title: What affects quality of life among caregivers of food-allergic children?
abstract: BACKGROUND
  Food allergy is associated with decreased caregiver quality of life (QoL). The influence of accurate reaction perception, allergen, and sociodemographic factors on caregiver QoL is poorly understood.
  
  
  OBJECTIVE
  To determine factors influencing caregiver food allergy QoL within an academic center cohort.
  
  
  METHODS
  Caregivers of children allergic to milk, egg, peanut, or tree nut evaluated from 2009 to 2011 completed a questionnaire assessing the details of the children's most severe food reaction and caregiver QoL using the Food Allergy Quality of Life-Parental Burden index. Survey responses were verified through chart review. A multiple linear regression model was used to determine factors influencing QoL score.
  
  
  RESULTS
  Of 305 caregivers surveyed, 65% had accurate reaction perception. This was higher in caregivers of children with provider-confirmed anaphylaxis (P = .008). Milk or egg allergy was associated with higher total and independent domain-specific QoL scores compared with peanut or tree nut allergy, and an income lower than $50,000 was associated with higher total QoL scores and higher scores for 5 of 17 individual domains. In a linear regression model, age at most severe reaction (-0.02, P = .01), peanut or tree nut allergy (-0.81, P = .004) and milk allergy (-1.12, P = .001) vs egg allergy, income higher than $50,000 (-0.53, P = .04), multiple food allergies (0.45, P = .007), accurate reaction perception (-0.37, P = .04), eczema (+0.49, P = .004), and caregiver report that the child had anaphylaxis (+0.48, P = .02) were significantly associated with QoL score.
  
  
  CONCLUSIONS
  Food allergen, having multiple food allergies, age at reaction, income, eczema, parent-reported anaphylaxis, and reaction perception can significantly affect caregiver food allergy QoL. Milk or egg allergy was associated with worse total and domain-specific caregiver QoL scores vs peanut or tree nut allergy, representing a high-risk subgroup.
authors.affiliation: The University of Michigan Food Allergy Center, Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Laura
authors.initials: L
authors.lastname: Howe
authors.affiliation: The University of Michigan Food Allergy Center, Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan; Family Allergy & Asthma, Florence, Kentucky.
authors.forename: Timothy
authors.initials: T
authors.lastname: Franxman
authors.affiliation: The University of Michigan Food Allergy Center, Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Esther
authors.initials: E
authors.lastname: Teich
authors.affiliation: The University of Michigan Food Allergy Center, Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: mgreenha@med.umich.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Greenhawt
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000276:immunology / Q000473:pathology; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D021181:Egg Hypersensitivity / Q000276:immunology / Q000473:pathology*; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007182:Income; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016269:Milk Hypersensitivity / Q000276:immunology / Q000473:pathology*; D021184:Nut Hypersensitivity / Q000276:immunology / Q000473:pathology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires