Relationship between quality of life and behavioural disorders in children with persistent asthma: a Multiple Indicators Multiple Causes (MIMIC) model
Laura Montalbano, Giuliana Ferrante, Silvia Montella, Giovanna Cilluffo, Antonio Di Marco, Sara Bozzetto, Emanuela di Palmo, Amelia Licari, Lucia Leonardi, Valeria Caldarelli, Michele Ghezzi, Stefania La Grutta, Franca Rusconi, the Italian Pediatric Severe Asthma Network (IPSAN) Program of Italian Paediatric Respiratory Society (IPRS), Sergio Amarri, Simona Barni, Alfio Capizzi, Fabio Cardinale, Silvia Carraro, Salvatore Cazzato, Renato Cutrera, Sabrina Di Pillo, Marzia Duse, Grazia Fenu, Ahmad Kantar, Salvatore Leonardi, Enrico Lombardi, Gian Luigi Marseglia, Luana Nosetti, Elio Novembre, Maria Francesca Patria, Giorgio Piacentini, Giovanna Pisi, Giampaolo Ricci, Oliviero Sacco, Francesca Santamaria, Laura Tenero, Maria Angela Tosca, M.C. Tripodi, Alessandro Volpini
Abstract
Knowledge on multiple interdependences between quality of life (QoL) and behavioural problems in relation to asthma severity and control is undetermined. The aims of the study were: (i) to assess the relationship of QoL and behavioural problems with asthma severity and control (ii) to predict children's "abnormal/borderline" status with variation in QoL. For these purposes a multicenter case-control study on 47 Severe Asthma (SA) and 94 Moderate Asthma (MA) children was performed. The MIMIC approach was applied to investigate the effect of SA and non-controlled asthma (NC) on QoL and behavioural disorders. Logistic regression was used to estimate probabilities of having an "abnormal/borderline" status with variation in QoL. The MIMIC model showed that the magnitude of the effect of SA and NC was larger on QoL (β = -0.37 and β = -0.30, respectively) than on behavioural problems (β = 0.27). With regards to the probability of having a borderline status, in MA a QoL of 1 returned a probability of 0.81, whereas in SA a QoL of 1 returned a probability of 0.89. In conclusion, SA children are highly affected by impaired QoL and behavioural problems. The MIMIC model allowed us to obtain a comprehensive assessment of QoL and behavioural problems with asthma severity and control.