Exploring factors influencing asthma control and asthma-specific health-related quality of life among children

Abstract Background Little is known about factors contributing to children’s asthma control status and health-related quality of life (HRQoL). The study objectives were to assess the relationship between asthma control and asthma-specific HRQoL in asthmatic children, and to examine the extent to which parental health literacy, perceived self-efficacy with patient-physician interaction, and satisfaction with shared decision-making (SDM) contribute to children’s asthma control and asthma-specific HRQoL. Methods This cross-sectional study utilized data collected from a sample of asthmatic children (n = 160) aged 8–17 years and their parents (n = 160) who visited a university medical center. Asthma-specific HRQoL was self-reported by children using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Impact Scale. Satisfaction with SDM, perceived self-efficacy with patient-physician interaction, parental health literacy, and asthma control were reported by parents using standardized measures. Structural equation modeling (SEM) was performed to test the hypothesized pathways. Results Path analysis revealed that children with better asthma control reported higher asthma-specific HRQoL (β = 0.4, P < 0.001). Parents with higher health literacy and greater perceived self-efficacy with patient-physician interactions were associated with higher satisfaction with SDM (β = 0.38, P < 0.05; β = 0.58, P < 0.001, respectively). Greater satisfaction with SDM was in turn associated with better asthma control (β = −0.26, P < 0.01). Conclusion Children’s asthma control status influenced their asthma-specific HRQoL. However, parental factors such as perceived self-efficacy with patient-physician interaction and satisfaction with shared decision-making indirectly influenced children’s asthma control status and asthma-specific HRQoL

Exploring factors influencing asthma control and asthma-specific health-related quality of life among children

Abstract Background Little is known about factors contributing to children’s asthma control status and health-related quality of life (HRQoL). The study objectives were to assess the relationship between asthma control and asthma-specific HRQoL in asthmatic children, and to examine the extent to which parental health literacy, perceived self-efficacy with patient-physician interaction, and satisfaction with shared decision-making (SDM) contribute to children’s asthma control and asthma-specific HRQoL. Methods This cross-sectional study utilized data collected from a sample of asthmatic children (n = 160) aged 8–17 years and their parents (n = 160) who visited a university medical center. Asthma-specific HRQoL was self-reported by children using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Impact Scale. Satisfaction with SDM, perceived self-efficacy with patient-physician interaction, parental health literacy, and asthma control were reported by parents using standardized measures. Structural equation modeling (SEM) was performed to test the hypothesized pathways. Results Path analysis revealed that children with better asthma control reported higher asthma-specific HRQoL (β = 0.4, P < 0.001). Parents with higher health literacy and greater perceived self-efficacy with patient-physician interactions were associated with higher satisfaction with SDM (β = 0.38, P < 0.05; β = 0.58, P < 0.001, respectively). Greater satisfaction with SDM was in turn associated with better asthma control (β = −0.26, P < 0.01). Conclusion Children’s asthma control status influenced their asthma-specific HRQoL. However, parental factors such as perceived self-efficacy with patient-physician interaction and satisfaction with shared decision-making indirectly influenced children’s asthma control status and asthma-specific HRQoL

Quality of life information and trust in physicians among families of children with life-limiting conditions

I-Chan Huang1,2, Kelly M Kenzik1, Tuli Y Sanjeev3, Patricia D Shearer3, Dennis A Revicki4, John A Nackashi3, Elizabeth A Shenkman1,21Department of Health Outcomes and Policy, 2Institute for Child Health Policy, 3Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida; 4United BioSource Corporation, Maryland, USAPurpose: To examine information that parents of children with life-limiting conditions want to discuss with children&amp;rsquo;s physicians to assist decision-making, and whether the desire for this information is associated with parents&amp;rsquo; trust in physicians.Study design: A cross-sectional study using a telephone survey.Patients and methods: Subjects comprised a random sample of 266 parents whose children were enrolled in Florida&amp;rsquo;s Medicaid Program. Parents were asked if they wanted to discuss information related to their children&amp;rsquo;s treatment, including quality of life (QOL), pain relief, spiritual beliefs, clinical diagnosis/laboratory data, changes in the child&amp;rsquo;s behavior due to treatment, changes in the child&amp;rsquo;s appearance due to treatment, chances of recovery, and advice from the physician and family/friends. The Wake Forest Physician Trust Scale was used to measure parents&amp;rsquo; trust in physicians. We tested the relationships between parents&amp;rsquo; age, race/ethnicity, education, parent-reported children&amp;rsquo;s health status, and the desired information. We also tested whether the desire for information was associated with greater trust in physicians.Results: Most parents wanted information on their children&amp;rsquo;s QOL (95%), followed by chance of recovery (88%), and pain relief (84%). Compared with nonHispanic whites, nonHispanic blacks and Hispanics showed a greater desire for information and achieve to discuss QOL information had greater trust in their children&amp;rsquo;s physicians than other information after adjusting for covariates (P &amp;lt; 0.05).Conclusions: Among children with life-limiting conditions, QOL is the most frequently desired information that parents would like to receive from physicians as part of shared decision-making. Parents&amp;rsquo; desire for QOL information is associated with greater trust in their children&amp;rsquo;s physicians.Keywords: children, information, life-limiting condition, quality of life, shared decision-makin

The Association of English Functional Health Literacy and the Receipt of Mammography among Hispanic Women Compared to Non-Hispanic U.S.-Born White Women.

Breast cancer is a leading cause of cancer death among Hispanic women in the U.S., and mammography is the recommended screening for early diagnosing and preventing breast cancer. Several barriers exist to influence mammography utilization including poor health literacy. However, it is unclear whether the effect of health literacy on mammography utilization is consistent between Hispanic women and non-Hispanic White women. The main objective of this study was to examine association between functional health literacy and the receipt of mammography among Hispanic women compared to non-Hispanic White women in the U.S.A cross-sectional design using participants engaged in the National Assessment of Adult Literacy. Study sample comprised of 4,249 Hispanic and non-Hispanic U.S.-born White women ≥ 40 years of age who completed the functional health literacy assessment. Regression analyses were performed to test the association between health literacy and receipt of mammography. Among Hispanic women, analyses considered the influence of language-preference acculturation.Equal percentages of Hispanic (59.3%) and non-Hispanic White (60.6%) women received mammography. After adjusting for covariates, health literacy was positively associated with receiving mammography among U.S.-born White women (β = 0.14, p<0.001), but negatively associated with mammography among Hispanic women (β = -0.13, p<0.001). Analyses stratified by acculturation status revealed that higher health literacy was associated with lower mammography among language-preference acculturated Hispanic women (β = -0.48, p<0.001), yet an opposite result among less acculturated Hispanic women (β = 0.08, p<0.001).Functional health literacy has different associations with mammography depending upon ethnicity. Language-preference acculturation may explain the differing association

Multivariate analyses for the associations of health literacy with mammography by ethnicity and language-preference acculturation.

<p>Multivariate analyses for the associations of health literacy with mammography by ethnicity and language-preference acculturation.</p

Sample characteristics by ethnicity and language-preference acculturation.

<p>Sample characteristics by ethnicity and language-preference acculturation.</p

Multivariate analyses for the associations of health literacy with mammography by ethnicity and language-preference acculturation.

<p>Multivariate analyses for the associations of health literacy with mammography by ethnicity and language-preference acculturation.</p