Impact of peanut allergy on quality of life, stress and anxiety in the family
TL;DR: The impact of PA on QoL and reported anxiety of children with clinically confirmed PA, their parents and older siblings, and all family members is established.
Abstract: Background: Peanut allergy (PA) is known to impact on quality of life (QoL) of the sufferer, but little research has focused on all family members. We therefore sought to establish the impact of PA on QoL and reported anxiety of children with clinically confirmed PA, their parents and older siblings. Methods: Forty-six families, who had a child with PA, completed QoL (PedsQLTM or WHOQOL-BREF), anxiety (SCAS or STAI) and perceived stress (PSS) scales. PA children completed a PA specific QoL questionnaire (Pediatr Allergy Immunol 2003;14:378). Parents and sibling also completed QoL proxy questionnaires for the PA child (PedsQLTM, Pediatr Allergy Immunol 2003;14:378). Results: Mothers rated their own psychological (P < 0.01) and physical (P < 0.05) QoL significantly worse than fathers rated theirs, and had higher scores than fathers for anxiety (P < 0.05) and stress (P < 0.001). Children with PA had significantly poorer physical health-related QoL (P < 0.05), QoL within school (P < 0.01) and general QoL (P < 0.05) than their siblings did, and greater separation anxiety (P < 0.05). The majority of differences were between girls with PA and female siblings. Mothers felt that there was a greater impact on QoL for their PA child, compared with that reported by siblings, fathers or the PA children themselves (P < 0.01). Conclusions: Mothers report that they have significantly poorer QoL and suffer more anxiety and stress than fathers do; this inter-parental difference may be an important feature of family stress caused by PA. Siblings have a similar view of how QoL affects the PA child as the PA child does, while mothers may possibly overestimate this impact.
Figures (4)
Table 2. Anxiety (SCAS) and quality of life (PedsQL TM ) mean scores (and standard deviations) for allergic children and siblings, with norm data for healthy children 
Table 4. Quality of life (PedsQL TM ) mean scores (and standard deviations) for allergic children with and without other atopic conditions 
Table 1. Anxiety (STAI), stress (PSS) and quality of life (WHOQOL-BREF) mean scores (and standard deviations) for parents, with norm data for healthy adults 
Table 3. Anxiety (SCAS) and quality of life (PedsQL TM ) mean scores (and standard deviations) for girls and boys with PA and male and female siblings
Citations
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Harvard University1, Cincinnati Children's Hospital Medical Center2, Duke University3, University of Arkansas for Medical Sciences4, Icahn School of Medicine at Mount Sinai5, Johns Hopkins University School of Medicine6, National Institutes of Health7, St Mary's Hospital8, University of Southampton9, LSU Health Sciences Center Shreveport10, University of Rochester Medical Center11, Rutgers University12, Boston Children's Hospital13, University of California, San Diego14, University of Colorado Denver15, Oregon Health & Science University16, University of Tennessee Health Science Center17, Food and Drug Administration18, University of California, Irvine19, Scripps Health20, University of Manitoba21, Children's National Medical Center22, University of Rochester23, University of Minnesota24
TL;DR: The National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy, which include a consensus definition for food allergy.
Abstract: Food allergy is an important public health problem that affects children and adults and may be increasing in prevalence. Despite the risk of severe allergic reactions and even death, there is no current treatment for food allergy: the disease can only be managed by allergen avoidance or treatment of symptoms. The diagnosis and management of food allergy also may vary from one clinical practice setting to another. Finally, because patients frequently confuse nonallergic food reactions, such as food intolerance, with food allergies, there is an unfounded belief among the public that food allergy prevalence is higher than it truly is. In response to these concerns, the National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy. These Guidelines are intended for use by a wide variety of health care professionals, including family practice physicians, clinical specialists, and nurse practitioners. The Guidelines include a consensus definition for food allergy, discuss comorbid conditions often associated with food allergy, and focus on both IgE-mediated and non-IgE-mediated reactions to food. Topics addressed include the epidemiology, natural history, diagnosis, and management of food allergy, as well as the management of severe symptoms and anaphylaxis. These Guidelines provide 43 concise clinical recommendations and additional guidance on points of current controversy in patient management. They also identify gaps in the current scientific knowledge to be addressed through future research.
