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Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis.

https://arctichealth.org/en/permalink/ahliterature160813
Source
J Clin Epidemiol. 2007 Nov;60(11):1176-83
Publication Type
Article
Date
Nov-2007
Author
Wendy J Ungar
Sara R Davidson-Grimwood
Martha Cousins
Author Affiliation
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. wendy.ungar@sickkids.ca
Source
J Clin Epidemiol. 2007 Nov;60(11):1176-83
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Asthma - epidemiology - psychology
Child
Child, Preschool
Databases, Factual
Emergency Service, Hospital
Female
Hospitalization
Humans
Infant
Male
Ontario - epidemiology
Outpatient Clinics, Hospital
Parents - psychology
Patient Acceptance of Health Care - psychology
Proxy - psychology
Quality of Life
Retrospective Studies
Socioeconomic Factors
Abstract
To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data.
A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type.
Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (kappa=0.80 [0.74, 0.86]), moderate for ED visits in the past year (kappa=0.60 [0.53, 0.67]), and slight for physician visits (kappa=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (P
PubMed ID
17938060 View in PubMed
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A qualitative analysis of a dyad approach to health-related quality of life measurement in children with asthma.

https://arctichealth.org/en/permalink/ahliterature168033
Source
Soc Sci Med. 2006 Nov;63(9):2354-66
Publication Type
Article
Date
Nov-2006
Author
Wendy J Ungar
Cara Mirabelli
Martha Cousins
Katherine M Boydell
Author Affiliation
Population Health Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, Ont., Canada M5G 1X8. wendy.ungar@sickkids.ca
Source
Soc Sci Med. 2006 Nov;63(9):2354-66
Date
Nov-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Asthma
Child
Evaluation Studies as Topic
Female
Health status
Humans
Male
Ontario
Quality of Life
Questionnaires
Abstract
The measurement of health-related quality of life (HRQOL) in children often relies on parents as proxy respondents. Yet, several studies have shown poor to moderate correlations between parent and child responses, questioning the validity of the parent as proxy. This qualitative study examined a dyad approach, where parent and child were interviewed together. The objective was to observe and describe the interaction in a dyad interview, wherein both parent and child perspectives are used and where the parent may expand the child's cognitive abilities to create a more meaningful description of the child's HRQOL. Children aged 8-15 years with a clinical diagnosis of asthma and their primary caregivers were recruited from The Hospital for Sick Children, Toronto, Canada. The dyads were administered the Health Utilities Index Mark II/III, the Pediatric Asthma Quality of Life Questionnaire and the PedsQL Pediatric Quality of Life Inventory. Interviews were audio-taped and a second researcher recorded observations. Consistent with Grounded Theory methodology, observations were indexed according to categories and subcategories related to the response process. Data were analysed using open, axial and selective coding and constant comparison. Saturation was achieved at 16 dyad interviews. A cultural review and reflexive role taking were included to minimize interviewer bias and enhance rigour. Findings were grouped in the following 11 themes: recall difficulty, respondent bias, interviewer bias, frustration, coercion/parental influence, inter-relational conflict, psychic discomfort for health states, emotional sensitivity, parent as advocate, parent as enabler and comprehension. The specification of these categories facilitated the creation of an interview guide to accompany the administration of standardized HRQOL questionnaires to parent-child dyads. Such a guide would facilitate discussion between parent and child and enhance the consistency of the interview process.
PubMed ID
16887248 View in PubMed
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