parents’ overall quality of life is negatively affected by having a child with feeding problems...
TRANSCRIPT
Parents’ Overall Quality of Life is Negatively Affected by Having a Child with Feeding Problems
Amy J. Majewski1, Alisha M. Neu1, Gustavo R. Medrano1, Kathryn S. Holman1, W. Hobart Davies1,3, & Alan H. Silverman2,3
University of Wisconsin-Milwaukee1, Children’s Hospital of Wisconsin2, & Medical College of Wisconsin3
• Childhood feeding problems are among the most common developmental issues brought to pediatricians (Linscheid, 2006).
• Feeding problems can have serious consequences for the child’s physical and psychological health and overall development (Rommel, 2003).
• The severe effects that feeding disorders have on a child’s health may often lead to increased emotional distress for parents (Greer, Gulotta, Masler, & Laud, 2008), and it may have serious consequences for the health of the parent as well (Varni, Sherman, Burwinkle, Dickinson, & Dixon, 2004).
• However, no previous studies have examined the effects of feeding problems on parents’ overall quality of life.
PARTICIPANTSN = 481: participants were parents with
young children recruited from the community.
Parents:• Mothers: 68.6 %• Age: mean age of 37.40 years (SD=7.71)• Education: 95.6% College-educated• Ethnicity: 84.8% CaucasianChildren• Gender: 52.6% female• Age: 1 to 7 years (M = 4.02, SD = 2.16)
Children were assigned to one of three groups based on their reported medical history:1. Feeding Problems: n=362. Other Chronic Conditions: n=1493. Healthy Control Group: n=296
Poster presented to the 2010 Wisconsin Psychological
Association Conference Middleton, WI. Correspondence to:
• The results of the current study suggest that the overall health-related quality of life of parents of children with feeding problems may be negatively impacted by the child’s illness; moreover, parents of children with feeding problems may be in more distress than parents of children with other chronic conditions.
• Feeding is a daily activity that is necessary to sustain life, and the child’s inability to feed and the parent’s own inability to effectively feed their child can lead to a great deal of frustration and stress. Furthermore, the accumulation of stress upon the parent can lead to the continued maintenance of feeding problems as the child notices the parental aversion to mealtime and responds with more avoidance and negative feeding behaviors (Greer et al., 2008).
• The current findings suggest that clinicians need to increase their awareness of how the parent is coping with their child’s feeding problem and ensure that they provide adequate support and resources for the parents. This will not only increase the overall well-being of the parent, but also may increase intervention success as the parent is influential in the treatment of the child.
• Due to the heterogeneous nature of feeding problems, further studies plan to examine the specific correlates of feeding problems. By gaining a better understanding of how individual disease-factors affect parent’s overall health-related quality of life, clinicians may then be able to better identify and address the individualized needs and necessary supports that are unique to each family of a child with a feeding problem.
MEASURESPedsQL™ Family Impact Module (FIM; Varni et al., 2004). The FIM is a 36-item measure used to assess parent health-related quality of life (HRQoL) and family functioning. The measure forms 8 subscale scores (Physical, Emotional, Social, and Cognitive Functioning; Communication; Worry; Daily Activities; and Family Relationships), 2 summary scores (Parent HRQoL and Family Functioning), and a Total Score. Internal consistency is high across scales ranging from α = .82 to α = .97.PedsQL™ 4.0 Generic Core Scales (PedsQL; Varni et al., 2001). The PedsQL is a parent-report measure used to assess the child’s health-related quality of life. The items forms 4 subscale scores (Physical, Emotional, Social, and School Functioning), 2 summary scores (Psychosocial and Physical Health), and a Total Score. Internal consistency is high across scales ranging from, α = .86 to α = .90.Mealtime Behavior Questionnaire (MBQ; Davies et al., 2005). The MBQ is a 33-item, parent-report measure used to assess problematic mealtime behaviors. The measure yields a Total score from four subscale scores (Avoidance; Food Manipulation; Aggression; and Choking, Gagging, Vomiting). Internal consistency is adequate across scales, ranging from α = .62 to α = .88.
STATISTICAL ANALYSISIndependent Samples T-tests were run to compare group means. Planned comparisons were controlled for using Bonferroni adjustments.
INTRODUCTION
METHODS
SPECIFIC OBJECTIVESThe primary objective of the current investigation was as follows:
1. To be the first examination of how parents’ health-related quality of life is impacted by childhood feeding problems.
•Parents of children in the feeding problems group reported significantly worse scores than parents of children in the healthy control group and other chronic conditions group on the Parents HRQoL Summary Score, t(291) = -5.863, p <.001. and t(165) = -3.508,
p < .05, respectively. •Parents of children with feeding problems also reported their children as having significantly worse PedsQL Total Scores as compared to parent reports of children in the healthy control group, t(285) = -4.183, p < .001. •There was no significant difference found in the parent-reported PedsQL Total Scores between parents of children with feeding problems and parents of children with other chronic conditions, t(169) = -2.097, p > .05.•Parents of children with feeding problems report significantly lower scores on most of the subscales of the FIM than parents of children in the healthy and other chronic conditions groups. Emotional Functioning and Communication subscales were not significantly different when compared to the other chronic conditions group.
RESULTS
DISCUSSION and SUMMARY
Avoidance Food Manipula-tion
Aggression Choking, Gag-ging, Vomiting
Total0
20
40
60
80
100
25.5
10.0314
4.58
57.93
Problematic Mealtime Behaviors
Healthy
Chronic Condition
Feeding Problem
HRQoL Summary Score0
20
40
60
80
100
58.71
Parent’s HRQoL Summary Scores
HealthyChronic ConditionFeeding Problem
Physical
Functionin
g
Emotio
nal Functi
oning
Social F
unctionin
g
Cognitive F
unctionin
g
Comm
unicatio
n
Worry
Daily A
ctiviti
es
Family
Rela
tionsh
ips
0
20
40
60
80
100
54.0459.86 62.33 64.03
69.29
61.56
48.84
57.94
Subscale Scores of the Family Impact Module
Healthy
Chronic Condition
Feeding Problem
PedsQL Total Score0
20
40
60
80
100
73.56
Children’s Pediatric Quality of Life Total Scores as Reported by Parents
Healthy
Chronic Condition
Feeding Problem