Psychological Stress in Parents of Children with Atopic Dermatitis: A Cross-sectional Study from the Korea National Health and Nutrition Examination Survey
DOI:
https://doi.org/10.2340/actadv.v103.2242Keywords:
atopic dermatitis, parents, mother, psychological stressAbstract
Atopic dermatitis is a chronically relapsing inflammatory skin condition that has profound impacts on quality of life of patients and their family. The aim of this study is to investigate the psychological stress in parents of children with atopic dermatitis in Korea, using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included parents of participants under 19 years of age (970 with atopic dermatitis and 5,733 without atopic dermatitis after excluding those who meet the exclusion criteria) from the 2009 to 2012 KNHANES. The psychological stress state was evaluated with the following four questionnaire items: self-perception of stress, depressed mood, suicidal ideation, and diagnosis of depression by a physician. After adjusting for age, gender, education level, occupation, and marital status, logistic regression analyses indicated that mothers of children with atopic dermatitis had a higher frequency of stress perception (adjusted odds ratio (aOR) 1.46 (95% confidence interval (95% CI) 1.22–1.74), p < 0.01) and suicidal ideation (aOR 1.40 (95% CI 1.1–1.79), p < 0.01) than those without atopic dermatitis. In contrast, fathers of children with atopic dermatitis did not show a significant difference in all items compared with those of children without atopic dermatitis. Understanding the psychological stress in parents of children with atopic dermatitis is important for clinicians, since evaluation, management and support for parents, especially mothers, of children with atopic dermatitis are required.
Downloads
References
Silverberg JI, Barbarot S, Gadkari A, Simpson EL, Weidinger S, Mina-Osorio P, et al. Atopic dermatitis in the pediatric population: a cross-sectional, international epidemiologic study. Ann Allergy Asthma Immunol 2021; 126: 417-428.e412.
https://doi.org/10.1016/j.anai.2020.12.020 DOI: https://doi.org/10.1016/j.anai.2020.12.020
Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 2006; 368: 733-743.
https://doi.org/10.1016/S0140-6736(06)69283-0 DOI: https://doi.org/10.1016/S0140-6736(06)69283-0
Yew YW, Thyssen JP, Silverberg JI. A systematic review and meta-analysis of the regional and age-related differences in atopic dermatitis clinical characteristics. J Am Acad Dermatol 2019; 80: 390-401.
https://doi.org/10.1016/j.jaad.2018.09.035 DOI: https://doi.org/10.1016/j.jaad.2018.09.035
Ständer S. Atopic dermatitis. N Engl J Med 2021; 384: 1136-1143.
https://doi.org/10.1056/NEJMra2023911 DOI: https://doi.org/10.1056/NEJMra2023911
Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG. The family impact of childhood atopic dermatitis: the Dermatitis Family Impact Questionnaire. Br J Dermatol 1998; 138: 107-113.
https://doi.org/10.1046/j.1365-2133.1998.02034.x DOI: https://doi.org/10.1046/j.1365-2133.1998.02034.x
Chow MY, Morrow AM, Cooper Robbins SC, Leask J. Condition-specific quality of life questionnaires for caregivers of children with pediatric conditions: a systematic review. Qual Life Res 2013; 22: 2183-2200.
https://doi.org/10.1007/s11136-012-0343-z DOI: https://doi.org/10.1007/s11136-012-0343-z
Moore K, David TJ, Murray CS, Child F, Arkwright PD. Effect of childhood eczema and asthma on parental sleep and well-being: a prospective comparative study. Br J Dermatol 2006; 154: 514-518.
https://doi.org/10.1111/j.1365-2133.2005.07082.x DOI: https://doi.org/10.1111/j.1365-2133.2005.07082.x
ang EJ, Beck KM, Sekhon S, Bhutani T, Koo J. The impact of pediatric atopic dermatitis on families: a review. Pediatr Dermatol 2019; 36: 66-71.
https://doi.org/10.1111/pde.13727 DOI: https://doi.org/10.1111/pde.13727
Lee JH, Han KD, Kim KM, Park YG, Lee JY, Park YM. Prevalence of atopic dermatitis in Korean children based on data from the 2008-2011 Korean National Health and Nutrition Examination Survey. Allergy Asthma Immunol Res 2016; 8: 79-83.
https://doi.org/10.4168/aair.2016.8.1.79 DOI: https://doi.org/10.4168/aair.2016.8.1.79
Holmbeck GN, Coakley RM, Hommeyer JS, Shapera WE, Westhoven VC. Observed and perceived dyadic and systemic functioning in families of preadolescents with spina bifida. J Pediatr Psychol 2002; 27: 177-189.