2,014 citations
TL;DR: The illustrated World Allergy Organization (WAO) Anaphylaxis guidelines focus on the supreme importance of making a prompt clinical diagnosis and on the basic initial treatment that is urgently needed and should be possible even in a low resource environment.
748 citations
Charité1, Aarhus University Hospital2, Medical University of Vienna3, University of Amsterdam4, Transylvania University5, University of Zurich6, Technische Universität München7, King's College London8, University of Cartagena9, Swiss Institute of Allergy and Asthma Research10, Queensland University of Technology11, Hospital Clínico San Carlos12, University of Salzburg13, Johns Hopkins University School of Medicine14, Katholieke Universiteit Leuven15, University of Giessen16, University of Lübeck17, Wrocław Medical University18, Australian Institute of Tropical Health and Medicine19, Utrecht University20, Guy's and St Thomas' NHS Foundation Trust21, Helsinki University Central Hospital22, Centre Hospitalier de Luxembourg23, Icahn School of Medicine at Mount Sinai24, University of Manchester25, University of Virginia26, Copenhagen University Hospital27, Ruhr University Bochum28, Karolinska University Hospital29, Paul Ehrlich Institute30, University of Colorado Denver31, Boston Children's Hospital32, University of Padua33, University of Southern Denmark34
TL;DR: The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) as mentioned in this paper provides comprehensive information on important allergens and describes the diagnostic options using component-resolved diagnosis (CRD).
Abstract: The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.
558 citations
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TL;DR: A series of consensus documents called International Consensus ON (ICON) are being developed to serve as an important resource and support physicians in managing different allergic diseases.
Abstract: Food allergies can result in life-threatening reactions and diminish quality of life. In the last several decades, the prevalence of food allergies has increased in several regions throughout the world. Although more than 170 foods have been identified as being potentially allergenic, a minority of these foods cause the majority of reactions, and common food allergens vary between geographic regions. Treatment of food allergy involves strict avoidance of the trigger food. Medications manage symptoms of disease, but currently, there is no cure for food allergy. In light of the increasing burden of allergic diseases, the American Academy of Allergy, Asthma & Immunology; European Academy of Allergy and Clinical Immunology; World Allergy Organization; and American College of Allergy, Asthma & Immunology have come together to increase the communication of information about allergies and asthma at a global level. Within the framework of this collaboration, termed the International Collaboration in Asthma, Allergy and Immunology, a series of consensus documents called International Consensus ON (ICON) are being developed to serve as an important resource and support physicians in managing different allergic diseases. An author group was formed to describe the natural history, prevalence, diagnosis, and treatment of food allergies in the context of the global community.
551 citations
TL;DR: The unique World Allergy Organization (WAO) Guidelines for the Assessment and Management of Anaphylaxis incorporate contributions from more than 100 allergy/immunology specialists on 6 continents received through the WAO member societies and theWAO Board of Directors.
Abstract: The uniqueWorld Allergy Organization (WAO) Guidelines for the Assessment and Management of Anaphylaxis were created in response to the absence of global guidelines for anaphylaxis. They were developed after documenting that essential medications, supplies, and equipment for assessment andmanagement of anaphylaxis are not universally available worldwide. Additionally, they were developed with the awareness that any health care professional might, at some time, have to assess and manage anaphylaxis in a low-resource environment, whether this be a country, a region, or a specific location, such as an aircraft cabin or a remote area. They incorporate contributions frommore than 100 allergy/immunology specialists on 6 continents received through the WAO member societies and the WAO Board of Directors. In order to transcend language barriers, the principles of anaphylaxis assessment and management set forth in the guidelines are summarized in 5 comprehensive illustrations. The guidelines review patients’ risk factors for severe or fatal anaphylaxis, cofactors that amplify anaphylaxis, and anaphylaxis in vulnerable patients, such as pregnant women, infants, and the
523 citations
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TL;DR: The STAI as mentioned in this paper is an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level, which is appropriate for those who have at least a sixth grade reading level.
Abstract: The STAI serves as an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level.The STAI, which is appropriate for those who have at least a sixth grade reading level, contains four-point Likert items. The instrument is divided into two sections, each having twenty questions. Approximately 15 minutes are required for adults to complete the both STAI. The number on the scale is positively correlated to the anxiety related to in the question.
