title: Factors that influence quality of life in rural children with asthma and their parents.
abstract: BACKGROUND
  Among rural children with asthma and their parents, this study examined the relationship between parental and child reports of quality of life and described the relationship of several factors such as asthma severity, missed days of work, and asthma education on their quality of life.
  
  
  METHODS
  Two hundred one rural families with asthma were enrolled in a school-based educational program. Intervention parents and children participated in interactive asthma workshop(s) and received asthma devices and literature. Parent and child quality of life measurements were obtained before and after the intervention using Juniper's Paediatric Caregivers Quality of Life and Juniper's Paediatric Quality of Life Questionnaires. Asthma severity was measured using criteria from the National Asthma Education and Prevention Program guidelines.
  
  
  RESULTS
  There was no association between parent and child total quality of life scores, and mean parental total quality of life scores were higher at baseline and follow-up than those of the children. All the parents' quality of life scores were correlated with parental reports of missed days of work. For all children, emotional quality of life (EQOL) was significantly associated with parental reports of school days missed (P = .03) and marginally associated with parental reports of hospitalizations due to asthma (P = .08). Parent's EQOL and activity quality of life (AQOL) were significantly associated with children's asthma severity (EQOL, P = .009; AQOL, P = .03), but not the asthma educational intervention. None of the child quality of life measurements was associated with asthma severity.
  
  
  CONCLUSIONS
  Asthma interventions for rural families should help families focus on gaining and maintaining low asthma severity levels to enjoy an optimal quality of life. Health care providers should try to assess the child's quality of life at each asthma care visit independently of the parents.
authors.affiliation: Johns Hopkins University, School of Medicine, 200 N Wolfe St, Baltimore, MD 21205, USA. jwalker@jhsph.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Walker
authors.forename: Marilyn
authors.initials: M
authors.lastname: Winkelstein
authors.forename: Cassia
authors.initials: C
authors.lastname: Land
authors.forename: Lapricia
authors.initials: L
authors.lastname: Lewis-Boyer
authors.forename: Ruth
authors.initials: R
authors.lastname: Quartey
authors.forename: Luu
authors.initials: L
authors.lastname: Pham
authors.forename: Arlene
authors.initials: A
authors.lastname: Butz
mesh_terms: D000328:Adult; D001249:Asthma / Q000503:physiopathology*; D017028:Caregivers; D002648:Child; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D010353:Patient Education as Topic; D011788:Quality of Life; D012424:Rural Population; D012720:Severity of Illness Index