Assessment of quality of life among children with bronchial asthma and their caregivers at the National Hospital Abuja, Nigeria

Abstract

Background: The global disease burden associated with bronchial asthma has continued to increase particularly among children. Asthma-related quality of life is a health related assessment of disease impact on patient and care givers.

Aim: To determine the perceived quality of life (QOL) among children with bronchial asthma and their caregivers as well as the related factors.

Subjects and methods: This was a prospective study of children diagnosed with bronchial asthma and the caregivers attending the Respiratory Clinic of the National hospital Abuja, Nigeria. Using the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) information from the various domains was obtained. The PAQLQ 23 questions assessed the child physical domain (5), emotional (8) and social behaviors (10), and the PACQLQ 13 questions assessed the caregivers’ activity limitation domain (4) and emotional function (9).Mean QOL scores from each domain and overall scores were calculated based on a seven-point scale. A QOL score of 7 was reported as best with no impairment; score one as least and severest impairment; score 4 as mid point in the range from 2-6 of moderate degree impairment. Other information on the demographic biodata and clinical information from child and caregivers was also obtained.

Results: Forty-three children and 43 caregivers each were enrolled, from August to December 2014. Patients were aged 7-15years; 25(58.1%) males, 18(41.9%) females; while caregiver’s were males 23(53.5%), females 20(46.5%), age range 21- 48years. 25(58.1%) caregivers were of middle- lower socio-economic status; 20(46.5%) children had persistent asthma, 22(51.2%) well controlled, 21(48.8%) partly controlled. Medication use were; none, 17 (39.5%); long acting beta2 agonist/ inhaled corticosteroids (LABA/ ICS), 13(30.2%); antihistamine, 8 (18.6%); leukotriene receptor antagonist (LTRA),5(11.6%). Overall mean QOL was 4.89(4.54- 5.24;95% CI) for the children and 4.6 (3.91- 4.82; 95% CI) for caregivers; correlation (R) 0.438 p=0.003. Multiple regression showed that females gender had significant impairment in mean QOL scores in the activity domain (p= 0.022), and those with poor control and severe asthma also had significant impairment in mean QOL (p <0.05).

Conclusion: Asthma impacted QOL of both the asthmatic children and caregivers with female gender in the activity domain, severe and not well controlled disease as independent predictors of quality of life.

Keywords: Asthma, Paediatrics, Caregivers, QOL, Assessment