Family management variables predict quality of life in children with chronic conditions

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Children with attention deficit disorder or developmental delay have the greatest risk for activity difficulties.
Children with attention deficit disorder or developmental delay have the greatest risk for activity difficulties.
The following article is part of The Clinical Advisor's coverage from the National Association of Pediatric Nurse Practitioners' 39th National Conference on Pediatric Health Care in Chicago. Our staff will be reporting live on the latest news and clinically relevant practice information from leading pediatric NPs in many specialty areas. Check back for ongoing updates from NAPNAP 2018. 

CHICAGO—Family management variables, such as changes in parents' work life, are associated with quality of life measures in children with chronic conditions, according to research presented at the National Association of Pediatric Nurse Practitioners' 39th National Conference on Pediatric Health Care.

Janet Gehring, PhD, CRNP, CPNP-PC, Assistant Clinical Professor at the Catholic University of America School of Nursing in Washington, DC, analyzed the predictive risk/protective aspects as well as family management values on quality of life (QOL) in children with special healthcare needs (CSHCN) with outcomes including emotional challenges, activity challenges, and missed school days (values were controlled for behavioral circumstances).

Of the 40,242 child participants, a majority were male (60.2%), with the largest group of children ranging from ages 12 to 17 years (42.5%); 69.9% were white.

The 9 most common health conditions among the cohort were allergies (51.6%), asthma (39.7%), attention deficit disorder (ADD) or attention-deficit/hyperactivity disorder (1.9%), developmental delay (22.1%), anxiety (20.7%), conduct disorder or oppositional defiant disorder (14.0%), depression (13.9%), migraine headaches/frequent headaches (11.0%), and autism (10.0%).

When assessing the impact of family management, risk/protective factors on emotional behavioral challenges (controlling for emotional behavioral conditions) results revealed significantly elevated odds of depression (odds ratio [OR], 9.55) and anxiety (OR, 10.42).

In the activity challenges outcome, the greatest risks were in children with ADD (OR, 11.88) and development delay (OR, 10.14). Activity limitations helped predict the final outcome studied, missed school days. Children that required 5 to 10 hours of care per week had an odds ratio of 1.55 for missing school, while children who required more than 11 hours of care per week had an odds ratio of 1.63 for missing school. This was most significant in children with depression (OR, 1.39).

“For management of CSHCN, healthcare providers need to assess aspects of family management and quality of life,” wrote Dr Gehring. “It is important for providers to assess aspects of family management such as hours of care, the child's activity limitations, and any changes in family work life and their relationship to a child's quality of life.”

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Reference

  1. Gehring J. Family management, risk/protective factors, and quality of life among pediatric chronic conditions. Presented at the National Association of Pediatric Nurse Practitioners 2018 National Conference; March 19-22, 2018; Chicago.
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