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