Illness perceptions and quality of life in families with child with atopic dermatitis

Main Article Content

V. Siafaka
A. Zioga
T. Evrenoglou
D. Mavridis
S. Tsabouri

Keywords

Atopic dermatitis, Children, Illness perceptions, Family quality of life, Disease severity, Chronicity

Abstract

Objective: To assess the Quality of Life (QoL) of children with Atopic Dermatitis (AD) and their families and the impact of the mothers’ illness perceptions on the family QoL.


Materials and methods: Seventy-five children with AD (54 infants and 21 children) and their mothers participated in the study. The following questionnaires were administrated: 1. Brief Illness Perception Questionnaire (Brief IPQ); 2. Infant’s Dermatitis Quality of Life Index (IDQOL); 3. Children’s Dermatology Life Quality Index (CDLQI); 4. Dermatitis Family Impact Questionnaire (DFIQ) and 5. The Severity Scoring of Atopic Dermatitis (SCORAD).


Results: Atopic dermatitis had a moderate impact on the QoL of the infants (6.67 ± 5.30), children (7.86 ± 7.19) and their families (9.42 ± 7.03). The DFIQ was associated with certain dimensions of the Brief IPQ, specifically, with Illness Identity (greater symptom burden) (r = 0.615, p = 0.000), beliefs about the Consequences of the illness (r = 0.542, p = 0.000), the Concerns (r = 0.421, p = 0.000) and the Emotional Representations (r = 0.510, p = 0.000). Correlation was demonstrated between IDQOL and DFIQ (r = 0.662, p = 0.000) and between CDLQI and DFIQ (r = 0.832, p = 0.000), and a weaker correlation between SCORAD and DFIQ (r = 0.255, p = 0.035). The chronicity of the AD showed negative association with DFIQ (p < 0.001).


Conclusions: The QoL of families with a child with AD is associated with the mother’s illness perceptions about AD, the children’s QoL and with both the severity and the chronicity of the disease. Therefore, clinicians should pay attention not only to the clinical characteristics of the children, but also to the parents’ beliefs and emotions, to improve the family QoL.

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References

1. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4, http://dx.doi.org/10.1038/s41572-018-0001-z.

2. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl. 1:8-16, http://dx.
doi.org/10.1159/000370220.

3. Kaaz K, Szepietowski JC, Matusiak L. Influence of itch and pain on sleep quality in atopic dermatitis and psoriasis. Acta Dermato Venereol. 2019;99:175-80, http://dx.doi.org/10.2340/00015555-3065.

4. Bridgman AC, Block JK, Drucker AM. The multidimensional burden of atopic dermatitis: An update. Ann Allergy Asthma Immunol. 2018;120:603-6, http://dx.doi.org/10.1016/j.anai.2018.03.009.

5. Im YJ, Park ES, Oh WO, Suk MH. Parenting and relationship characteristics in mothers with their children having atopic disease. J Child Health Care. 2014;18:215-29, http://dx.doi.org/10.1177/1367493513485824.

6. Warschburger P, Buchholz HT, Petermann F. Psychological adjustment in parents of young children with atopic dermatitis: which factors predict parental quality of life? Br J Dermatol. 2004;150:304-11, http://dx.doi.org/10.1111/j.1365-2133.2004.05743.x.

7. Hagger MS, Orbell S. A meta-analytic review of the common-sense model of illness representations. Psychol Health. 2003;18:141-84, http://dx.doi.org/10.1080/088704403100081321.

8. Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016;39:935-46, http://dx.doi.org/10.1007/s10865-016-9782-2.

9. Slusar MB, Nelson S. Caregiver illness perception of their child’s early childhood caries. Pediatr Dent. 2016;38:425-31.

10. Goldbeck L, Bundschuh S. Illness perception in pediatric somatization and asthma: complaints and health locus of control beliefs. Child Adolesc Psychiatry Mental Health. 2007;1, http://dx.doi.org/10.1186/1753-2000-1-5.

11. Breland JY, McAndrew LM, Burns E, Leventhal EA, Leventhal H. Using the Common Sense Model of Self-regulation to review the effects of self-monitoring of blood glucose on glycemic control for non-insulin-treated adults with type 2 diabetes. Diabetes Educ. 2013;39:541-59, http://dx.doi.org/10.1177/0145721713490079.

12. Salewski C. Illness representations in families with a chronically ill adolescent: differences between family members and impact on patients’ outcome variables. J Health Psychol. 2003;8:587-98, http://dx.doi.org/10.1177/13591053030085009.

13. Walker C, Papadopoulos L, Hussein M. Paediatric eczema and psychosocial morbidity: how does eczema interact with parents’ illness beliefs? J Eur Acad Dermatol Venereol. 2007;21:63-7, http://dx.doi.org/10.1111/j.1468-3083.2006.01866.x.

14. Paller AS, McAlister RO, Doyle JJ, Jackson A. Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr. 2002;41:323-32, http://dx.doi.org/10.1177/000992280204100505.

15. Hanifin J, Rajka G. Diagnostic features of atopic dermatitis. Acta Dermato Venereol (Stockh). 1980;92 Suppl.:44-7, http://dx.doi.org/10.2340/00015555924447.

16. Laitinen K, Kalliomaki M, Poussa T, Lagstrom H, Isolauri E. Evaluation of diet and growth in children with and without atopic eczema: follow-up study from birth to 4 years. Br J Nutr. 2005;94:565-74, http://dx.doi.org/10.1079/bjn20051503.

17. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631-7, http://dx.doi.org/10.1016/j.jpsychores.2005.10.020.

18. Lewis-Jones MS, Finlay AY, Dykes PJ. The infants’ dermatitis quality of life index. Br J Dermatol. 2001;144:104-10, http://dx.doi.org/10.1046/j.1365-2133.2001.03960.x.

