Children's Food Allergies: Assessing Family Management and Adaptation

儿童食物过敏：评估家庭管理和适应

• 批准号: 8015216
• 负责人: Mary D. Klinnert
• 金额: $ 18.79万
• 依托单位: NATIONAL JEWISH HEALTH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-20 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8015216
• 关键词: Accounting; Address; Affect; Allergic; Allergic Reaction; American; Anxiety; Asthma; Attention; Behavior; Child; Childhood; Country; Development; Distress; Equilibrium; European; Family; Family Study; Food; Food Hypersensitivity; Frequencies; Fright; Goals; Hypersensitivity; Intervention; Interview; Lead; Life; Measures; Parents; Pattern; Preparation; Prevalence; Quality of life; Reaction; Research; Safety; Schools; Services; Stress; System; base; coping; design; experience; family management; instrument; programs; psychosocial; public health relevance; service intervention; therapy development; tool; vigilance

DESCRIPTION (provided by applicant): Among children in North American and European countries, allergies to foods have increased in prevalence. This increase is accompanied by significant impact on families' quality of life and psychosocial functioning. Studies of families with food allergic children have shown a variety of negative effects consequent to the strains of daily management involving avoidance of indicated foods, as well as anxiety and distress that results from constant vigilance and fear of life-threatening reactions. However, it is unknown what proportion of families with food allergic children experience disabling psychosocial consequences. Given the increasing prevalence of pediatric food allergy (FA), there is an urgent need for a better understanding of how well parents are able to execute a food allergy management plan, how much anxiety and distress they experience as they struggle to manage food allergies, and to what extent they are achieving a balance between insuring their children's safety while achieving normative developmental and family functions. Maladaptive family patterns are believed to include both under-responders and over- responders; however, no measure exists to assess and describe these patterns of adaptation. Existing measures assess food allergy related quality of life or impact of food allergies on families, but no measure takes into account the adequacy with which families integrate management demands into a smoothly functioning and balanced family life. To address this need, we propose to develop an interview-based measure of family management and adaptation to children's food allergies based on an instrument previously developed by our research group for assessing family asthma management-the Family Asthma Management System Scale (FAMSS). The behaviors required for effective management of asthma are well understood, and have many similarities to the behaviors required for the management of food allergies. The resulting food allergy adaptation measure will be used to identify patterns of family adaptation to food allergies based on adequacy of action taken for avoidance and allergic reaction preparation as well as levels of anxiety and distress regarding various aspects of the children's food allergies. The patterns of adaptation and levels of distress that are identified with the new measure will lead to the development of intervention services tailored to the needs of families with maladaptive patterns. We expect that the information derived from this R21 project will form the basis of an R01 application to design, deliver and evaluate a psychosocial intervention for families of children with food allergies. PUBLIC HEALTH RELEVANCE: Food allergies have increased dramatically in prevalence in the past decade. The public media has drawn attention to the severe impact on families of food allergic children due to the strains of daily management and the anxiety and distress that results from constant vigilance and fear of life-threatening reactions. Attention has also turned to the needs of food-allergic children in the public school setting, where both affected and unaffected children are impacted. The goal of this study is to develop an interview-based measure of families' food allergy management and adaptation. With this tool it will be possible to evaluate families' adaptation to their children's food allergies, to determine how many families have significant distress or difficulty managing, and to develop services for families with difficulties in coping.

描述（由申请人提供）：在北美和欧洲国家的儿童中，食物过敏的患病率有所增加。这种增加伴随着对家庭生活质量和心理社会功能的重大影响。对有食物过敏儿童的家庭的研究表明，由于日常管理的压力，包括避免指定食物，以及因持续警惕和担心危及生命的反应而导致的焦虑和痛苦，会产生各种负面影响。然而，尚不清楚有食物过敏儿童的家庭中有多少比例经历了残疾性心理社会后果。鉴于儿童食物过敏（FA）的患病率不断增加，迫切需要更好地了解父母执行食物过敏管理计划的能力，以及他们在努力管理食物过敏时经历的焦虑和痛苦程度，他们在多大程度上在确保孩子的安全与实现规范的发展和家庭功能之间取得了平衡。适应不良的家庭模式被认为包括反应不足和反应过度的家庭。然而，不存在评估和描述这些适应模式的措施。现有的措施评估与食物过敏相关的生活质量或食物过敏对家庭的影响，但没有任何措施考虑到家庭将管理要求融入到顺利运转和平衡的家庭生活中的充分性。为了满足这一需求，我们建议基于我们研究小组先前开发的用于评估家庭哮喘管理的工具——家庭哮喘管理系统量表（FAMSS），开发一种基于访谈的家庭管理和适应儿童食物过敏的措施。有效治疗哮喘所需的行为已广为人知，并且与治疗食物过敏所需的行为有许多相似之处。由此产生的食物过敏适应措施将用于根据为避免和过敏反应准备而采取的充分行动以及儿童食物过敏各个方面的焦虑和痛苦程度来确定家庭对食物过敏的适应模式。新措施确定的适应模式和痛苦程度将导致开发适合适应不良模式家庭需求的干预服务。我们预计从 R21 项目中获得的信息将构成 R01 应用程序的基础，为食物过敏儿童的家庭设计、提供和评估心理干预措施。 公共卫生相关性： 在过去的十年中，食物过敏的患病率急剧上升。由于日常管理的压力以及对危及生命的反应的持续警惕和恐惧而产生的焦虑和痛苦，公共媒体已经引起了人们对食物过敏儿童家庭的严重影响的关注。人们的注意力也转向公立学校环境中食物过敏儿童的需求，受影响和未受影响的儿童都受到影响。本研究的目的是制定一种基于访谈的家庭食物过敏管理和适应措施。有了这个工具，就可以评估家庭对孩子食物过敏的适应情况，确定有多少家庭有严重的痛苦或管理困难，并为有应对困难的家庭提供服务。