https://doi.org/10.1093/jpepsy/27.2.177 DOI: https://doi.org/10.1093/jpepsy/27.2.177
Han JW, Lee H. Actor and partner effects of parenting stress and co-parenting on marital conflict among parents of children with atopic dermatitis. BMC Pediatr 2020; 20: 141.
https://doi.org/10.1186/s12887-020-02035-7 DOI: https://doi.org/10.1186/s12887-020-02035-7
Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol 2014; 71: 116-132.
https://doi.org/10.1016/j.jaad.2014.03.023 DOI: https://doi.org/10.1016/j.jaad.2014.03.023
Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol 2018; 32: 657-682.
https://doi.org/10.1111/jdv.14891 DOI: https://doi.org/10.1111/jdv.14891
Katayama I, Aihara M, Ohya Y, Saeki H, Shimojo N, Shoji S, et al. Japanese guidelines for atopic dermatitis 2017. Allergol Int 2017; 66: 230-247.
https://doi.org/10.1016/j.alit.2016.12.003 DOI: https://doi.org/10.1016/j.alit.2016.12.003
Holm EA, Jemec GB. Time spent on treatment of atopic dermatitis: a new method of measuring pediatric morbidity? Pediatr Dermatol 2004; 21: 623-627.
https://doi.org/10.1111/j.0736-8046.2004.21601.x DOI: https://doi.org/10.1111/j.0736-8046.2004.21601.x
Jemec GB, Esmann S, Holm EA, Tycho A, Jørgensen TM. Time spent on treatment (TSOT). An independent assessment of disease severity in atopic dermatitis. Acta Dermatovenerol Alp Pannonica Adriat 2006; 15: 119-124.
OECD. OECD Gender Data Portal. 2021 [Assessed on 05 July 2022] Available from: http://www.oecd.org/gender/data.
Pustišek N, Vurnek Živković M, Šitum M. Quality of life in families with children with atopic dermatitis. Pediatr Dermatol 2016; 33: 28-32.
https://doi.org/10.1111/pde.12698 DOI: https://doi.org/10.1111/pde.12698
Hwang TY, Kim SK, Kim SH, Kim M. A cross sectional survey on health-related quality of life among parents of children with allergic symptoms using the EQ-5D-5L. J Asthma 2019; 56: 1239-1245.
https://doi.org/10.1080/02770903.2019.1571086 DOI: https://doi.org/10.1080/02770903.2019.1571086
Zuberbier T, Orlow SJ, Paller AS, Taïeb A, Allen R, Hernanz-Hermosa JM, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol 2006; 118: 226-232.
https://doi.org/10.1016/j.jaci.2006.02.031 DOI: https://doi.org/10.1016/j.jaci.2006.02.031
Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The burden of atopic dermatitis: summary of a report for the national eczema association. J Invest Dermatol 2017; 137: 26-30.
https://doi.org/10.1016/j.jid.2016.07.012 DOI: https://doi.org/10.1016/j.jid.2016.07.012
Chamlin SL, Mattson CL, Frieden IJ, Williams ML, Mancini AJ, Cella D, et al. The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med 2005; 159: 745-750.
https://doi.org/10.1001/archpedi.159.8.745 DOI: https://doi.org/10.1001/archpedi.159.8.745
Warschburger P, Buchholz HT, Petermann F. Psychological adjustment in parents of young children with atopic dermatitis: which factors predict parental quality of life? Br J Dermatol 2004; 150: 304-311.
https://doi.org/10.1111/j.1365-2133.2004.05743.x DOI: https://doi.org/10.1111/j.1365-2133.2004.05743.x
Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol 2019; 123: 144-151.
https://doi.org/10.1016/j.anai.2019.04.020 DOI: https://doi.org/10.1016/j.anai.2019.04.020
Kage P, Zarnowski J, Simon JC, Treudler R. Atopic dermatitis and psychosocial comorbidities - what's new? Allergol Select 2020; 4: 86-96.
https://doi.org/10.5414/ALX02174E DOI: https://doi.org/10.5414/ALX02174E
Deckert S, Kopkow C, Schmitt J. Nonallergic comorbidities of atopic eczema: an overview of systematic reviews. Allergy 2014; 69: 37-45.
https://doi.org/10.1111/all.12246 DOI: https://doi.org/10.1111/all.12246
Kahn D, Iturriaga C, Bertran K, Fernandez I, Perez-Mateluna G, Borzutzky A, et al. Sleep quality in children with atopic dermatitis during flares and after treatment. Sleep Sci 2020; 13: 172-175.
Published
How to Cite
License
Copyright (c) 2023 Hyun Ji Lee, Gyu-Na Lee, Ji Hyun Lee, Ju Hee Han, Kyungdo Han, Young Min Park
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.