19. Lewis-Jones MS, Finlay AY. The Children’s Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol. 1995;132:942-9, http://dx.doi.org/10.1111/j.1365-2133.1995.tb16953.x.

20. Holme SA, Man I, Sharpe JL, Dykes PJ, Lewis-Jones MS, Finlay AY. The children’s dermatology life quality index: validation of the cartoon version. Br J Dermatol. 2003;148:285-90, http://dx.doi.org/10.1046/j.1365-2133.2003.05157.x.

21. 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;138:107-13, http://dx.doi.org/10.1046/j.1365-2133.1998.02034.x.

22. Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157:645-8, http://dx.doi.org/10.1111/j.1365-2133.2007.08112.x.

23. Position paper: Allergen standardization and skin tests. The European Academy of Allergology and Clinical Immunology. Allergy. 1993;48 Suppl. 14:48-82.

24. Marciniak J, Reich A, Szepietowski JC. Quality of life of parents of children with atopic dermatitis. Acta Dermato-Venereol. 2017;97:711-4, http://dx.doi.org/10.2340/00015555-2633.

25. Ramirez FD, Chen S, Langan SM, Prather AA, McCulloch CE, Kidd SA, et al. Association of atopic dermatitis with sleep quality in children. JAMA Pediatr. 2019;173:e190025, http://dx.doi.org/10.1001/jamapediatrics.2019.0025.

26. Chernyshov PV. Gender differences in health-related and family quality of life in young children with atopic dermatitis. Int J Dermatol. 2012;51:290-4, http://dx.doi.org/10.1111/j.1365-4632.2011.04997.x.

27. Manzoni AP, Pereira RL, Townsend RZ, Weber MB, Nagatomi AR, Cestari TF. Assessment of the quality of life of pediatric patients with the major chronic childhood skin diseases. An Bras Dermatol. 2012;87:361-8, http://dx.doi.org/10.1590/s0365-05962012000300002.

28. Jang HJ, Hwang S, Ahn Y, Lim DH, Sohn M, Kim JH. Family quality of life among families of children with atopic dermatitis. Asia Pac Allergy. 2016;6:213-9, http://dx.doi.org/10.5415/apallergy.2016.6.4.213.

29. Kim DH, Li K, Seo SJ, Jo SJ, Yim HW, Kim CM, et al. Quality of life and disease severity are correlated in patients with atopic dermatitis. J Korean Med Sci. 2012;27:1327-32, http://dx.doi.org/10.3346/jkms.2012.27.11.1327.

30. Chernyshov PV, Jirakova A, Ho RC, Moed H, Caldeira AP, Alvarenga TM, et al. An international multicenter study on quality of life and family quality of life in children with atopic dermatitis. Indian J Dermatol Venereol Leprol. 2013;79:52-8, http://dx.doi.org/10.4103/0378-6323.104669.

31. Chamlin SL. The psychosocial burden of childhood atopic dermatitis. Dermatol Therapy. 2006;19:104-7, http://dx.doi.org/10.1111/j.1529-8019.2006.00060.x.

32. Rodriguez-Orozco AR, Kanan-Cedeno EG, Guillen Martinez E, Campos Garibay MJ. Family functioning and illness perception of parents of children with atopic dermatitis, living without skin symptoms, but with psychosomatic symptoms. Iran J Allergy Asthma Immunol. 2011;10:61-5, http://dx.doi.org/10.1001/ijaai.6165.

33. Shiloh S, Rashuk-Rosenthal D, Benyamini Y. Illness causal attributions: an exploratory study of their structure and associations with other illness cognitions and perceptions of control. J Behav Med. 2002;25:373-94, http://dx.doi.org/10.1023/a:1015818532390.

34. Yang EJ, Beck KM, Sekhon S, Bhutani T, Koo J. The impact of pediatric atopic dermatitis on families: a review. Pediatr Dermatol. 2019;36:66-71, http://dx.doi.org/10.1111/pde.13727.

35. Monti F, Agostini F, Gobbi F, Neri E, Schianchi S, Arcangeli F. Quality of life measures in Italian children with atopic dermatitis and their families. Ital J Pediatr. 2011;37, http://dx.doi.org/10.1186/1824-7288-37-59.

36. Hebert AA, Stingl G, Ho LK, Lynde C, Cappelleri JC, Tallman AM, et al. Patient impact and economic burden of mild-to-moderate atopic dermatitis. Curr Med Res Opin. 2018;34:2177-85, http://dx.doi.org/10.1080/03007995.2018.1498329.

37. Staab D, von Rueden U, Kehrt R, Erhart M, Wenninger K, Kamtsiuris P, et al. Evaluation of a parental training program for the management of childhood atopic dermatitis. Pediatr Allergy Immunol. 2002;13:84-90, http://dx.doi.org/10.1034/j.1399-3038.2002.01005.x.

38. Morawska A, Calam R, Fraser J. Parenting interventions for childhood chronic illness: a review and recommendations for intervention design and delivery. J Child Health Care. 2015;19:5-17, http://dx.doi.org/10.1177/1367493513496664.

39. Shin JY, Kim DW, Park CW, Seo SJ, Park YL, Lee JR, et al. An educational program that contributes to improved patient and parental understanding of atopic dermatitis. Ann Dermatol. 2014;26:66-72, http://dx.doi.org/10.5021/ad.2014.26.1.66.

40. Morawska A, Mitchell AE, Burgess S, Fraser J. Fathers’ perceptions of change following parenting intervention: randomized controlled trial of triple p for parents of children with asthma or eczema. J Pediatr Psychol. 2017;42:792-803, http://dx.doi.org/10.1093/jpepsy/jsw106.