Please use this template to create presentations utilizing the WVU brand. Perceptions of Asthma QOL in Child-parent Dyads in two Rural Counties in West Virginia Susan Pinto, APRN Susan McCrone, PhD, PMHCNS-BC Supported by a grant from the Sisters of Saint Joseph Charitable Fund In Honor and Memory of our late friend and colleague, Dr. Heidi Putman-Casdorph

Objectives The participant will be able to understand relationships between perceived QOL in child-parent/ guardian dyads living with asthma The participant will identify strategies to utilize a QOL assessment tool in school settings. The participant will understand the importance of academic/school partnerships to improve health outcomes in school aged children.

Background & Significance Asthma – one of most common chronic disorders of childhood: Affects nearly 7 million children under age 181 One of leading causes of missed school days 2 Annual U.S. health care costs $56 billon 3 Stressful symptoms impact QOL for child and parent

QOL related to asthma severity Related to source of information and type of instrument Recommended use of asthma-specific QOL tool 4 Rural school aged children Coping frequency, asthma severity & minority status predicted child’s asthma QOL using PAQOL scale 5 Child and parent perception of health related QOL influenced by asthma control 6, 7

Poorly controlled asthma symptoms impaired QOL of children and caregivers 6 One study addressed agreement of child parent scores Mean scores for children lower than parents perception except for older children with severe asthma 8

Educational interventions improved parent’s QOL symptom assessment and was associated with child’s asthma management 9 Case management improved child’s perceived QOL in relation to asthma symptom and treatment scores10

Methods IRB and Board of Education approval obtained Child/parent dyads recruited from 2 WV schools in Health Professional Shortage Areas School nurses (trained as study personnel) sent recruitment letters to children with Asthma Action plans, collected demographics on participants, and administered Peds QL 3.0 TM Asthma Module to children 11

Parents completed tool at home and returned them to school Data analysis with SPSS Frequencies and descriptive statistics calculated on demographics Mean scores calculated for each dimension Correlations calculated between child to child, parent to parent, and parent to child dimensions on the Peds QLTM 3.0 Asthma module

Instrument The Peds QL TM 3.0 Asthma module was used to describe the child’s and parent’s perceptions of problems with four dimensions: asthma symptoms asthma treatment aspects of worry communication about problems with asthma

Four Dimensions Asthma (11 items) - focused on problems related to asthma symptoms like chest pain or tightness, wheezing, and ability to take deep breaths Treatment (11 items) - focused on problems with administration, use and side effects of medications Worry (3 items) - focused on problems related to treatment side effects and effectiveness and worry about asthma in general Communication (3 items) – focused on problems the child has talking to health care providers about his/her asthma

Demographics of Children Participating (N = 49) Characteristics N Range % Age (Years) Mean SD 9.59 1.31 7-11 N/A Gender Male Female 25 24 51.0 49.0 Race/Ethnicity White Black Biracial 43 1 5 87.8 2.0 10.2 Number of School Days Missed 6.82 5.61 0-26

Demographics of Children Participating (N = 49) Characteristics N Range % Comorbidities Yes No 17 28 N/A 37.8 62.2 Allergies 8 37 17.8 82.2 Lives with One Parent Two Parents 12 36 25.0 75.0

Results Pearson’s Correlations (r) Between Asthma Module PedsQL™ 3.0 Dimension Scores Child Asthma Child Treatment Worry Communication Adult Treatment ------   .663** .511** .564** .162 .665** .611** .326* .535** .083 .468** .215 .431** .473** .320* .361* .464**

Results Higher child mean scores in all dimensions compared to QOL scores in children with asthma in the literature Parents of males perceived son’s QOL to be higher in asthma and treatment dimension Strongest relationships between child treatment and child worry dimensions & child asthma and child treatment dimensions Strong relationships between child asthma & child communication scores, child worry & child communication, and child asthma & child worry

Implications School nurses positioned to serve as educator, case manager and advocate for children in rural settings as they may be only health care provider children see on a regular basis Permission was received from author of PedsQL™ 3.0 Asthma Module for school nurses to use the tool in school settings 11 Implementing the routine use of an asthma QOL assessment tool that explores child & parent perceptions would provide information to enhance the care and potentially the QOL of children living with asthma.

How to access the tool??? Log on to www.proqolid.org Search for Peds QL 3.0 Asthma Module Select and click on “Conditions of Use” tab Scroll to bottom of the page and click “Download” Complete user agreement ··         ·         

Download, continued Click “Next” at the end of each page Make sure to select option that you intend to use the questionnaire in non-funded academic studies, individual practice only Follow the next instructions to download the questionnaire (a new screen will appear and you will be able to download the questionnaires by clicking on each link highlighted in orange)

TERESA BAYER MOOREHEAD JUDY HUDSON KERI STRAIGHT SPECIAL THANK YOUS!!!!!!!!! TERESA BAYER MOOREHEAD JUDY HUDSON KERI STRAIGHT

Questions ?????? Contact Info- Susan Pinto=spinto@hsc.wvu.edu Susan McCrone= smccrone@hsc.wvu.edu