Differences Between Child and Parent Reports of Symptoms Among Latino Children With Asthma

Abstract

ABSTRACT. Objectives. To determine, in a population of predominantly Latino children with asthma 6 to 18 years old, whether parent and child reports of asthma symptoms with exercise differ and to evaluate the validity of child and parent reports of symptoms.Design. Data obtained from child and parent interviews; pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow , peak expiratory flow), and observation of symptoms after exercise.Setting. Three summer camps for minority children with asthma in Los Angeles County.Participants. A total of 97 children with asthma (78% Latino, 12% non-Latino White, 9% Other; 6 to 18 years of age) and their parents.Intervention(s). None. Primary Outcome Measures. Child and parent reports of cough and wheezing with exercise and pulmonary function tests before and after exercise. While at camp, children underwent spirometry after completing the selfadministered survey. The pulmonary function tests were conducted and interpreted according to the pediatric specifications for spirometry, and results >80% of predicted, adjusted for gender, age, height, and race, were considered normal. Six peak expiratory flow rates (PEFR) by peak flow meter also were recorded by trained research assistants immediately before spirometry, and values >80% of predicted based on height were considered normal. To observe child symptoms with exercise, children participated in a relay running race of 200 feet followed by a swimming race of 300 feet. Research assistants measured heart rate and 6 PEFRs using ASSESS portable peak flow meters immediately before and after each exercise. A positive exercise challenge was defined as a 15% reduction in mean PEFR and/or observed asthma symptoms (cough, wheezing, chest pain, asthma attack).Results. Of the children, 18% reported never having a cough when they exercised, 46% reported having it occasionally when they exercised, and 36% reported having it quite often or always when they exercised. For wheezing, 20% of children reported never having wheezing when they exercised, 35% having it occasionally when they exercised, and 45% having it quite often or always when they exercised. Parents reported fewer symptoms than did their children. Of the parents, 34% reported that their children did not have cough with exercise, 37% reported few to some days, and 29% reported most days or every day. Forty-seven percent of parents reported that their child did not wheeze with exercise in the last 2 months, 35% reported wheezing on a few days to some days, and 17% reported wheezing most days to every day.Parent and child reports of cough or wheezing after exercise correlated mildly with each other (parent/child cough r ‫؍‬ 0.23; ‫؍‬ 0.03; parent/child wheezing r ‫؍‬ 0.21; ‫؍‬ 0.14). Children were more likely to report cough: 59 of 71 (83%) of children versus 44 of 71 (62%) of parents. The 22 children who reported cough when their parents did not account for most of the disagreement between parents and children. Children were mo...

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

“…This finding is similar to what others have suggested for report of daytime symptoms (Braun-Fahrlander et al, 1998;Fritz, McQuaid, Spirito, & Klein, 1996;Horak, Grassl, Skladal, & Ulmer, 2003;Lara et al, 1998);Mittal, Khanna, Panjabi, & Shah, 2006;Renzoni et al, 1999). Parents and children can be taught symptom specific identification skills, such as wheezing (Lee, Arroyo, & Rosenfeld, 1996), and this can be a focus of educational efforts, especially if the child has moderate-severe symptoms where inaccurate appraisal has had the greatest negative impact on control assessments (Halterman, 2006).…”

Development of a Web-based questionnaire to collect exposure and symptom data in children and adolescents with asthma

“…Differences between parent and child reports of asthma symptoms in the child have been published, with parent's reports underestimating the number of symptoms compared with their children's reports. 15,16 The Web-based system also has the advantages of immediate access to results for preliminary analyses and for calculating incentives for participants based on response rate, identifying individuals who are not completing the questionnaire routinely or within a short time so that steps may be taken during the study to try to minimize recall bias, and reducing errors involved in the transcription of data. The data collected in this study are being evaluated to determine whether associations exist between the participants' peak expiratory flow rates or symptoms of asthma and air pollutant concentrations measured in the community (sulfur dioxide and particulate matter).…”

Asma inducida por ejercicio: Diferencias en la percepciónde síntomas entre pacientes pediátricos y sus padres

“…En la práctica clínica habitual, es frecuente que el personal de salud se base en la historia aportada por los padres más que preguntar al paciente acerca de sus síntomas, sin embargo, en asma inducida por ejercicio, la correlación que existe entre la percepción de padre respecto de la del hijo acerca de los síntomas es muy pobre y es reconocida 6,[13][14][15] . Nuestro estudio confirma este hecho en una población de escolares con asma, dejando además en evidencia el poco conocimiento que tienen los padres de la actividad física regular de sus hijos.…”

“…Esto sustentado en el hecho que los escolares con asma son capaces de aportar una historia confiable respecto de sus síntomas y limitaciones producidas por el ejercicio 7,[13][14][15][16][17][18][19] . La prueba de ejercicio es una prueba funcional de alta especificidad pero baja sensibilidad.…”