Renee DeLeuil

Date of Award

1-1-2006

Document Type

Thesis - ECU Access Only

Publisher

Edith Cowan University

Degree Name

Master of Nursing

School

School of Nursing, Midwifery and Postgraduate Medicine

Faculty

Faculty of Computing, Health and Science

First Supervisor

Leanne Monterosso

Second Supervisor

Peter Richmond

Abstract

Introduction: Allergic diseases are highly prevalent conditions that have significant social and economic implications. Seasonal allergic rhinitis (SAR) is a common disease characterised by nasal itch and sneezing. It is estimated that the prevalence of SAR in the Australian population is around 41 %. A recent study found that the prevalence of rhinitis in Australian children is among the highest in the world. Despite this there have been no Australian studies performed to assess the impact of SAR on children and their caregivers.

Objectives: To assess the impact of SAR on the quality of life of children aged 6 to 12 years, and on caregivers of caring for a child with SAR.

Design: A prospective single cohort study was conducted. Participants included children suffering from Seasonal Allergic Rhinitis (SAR) and their caregivers who were seen at a single visit.

Setting: The study was conducted during the pollen seasons of the years 2003 and 2004. The setting for this "tudy was the Allergy/Immunology and Ear, Nose and Throat (ENT) outpatient clinics at Princess Margaret Hospital (PMH) for Children in Perth Western Australia.

Sample: Sixty children and their caregivers were recruited from the outpatient department of the major paediatric tertiary referral centre for Western Australia.

Method: Sixty children and 59 caregivers were recruited between 12 September 2003 and 5 December 2004 (during the pollen season of these years). Children were assessed using the 'Paediatric Rhinoconjunctivitis Quality of Life Questionnaire'. This questionnaire comprised five domains: nose symptoms, eye symptoms, practical problems, impact on daily activities and other symptoms of SAR. Caregivers were assessed using a previously validated questionnaire that assessed the impact of a child's SAR on their lives. This questionnaire also comprised five domains focusing on the impact of caring for a child with SAR on: social activities, routine daily activities, ability to work, ability to be productive at work and how much they worry about their child. Caregivers were also asked questions about their child’s sleeping habits. All questionnaires were completed by participants following informed consent.

Results: Results from the children's questionnaire, indicated that SAR has a significant impact on the child's daily life, in particular related to eye and nose symptoms. Children also reported feeling tired and irritable due to the symptoms of SAR. Further, children also reported sleep difficulties, which corresponded to the results from the caregiver questionnaire about their child's sleep. When children and caregiver results were analysed by severity of the child's SAR (either severe or moderate) the moderate sufferers recorded higher median scores in the eye symptom domain, the severe group recorded higher median scores in the nose symptom and practical problem domains, equivalent median scores in the Other symptoms domain and a statistically significant higher median for the activities domain (i.e. children in this group experienced a more severe impact on their activities). Caregivers also reported their child's SAR impacted on their own work and non-work activities and that their child's SAR did cause them to worry about their child's health. Caregivers reported observing their children to have poor sleep patterns, and difficulty affording the medications.

Conclusions: Results indicated that SAR does have an impact on aspects of quality of life of children and their caregivers, which concurs with findings from previous international studies. The use of the quality of life tool to assess these children provides clinically important results which suggest that it could be used effectively and routinely in the clinical setting to improve both patient outcomes and satisfaction. Further education of caregivers, health professionals and teachers is needed to improve awareness of the impact of SAR in this age group.

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