	83.3	.02
age 10-12	80.5	86.2	.001
age 13-16	77.3	83.7	.001
EMOTIONAL HEALTH
age 7-9	73.1	77.3	.07
age 10-12	80.6	78.8	.40
age 13-16	79.3	69.1	.001

Paired sample t-tests. Higher scores indicate better health.

 

With all ages combined, children rated their emotional health (eg, frustrated about having asthma, feel left out because of asthma) equivalent to their parents (77.7 vs. 75.4). However, there were distinct age differences for emotional health, with teenagers (13-16 years) rating their emotional health better than did their parents (79.3 vs. 69.1, p <.001).

 

CONCLUSIONS: Child and parent reports differ, with children rating their asthma physical health worse than did their parents. The largest differences between parents and children were found among adolescents, who reported less of an impact of asthma on emotional health than did their parents. The findings underscore the importance of assessing both child and parents reports about symptoms and impact of asthma and other health conditions.