INVESTIGATIVE REPORT
711 Advances in dermatology and venereology ActaDV Acta Dermato-Venereologica ActaDV
Quality of Life of Parents of Children with Atopic Dermatitis
Joanna MARCINIAK, Adam REICH and Jacek C. SZEPIETOWSKI Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
Atopic dermatitis( AD) is the most common chronic dermatitis in children. The influence of AD on quality of life of parents of children with AD was studied using the Family Dermatology Life Quality Index( FDLQI). Fifty children with AD were included in the study( age range 2 – 24 months) together with their parents. Children’ s AD was found to influence the quality of life of both parents; however, it had a more significant influence on quality of life of mothers than that of fathers( mean FDLQI: 17.1 ± 5.3 vs. 14.7 ± 5.8 points; p < 0.001). Due to the children’ s AD, mothers spent more time caring for them and carried out more household duties. Childhood AD had a greater impact on quality of life of fathers through influence on their work or education. The influence of AD on the quality of life of family members is significant, and this should be taken into account in the therapeutic process.
Key words: atopic dermatitis; quality of life; parents’ quality of life.
Accepted Feb 15, 2017; Epub ahead of print Feb 16, 2017 Acta Derm Venereol 2017; 97: 711 – 714.
Corr: Jacek Szepietowski, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Ul. Chalubinskiego 1, PL-50-368 Wroclaw, Poland. E-mail: jacek. szepietowski @ umed. wroc. pl
Atopic dermatitis( AD) is the most common chronic dermatitis in children. Due to the chronic nature of AD and the inconvenience of treatment methods, the condition has a significant influence on patients’ quality of life( QoL). AD often affects the youngest patients( 1) and therefore also has an impact on the QoL of parents( 2, 3).
Interest in patients’ QoL, including that of dermatological patients, has increased in recent years( 4 – 6). Several tools, mostly self-reported questionnaires, are available to measure the QoL of dermatological patients( 7, 8). Numerous studies have confirmed that there is a significant decrease in QoL of patients with AD with reference to both the healthy population and other dermatological or systemic diseases( 7, 9). However, there is little research made showing the influence of a child’ s disease on other family members. There are a limited number of studies concerning the QoL of families of patients with AD, which show that skin disease in children has a negative impact on the well-being of parents( 3, 10, 11). If mothers and fathers perform different roles in families, the influence of AD on their QoL may differ, although previous studies are inconclusive on this point( 12, 13). The aim of the current study was to investigate the impact of children with AD on the QoL of both parents, in order to enable a better focus on patients’ and parents’ needs.
MATERIALS AND METHODS
The study included the parents of 50 children with AD who were hospitalized in the Department of Paediatrics, Allergology and Cardiology of Wroclaw Medical University, Poland. Patients were recruited consecutively. Inclusion criteria were: written consent of both parents( or of one parent if the second parent did not raise the child) to participate in the study; child’ s age between 1 and 24 months; confirmed diagnosis of AD based on clinical manifestation and disease course; no other major skin or systemic diseases that might influence the results of the study; parents are native Polish speakers; and parents were able to understand the questionnaires. There were 36 boys( 72 %) and 14 girls( 28 %), age range 2 – 24 months( mean ± standard deviation( SD) 10.2 ± 6.5 months) included in the study. In the parents’ group there were 50 mothers and 46 fathers( 4 patients’ fathers were not in contact with their family). Based on their medical histories it was established that the major caregivers in all children with AD were the mothers.
The Polish language version of the Family Dermatology Life Quality Index( FDLQI) was used to assess the impact of the children’ s AD on the parents’ QoL( 14, 15). The questionnaire comprises 10 questions concerning the influence of the children’ s disease on different fields of life of their family members, such as emotional distress, physical well-being, relationships, other peoples’ reactions, social life, free time, time spent looking after the child, extra housework, work or education, and daily expenditure. Questions concern the influence of the disease on parents’ QoL in the last month. Each question can be answered by choosing 1 out of 4 answers scored 0 – 3. The maximum score is 30 points and minimum 0 points. The higher the score, the lower the parents’ QoL.
In addition, in order to evaluate the QoL of children with AD the following questionnaire was used: Infant’ s Dermatitis Quality Life Index( IDQOL) in the Polish language version( 16), in which the answers were given by parents. Both questionnaires were chosen for several reasons: they are validated, are available in Polish, have numerous language versions that enable comparison of the results with those of other authors, they can be applied in different skin conditions, and enable comparisons to be made between AD and other dermatoses. Both questionnaires( FDLQI and IDQOL) were completed separately by mothers and fathers. Whilst the questionnaires were being completed parents were not allowed to communicate with each other. The severity of AD was measured by one of the co-authors( J. M., a paediatrician, allergist) using the Severity Scoring of Atopic Dermatitis( SCORAD) and the Eczema Area and Severity Index( EASI)( 17, 18).
Statistical analysis
All data were analysed with Statistica ® 12.0 software for Windows Software. Student’ s t-test and Mann – Whitney U test were used, where appropriate. Possible correlations between parameters were measured with Pearson’ s correlation test. The statistical significance level was set at 0.05. For multiple comparisons Bonfer-
This is an open access article under the CC BY-NC license. www. medicaljournals. se / acta Journal Compilation © 2017 Acta Dermato-Venereologica. doi: 10.2340 / 00015555-2633 Acta Derm Venereol 2017; 97: 711 – 714