26-01-2021 | Uitgave 5/2021
Influences of health and environmental deprivation on family relationships among children with chronic disease
- Tijdschrift:
- Quality of Life Research > Uitgave 5/2021
Belangrijke opmerkingen
Supplementary information
The online version of this article (https://doi.org/10.1007/s11136-020-02737-6) contains supplementary material, which is available to authorized users.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Abstract
Purpose
Families play a key role in managing chronic illness. Among chronically ill children, we describe the Patient-Reported Outcomes Measurement Information System (PROMIS) Family Relationships measure over time and its associations with sociodemographics, environmental deprivation, and health.
Methods
Parents of children aged 8–18 years with asthma (n = 171), type 1 diabetes (n = 199), or sickle cell disease (n = 135), recruited in pediatric clinics and emergency departments (ED), completed demographic surveys. Every six months for up to three years, children completed PROMIS Family Relationships, Anxiety, and Depressive Symptoms short forms (T-scores; mean 50, SD = 10), and a 5-level health status item. Linear mixed models were fit to estimate associations.
Results
Older baseline age was associated with weaker family relationships. For example, for each 3-year higher baseline age, relationships were 3 points weaker for males (− 3.0; 95%CI − 5.7 to − .0.2) and females (− 3.1; 95%CI − 6.0 to − 0.3) with asthma recruited in the ED. For each 1-unit higher mean overall health, relationships were 4.6 points (95%CI 3.2–6.1) stronger for children with diabetes and about 2 points stronger for children with asthma (2.3; 0.7–3.9) and sickle cell disease (2.1; 0.3–3.9). Family relationships were 0.3–0.5 points weaker for each 1-unit increment in mean anxiety or depressive symptoms across all three diseases. Relationships were not significantly associated with environmental deprivation and generally stable over time.
Conclusions
Family relationships were weaker among older children and generally stable over time, yet fluctuated with physical and mental health. Monitoring PROMIS Family Relationships scores may facilitate referrals for chronically ill children who need support.