title: The burden of disease in pediatric non-cystic fibrosis bronchiectasis.
abstract: BACKGROUND
  The burden of disease in children with non-cystic fibrosis (non-CF) bronchiectasis is unknown. Our study aimed to identify the determinants of quality of life (QOL) and parental mental health in this group of patients and their parents and to evaluate the effect of exacerbations on these parameters.
  
  
  METHODS
  Parents of 69 children (median age 7 years) with non-CF bronchiectasis prospectively completed two questionnaires (parent-proxy cough-specific quality of life [PC-QOL] and the Depression, Anxiety, and Stress Scale [DASS]) at stable and exacerbation states. Data on clinical, investigational, and lung function parameters were also collected.
  
  
  RESULTS
  During the stable state, the median interquartile range (IQR) PC-QOL score was 6.5 (5.3-6.9) and the DASS 21-item questionnaire score was 6 (0-20). Being of a young age correlated with a worse QOL (r(5) = 0.242, P = .04) but radiologic extent, lung function, underlying cause, environmental tobacco smoke exposure, and chronic upper-airway disease did not influence these scores. Exacerbations caused significant worsening in the PC-QOL scores (median [IQR], 4.6 [3.8-5.4]; P = .001) and DASS scores (median [IQR], 22 [9-42]; P < .001; 38% with elevated anxiety, 54% with abnormal depression/stress scores during exacerbation). The presence of viral infection, hypoxia, and hospitalization did not influence the exacerbation PC-QOL and DASS scores.
  
  
  CONCLUSIONS
  There is a significant burden of disease, especially during exacerbation, on parents of children with bronchiectasis. Prevention, early detection, and appropriate treatment of exacerbations are likely to reduce psychologic morbidity in this group.
authors: Department of Respiratory Medicine and the Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, QLD, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. Electronic address: dr.nitinkapur@gmail.com.
authors: Nitin
authors: N
authors: Kapur
authors: Department of Respiratory Medicine and the Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, QLD, Australia.
authors: I Brent
authors: IB
authors: Masters
authors: School of Social Work and Applied Human Sciences, University of Queensland, Brisbane, QLD, Australia.
authors: Peter
authors: P
authors: Newcombe
authors: Department of Respiratory Medicine and the Queensland Children's Medical Research Institute, Royal Children's Hospital, Herston, QLD, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
authors: Anne B
authors: AB
authors: Chang
mesh_terms: D001987:Bronchiectasis / Q000150:complications / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires