Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha = 0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma

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Abordaje de la tos crónica en Atención Primaria a través de casos clínicos / No disponible

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Educando en asma / Asthma education

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"Puntos negros" de la asistencia a la población infanto juvenil en Atención Primaria en España (primera parte) / Weak points of child and adolescent Primary Health Care in Spain (first part)

Introducción: desde la Junta Directiva de la Asociación Española de Pediatría de Atención Primaria (AEPap) nos planteamos realizar un análisis comparativo de la situación de la asistencia a la población infantojuvenil en Atención Primaria en las distintas comunidades autónomas españolas a través de los datos aportados por las diferentes sociedades autonómicas federadas. Material y métodos: en la primavera de 2010 realizamos una encuesta utilizando la tecnología Web 2.0 a 16 pediatras expertos conocedores de la situación de la asistencia a la población infantojuvenil en España, uno por cada una de las comunidades autónomas federadas en la AEPap. Han contestado a 39 preguntas consensuadas seleccionadas que buscan diferencias organizativas y asistenciales intercomunitarias. Resultados: se han encontrado importantes discrepancias en la manera de organizar las consultas de Atención Primaria entre las distintas regiones, que generan inequidades para los niños, sus familias y los profesionales. Discusión y conclusiones: hemos denominado "puntos negros" a las características más desfavorables, como plazas de Pediatría de Atención Primaria cubiertas por profesionales sin la especialidad, escasez de personal de Enfermería Pediátrica, horarios de trabajo vespertinos, sueldos bajos y dificultades en el acceso a Internet. Las comunidades más deficientes en la calidad de la asistencia pediátrica son Andalucía y Madrid con tres de estos puntos negros; seguidas de Cataluña y Murcia, con dos. Corresponde a la Administración sanitaria mejorar estas diferencias, o se crearán divergencias insalvables en los recursos adjudicados a la asistencia sanitaria de los niños y adolescentes en función del lugar donde residan (AU)

Introduction: the board of directors of the Spanish Association of Primary Care Paediatrics (AEPap) decided to address an analysis comparing the situation of child and adolescent assistance in primary care in different regions through the data provided by the corresponding regional federated societies. Material and methods: in spring 2010 we conducted a survey using Web 2.0 technology with 16 expert paediatricians on the status of child and adolescent primary health care in Spain, we chose one paediatrician for each of the Spanish autonomous region. They answered 39 selected consensuated questions seeking organizational and intercommunity health care differences. Results: we found significant discrepancies in the way of organizing the consultations in primary care among different regions. It generates iniquities to children, their families and professionals. We defined weak points as the posts with the most unfavourable features, such as general practitioners in paediatric offices, shortage of paediatric nursing, long work hours (work in the evening), low wages and lack of access to the Internet. The worst communities in this regard are Andalucia and Madrid with three of these weak points, followed by Catalonia and Murcia. We have only found four communities without weak points of care. Conclusion: to reduce these differences in order to avoid important gaps in health resources devoted to children and adolescents falls on health authorities (AU)