Health-Related Quality of Life in Youth With Crohn Disease: Role of Disease Activity and Parenting Stress

作者：Gray Wendy N^*; Boyle Shana L; Graef Danielle M; Janicke David M; Jolley Christopher D; Denson Lee A; Baldassano Robert N; Hommel Kevin A

来源：Journal of Pediatric Gastroenterology and Nutrition, 2015, 60(6): 749-753.

DOI：10.1097/MPG.0000000000000696

• adolescents
• family
• inflammatory bowel disease
• mediation
• pediatric

Objectives: Health-related quality of life (HROOL) is an important, but understudied construct in pediatric inflammatory bowel disease. Family level predictors of HRQOL have been understudied as are the mechanisms through which disease activity affects HROOL. The present study examines the relation between a family level factor (parenting stress) and HRQOL in youth with Crohn disease. Parenting stress is examined as a mechanism through which disease activity affects HROOL.
Methods: A total of 99 adolescents with Crohn disease and their parents were recruited across 3 sites. Adolescents completed the IMPACT-III (inflammatory bowel disease specific HROOL). Parents completed the Pediatric Inventory for Parents, a measure of medically related parenting stress that assesses stress because of the occurrence of medical stressors and stress because of the perceived difficulty of stressors. Disease activity was obtained from medical records.
Results: Parenting stress because of the occurrence of medical stressors partially mediated the disease severity HRQOL relation, reducing the relation between these variables from 49.67% to 31.58% (B = -0.56, P < 0.0001). Bootstrapping analysis confirmed that the indirect effect of disease severity on HRQOL via parenting stress significantly differed from zero. Parenting stress because of the perceived difficulty of medical stressors partially mediated the disease severity BRQOL relation, reducing the relation from 49.67% to 30.29% (B = 0.55, P < 0.0001). The indirect effect was confirmed via bootstrapping procedures.
Conclusions: As disease severity increased, parenting stress also increased, and adolescent HRQOL decreased. Parenting stress should be considered and assessed for along with medical factors as part of a comprehensive approach to improve BRQOL in adolescents with Crohn disease.

• 出版日期2015-6