Health care experiences of mothers of children with bronchiectasis in Counties Manukau, Auckland, New Zealand

Relationship between maternal communicative/critical health literacy and child's asthma symptoms: Results from a population-based survey in metropolitan Japan

OBJECTIVE

To examine the association between maternal communicative/critical health literacy (CCHL) and child's asthma symptoms.

METHODS

In a population-based survey in greater Tokyo (N = 790 mother-child [aged 2-11 years] pairs), maternal CCHL was assessed with a validated questionnaire, and the presence of asthma symptoms in children was assessed by parent report using the International Study of Asthma and Allergies in Childhood score. Multiple logistic regression was conducted to analyze the association between child's asthma and maternal health literacy, adjusting for potential confounders.

RESULTS

The prevalence of child's asthma in the past year was significantly higher in the high maternal CCHL group than in the low CCHL group (18.0% vs 12.3%,p;0.035). High maternal CCHL was positively associated with the presence of child's asthma symptoms after adjusting for the child's clinical factors; household income; and maternal educational attainment, psychological distress, and employment status (coefficient = 0.494, 95% confidence interval: 0.012-0.976).

CONCLUSION

High maternal CCHL does not necessarily lead to appropriate asthma control in children. CCHL's role in information overload environments requires further investigation.

PRACTICE IMPLICATIONS

Health care practitioners should provide support even to parents with high CCHL to enable them to make appropriate decisions.

Health-resource use and quality of life in children with bronchiectasis: a multi-center pilot cohort study

Background

Bronchiectasis in children is an important, but under-researched, chronic pulmonary disorder that has negative impacts on health-related quality of life. Despite this, it does not receive the same attention as other chronic pulmonary conditions in children such as cystic fibrosis. We measured health resource use and health-related quality of life over a 12-month period in children with bronchiectasis.

Methods

We undertook a prospective cohort study of 85 children aged < 18-years with high-resolution chest computed-tomography confirmed bronchiectasis undergoing management in three pediatric respiratory medical clinics in Darwin and Brisbane, Australia and Auckland, New Zealand. Children with cystic fibrosis or receiving cancer treatment were excluded. Data collected included the frequency of healthcare attendances (general practice, specialists, hospital and/or emergency departments, and other), medication use, work and school/childcare absences for parents/carers and children respectively, and both parent/carer and child reported quality of life and cough severity.

Results

Overall, 951 child-months of observation were completed for 85 children (median age 8.7-years, interquartile range 5.4–11.3). The mean (standard deviation) number of exacerbations was 3.3 (2.2) per child-year. Thirty of 264 (11.4%) exacerbation episodes required hospitalization. Healthcare attendance and antibiotic use rates were high (30 and 50 per 100 child-months of observation respectively). A carer took leave from work for 53/236 (22.5%) routine clinic visits. Absences from school/childcare due to bronchiectasis were 24.9 children per 100 child-months. Quality of life scores for both the parent/carer and child were highly-correlated with one another, remained stable over time and were negatively associated with cough severity.

Conclusions

Health resource use in this cohort of children is high, reflecting their severe disease burden. Studies are now needed to quantify the direct and societal costs of disease and to evaluate interventions that may reduce disease burden, particularly hospitalizations.

Electronic supplementary material

The online version of this article (10.1186/s12913-019-4414-5) contains supplementary material, which is available to authorized users.