천식 환아와 보호자의 삶의 질에 영향을 주는 요인 조사를 위한 다 기관 공동 연구
Multicenter Study on Factors Influencing the Quality of Life of Asthmatic Children and Their Caregivers
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초록
목 적:소아 천식은 환아와 보호자 모두에게 활동 제한과 정신적, 경제적 영향을 줄 수 있으므로 이들의 삶의 질을 비교, 조사하고 각각에 영향을 줄 수 있는 요인들을 찾아보았다. 방 법:2009년 1월부터 2010년 6월까지 전국 9개 병원 소아청소년과 외래에 내원하는 천식 환아 247명과 그 보호자를 대상으로 KPAQLQ (Korean Pediatric Asthma Quality of Life Questionnaire), KPACQLQ (Korean Pediatric Asthma Caregivers Quality of Life Questionnaire)를 통한 설문 조사를 바탕으로 삶의 질을 평가하였으며 여기에 영향을 주는 관련 요인을 알아보고자 내원 당시 forced expiratory volume in 1 second (%), 천식 유병기간, 입원, 응급실 및 외래 방문 횟수, 사용하는 약제 등을 조사하였다. 결 과:여아보다 남아에서 삶의 질 점수가 높았으며 폐기능과 천식 중증도 분류에 따른 비교에서 환아와 보호자 모두 삶의 질에 유의한 차이가 없었지만, 환아의 주관적인 천식 증상 점수를 기준으로 비교하였을 때 증상 점수가 높은 환아와 보호자 군이 낮은 군에 비해 삶의 질 점수가 더 높았다. 결 론:천식 환아와 보호자의 삶의 질을 향상시키기 위해서는 천식 증상 조절을 통한 주관적인 천식 증상 개선이 중요하며 이와 함께 천식 환아와 보호자 모두의 삶의 질을 평가하고 조절하는 것이 이들의 삶의 질 향상을 위하여 반드시 필요하다.
Abstract
Purpose:Pediatric asthma is the most common chronic disease in children. It negatively affects the health-related quality of life (QoL) in children with this disease and of their caregivers. This study evaluated the relationship between clinical disease severity and the QoL of patients with asthma and their caregivers. Methods:The study included 247 patients with asthma and their caregivers. The patients and caregivers completed the Korean Pediatric Asthma Quality of Life Questionnaire and the Korean Pediatric Asthma Caregivers Quality of Life Questionnaire, respectively, during clinic visits. The results were expressed as the mean score for each domain. All items were rated from 1 to 5: 1, low QoL; and 5, satisfactory QoL. Results:The emotion and activity QoL scores of boys were significantly higher than those of girls (P=0.001). The QoL of both patients and their caregivers was correlated more with the patients’ subjective symptom scores than with the clinical severity of asthma or with lung function. Conclusion:The QoL of patients with asthma and their caregivers decreased as asthmatic symptoms became worse. Controlling asthma symptoms is important for improving the QoL of both patients and their caregivers. Patients and their caregivers need to be evaluated and counseled during asthma treatment to improve their QoL.