24,997 citations
TL;DR: The Perceived Stress Scale showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance and was a better predictor of the outcome in question than were life- event scores.
Abstract: This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
23,500 citations
"Impact of peanut allergy on quality..." refers background in this paper
...Perceived stress scale - 14 (PSS-14) (18) is a 14-item self-report measure, which asks about thoughts and feelings in the last month and includes items such as In the last month, how often have you dealt with irritating life hassles? Items are measured on a Likert scale scoring 0 (never) –4 (always) with a higher score indicating greater perceived stress....
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...Perceived stress scale - 14 (PSS-14) (18) is a 14-item self-report measure, which asks about thoughts and feelings in the last month and includes items such as In the last month, how often have you dealt with irritating life hassles?...
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01 Jan 1988
4,196 citations
"Impact of peanut allergy on quality..." refers background or result in this paper
...Cohen and Williamson (19) have suggested that in an adult healthy US population scores range between 0 and 45, with a mean of 19....
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...Cohen and Williamson (19) have suggested that in an adult healthy US population scores range between 0 and 45, with a mean of 19.62 (Table 1)....
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...Mothers reported greater anxiety and stress than fathers did and their trait anxiety and perceived stress levels were significantly higher than reported norm mean values for these scales, while fathers scores were more in line with or lower than norm scores (17, 19)....
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TL;DR: The PedsQL distinguished between healthy children and pediatric patients with acute or chronic health conditions, was related to indicators of morbidity and illness burden, and displayed a factor-derived solution largely consistent with the a priori conceptually-derived scales.
Abstract: Background.The PedsQL (Pediatric Quality of Life Inventory) (Children’s Hospital and Health Center, San Diego, California) is a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales are multidimensional ch
4,155 citations
"Impact of peanut allergy on quality..." refers background in this paper
...children aged 5-16 years (24) are reported in Table 2....
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...Peanut allergic children’s generic quality of life scores were generally poorer than healthy children’s norms for this scale, whereas siblings generally reported better quality of life than the norm scores (24)....
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TL;DR: Overall, the WHOQOL-BREF is a sound, cross-culturally valid assessment of QOL, as reflected by its four domains: physical, psychological, social and environment.
Abstract: Quality of life (QOL) assessments that are easily administered and which do not impose a great burden on the respondent are needed for use in large epidemiological surveys, clinical settings and clinical trials. Using data from the WHOQOL-BREF field trials, the objectives of this work are to examine the performance of the WHOQOL-BREF as an integrated instrument, and to test its main psychometric properties. The WHOQOL-BREF is a 26-item version of the WHOQOL-100 assessment. Its psychometric properties were analysed using cross-sectional data obtained from a survey of adults carried out in 23 countries (n = 11,830). Sick and well respondents were sampled from the general population, as well as from hospital, rehabilitation and primary care settings, serving patients with physical and mental disorders and with respect to quotas of important socio-demographic variables. The WHOQOL-BREF self-assessment was completed, together with socio-demographic and health status questions. Analyses of internal consistency, item-total correlations, discriminant validity and construct validity through confirmatory factor analysis, indicate that the WHOQOL-BREF has good to excellent psychometric properties of reliability and performs well in preliminary tests of validity. These results indicate that overall, the WHOQOL-BREF is a sound, cross-culturally valid assessment of QOL, as reflected by its four domains: physical, psychological, social and environment.
3,518 citations
"Impact of peanut allergy on quality..." refers background or methods in this paper
...Mothers reported significantly poorer psychological and physical QoL than fathers, however in general both parents reported better QoL than the norm scores of a healthy UK population (20)....
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...Methods: Forty-six families, who had a child with PA, completed QoL (PedsQLTM or WHOQOL-BREF), anxiety (SCAS or STAI) and perceived stress (PSS) scales....
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...The World Health Organization QoL scale (Brief version) (WHOQOL-BREF) (20) is a 26 item QoL scale, using a 1–5 Likert scale, which measures four major domains: physical, psychological, social relationships and environment....
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...Norm data for a UK adult healthy population adjusted for age and sex (20) are reported in Table 1....
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...Parents were asked to complete the STAI, the PSS and the WHOQOL-BREF for themselves and the Avery scale and PedsQLTM as a proxy measure for the PA child....
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