Validación inicial de una escala para medir el nivel de sobrecarga de padres o cuidadores de niños asmáticos / Initial validation of a scale to measure the burden for parents/caregivers of children with asthma and factors associated with this burden in a population of asthmatic children

Introducción. A pesar de la alta probabilidad de que los padres o cuidadores de niños asmáticos presenten sobrecarga, no se han validado instrumentos para medirla en el contexto del asma pediátrica. Objetivo. Iniciar la validación de una escala para medir la sobrecarga de los padres o cuidadores de niños asmáticos y determinar los factores asociados con esta sobrecarga. Materiales y métodos. Mediante un estudio analítico de corte transversal se midió el nivel de sobrecarga de los padres o cuidadores de niños asmáticos de 1 a 16 años, utilizando una versión abreviada de la escala de Zarit. Se hizo un análisis factorial exploratorio de los componentes principales de esta escala, y se evaluó su validez de constructo y su validez interna. Se ajustaron modelos de regresión logística para identificar los factores asociados con una sobrecarga intensa en los padres o cuidadores de los niños asmáticos. Resultados. La mediana (rango intercuartílico) de la edad de los 162 niños analizados fue de 6 años (rango, 4 a 9). Del total de padres o cuidadores, 37 (22,8 %) estaban experimentando sobrecarga intensa. El análisis factorial mostró una estructura probable de dos factores que, en conjunto, explican el 61,5 % de la varianza total de los resultados. La única variable que se asoció de forma independiente con una sobrecarga intensa en el análisis multivariado, fue el asma no controlada (OR=5,38; IC95 %: 1,43-20,16; p=0,012). Conclusiones. La escala de Zarit utilizada tiene una aceptable validez interna y una adecuada validez de constructo para determinar el nivel de sobrecarga que experimentan los padres o cuidadores de niños asmáticos. El grado de control del asma del niño fue la única variable que se asoció de forma independiente con este nivel de sobrecarga.

Introduction . Despite the high probability of a heavy burden for parents and/or caregivers of children with asthma, instruments intended to measure it have not been validated in the context of asthma. Moreover, factors associated with this burden are unknown. Objective. To begin the validation of a scale to measure the burden for parents/caregivers of asthmatic children, and to determine the factors associated with this burden. Materials and methods. We performed an analytical cross-sectional and validation of scale study. At the outpatient section of the Clinic of Pediatric Pulmonology in the Hospital Universitario Clinica San Rafael, we measured the burden of parents and/or caregivers of children with asthma using a shortened version of the Zarit scale throughout 2011. We performed a principal components factor analysis and adjusted logistic regression models to identify independent factors associated with a heavy burden. Results . The median (interquartile range) age of the 162 children included in the study was 6 (4-9) years. Out of the total of parents and/or caregivers, 37 (22.8%) were experiencing a heavy burden. Factor analysis of the Zarit scale showed a probable structure of two factors, which together accounted for 61.5% of the variance of the results. Uncontrolled asthma was the only predictor independently associated with a heavy burden in the multivariate analysis (OR 5.38; 95% CI 1.43-20.16, p = 0.012). Conclusions . The Zarit scale used has an adequate factorial structure, an acceptable internal consistency, and an adequate construct validity for measuring the burden for parents and/or caregivers of children with asthma. The level of a child's asthma control is the most important independent predictor of this burden.

[Initial validation of a scale to measure the burden for parents/caregivers of children with asthma and factors associated with this burden in a population of asthmatic children]. / Validación inicial de una escala para medir el nivel de sobrecarga de padres o cuidadores de niños asmáticos.

INTRODUCTION: Despite the high probability of a heavy burden for parents and/or caregivers of children with asthma, instruments intended to measure it have not been validated in the context of asthma. Moreover, factors associated with this burden are unknown. OBJECTIVE: To begin the validation of a scale to measure the burden for parents/caregivers of asthmatic children, and to determine the factors associated with this burden. MATERIALS AND METHODS: We performed an analytical cross-sectional and validation of scale study. At the outpatient section of the Clinic of Pediatric Pulmonology in the Hospital Universitario Clinica San Rafael, we measured the burden of parents and/or caregivers of children with asthma using a shortened version of the Zarit scale throughout 2011. We performed a principal components factor analysis and adjusted logistic regression models to identify independent factors associated with a heavy burden. RESULTS: The median (interquartile range) age of the 162 children included in the study was 6 (4-9) years. Out of the total of parents and/or caregivers, 37 (22.8%) were experiencing a heavy burden. Factor analysis of the Zarit scale showed a probable structure of two factors, which together accounted for 61.5% of the variance of the results. Uncontrolled asthma was the only predictor independently associated with a heavy burden in the multivariate analysis (OR 5.38; 95% CI 1.43-20.16, p = 0.012). CONCLUSIONS: The Zarit scale used has an adequate factorial structure, an acceptable internal consistency, and an adequate construct validity for measuring the burden for parents and/or caregivers of children with asthma. The level of a child's asthma control is the most important independent predictor of this burden.