참고문헌 (30)
- 홍수종, "한국 소아알레르기 질환의 유병률", Korean Journal of Pediatrics, 51(4), pp.343~350 (2008), 대한소아과학회
- Clark NM, "The impact of health education on frequency and cost of health care use by low income children with asthma", J Allergy Clin Immunol, 78(1 Pt 1), pp.108~115 (1986)
- Rachelefsky GS, "patient adherence: the asthma template", Pediatr Asthma Allergy Immunol, 20, pp.146~156 (2007)
- Bender BG, "Overcoming barriers to nonadherence in asthma treatment", J Allergy Clin Immunol, 109(6 Suppl), pp.554~559 (2002)
- Rand CS, "Adherence to asthma therapy in the preschool child", Allergy, 57(Suppl 74), pp.48~57 (2002)
- Ungar WJ, "A qualitative analysis of a dyad approach to health-related quality of life measurement in children with asthma", Soc Sci Med, 63, pp.2354~2366 (2006)
- "GINA report, global strategy for asthma management and prevention" (2006)[URL]
- Bacharier LB, "Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function", Am J Respir Crit Care Med, 170, pp.426~432 (2004)
- Yang E, "Relationship among pulmonary function, bronchial hyperresponsiveness, and atopy in children with clinically stable asthma", LUNG, 184(2), pp.73~79 (2006)
- Cha JK, "Development and multicenter study on Korean pediatric asthma caregiver's quality of life questionnaire (KPACQLQ)", J Asthma Allergy Clin Immunol, 20, pp.480~491 (2000)
- Cha JK, "Development and multicenter study on Korean pediatric asthma quality of life questionnaire (KPAQLQ)", J Asthma Allergy Clin Immunol, 20, pp.492~508 (2000)
- Juniper EF, "Measuring quality of life in asthma", Am Rev Respir Dis, 147, pp.832~838 (1993)
- Juniper EF, "Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials", Thorax, 47, pp.76~83 (1992)
- Rowe BH, "Performance of an asthma quality of life questionnaire in an outpatient setting", Am Rev Respir Dis, 148, pp.675~681 (1993)
- Juniper EF, "Measuring quality of life in children with asthma", Qual Life Res, 5, pp.35~46 (1996)
- Juniper EF, "Quality of life in asthma clinical trials: comparison of salmeterol and salbutamol", Am J Respir Crit Care Med, 151, pp.66~70 (1995)
- Mrazek DA, "Psychiatric complications of pediatric asthma", Ann Allergy, 69, pp.285~290 (1992)
- Kim NH, "The psychological recognition of asthmatic children from parents' views", J Korean Pediatr Soc, 40, pp.1725~1730 (1997)
- Juniper EF, "Determining a minimal important change in a disease-specific Quality of Life Questionnaire", J Clin Epidemiol, 47, pp.81~87 (1994)
- Malo JL, "Quality of life of subjects with occupational asthma", J Allergy Clin Immunol, 91, pp.1121~1127 (1993)
- Juniper EF, "The value of quality of life in asthma", Eur Respir Rev, 7, pp.333~337 (1997)
- Josie KL, "Health-related quality-of-life measures for children with asthma: reliability and validity of the Children's Health Survey for Asthma and the Pediatric Quality of Life Inventory 3.0 Asthma Module", Ann Allergy Asthma Immunol, 98, pp.218~224 (2007)
- Zandieh F, "Assessment of quality of life in Iranian asthmatic children, young adults and their caregivers", Iran J Allergy Asthma Immunol, 5, pp.79~83 (2006)
- Raat H, "Responsiveness, longitudinal- and cross-sectional construct validity of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Dutch children with asthma", Qual Life Res, 14, pp.265~272 (2005)
- Rho HJ, "Factors influencing quality of life of asthmatic patients in Korea", J Asthma Allergy Clin Immunol, 20, pp.209~221 (2000)
- 김의철, "건강과 삶의질에 영향을 주는 요인에 대한 분석: 자기 효능감, 사회적 지원 및 질병관리를 중신으로", 한국심리학회지: 문화 및 사회문제, 11(2), pp.143~181 (2005), 한국문화및사회문제심리학회
- 정지예, "천식 환자에서 전반적 자기 평가와 한국 성인 천식 환자의 삶의 질 평가 설문과의 비교 분석", 천식 및 알레르기, 28(2), pp.134~142 (2008), 대한천식알레르기학회
- van der Molen T, "Quality of life during formoterol treatment: comparison between asthma-specific and generic questionnaires. Canadian and the Dutch Formoterol Investigators", Eur Respir J, 12, pp.30~34 (1998)
- Boushey HA, "Effects of inhaled corticosteroids on the consequences of asthma", J Allergy Clin Immunol, 102(4 Pt 2), pp.5~16 (1998)
- Maillé AR, "Assessing quality of life in chronic non- specific lung disease--a review of empirical studies published between 1980 and 1994", Qual Life Res, 5, pp.287~301 (1996)