Stress management is important for mothers of pediatric patients with atopic dermatitis

Parents of children who have atopic dermatitis (AD), their mothers in particular, have been shown in a new study to experience high levels of stress and decreased quality of life (QOL) due to childcare. These findings indicate the lack and great need for more substantial support for caregivers of pediatric AD patients, as well as the potential for government-supported stress relief programs.

“Chronic disease course, including recurrent acute exacerbations, burden of treatment, dermatologic complications, and coexisting medical comorbidities, as well as psychiatric conditions, degrade the quality of life for patients and their families,” the authors wrote. of the study in Dermato-Venereological Act. “Although several journals have reported on psychological stress in parents of children with AD, there have been no large-scale, well-designed statistical studies.”

Their cross-sectional analysis used data from 2009 to 2012 from the Korea National Health and Nutrition Examination Survey, and covered 6903 pediatric patients (under 19 years of age) matched 1:6 with the AD group (n = 970) or healthy controls ( n = 5733). Psychological stress was assessed in 4 areas: self-perception of stress, depressed mood, suicidal ideation, and receiving a diagnosis of depression from a physician.

Mean (SD) measures of patient statistics were comparable between groups, with 51.49% (1.88%) and 53.36% (0.78%), respectively, male patients; mean ages (SD) of 9.75 (0.21) and 10.48 (0.11) years; most patients are under 10 years of age (49.18% [2.13%] and 40.65% [0.97%]) or from 10 to 15 years (30.56% [1.85%] and 30.69 [0.72%]); 8.77% (1.48%) and 9.63% (0.76%) considered low income; and body mass indices of 18.74 (0.17) and 19.2 (0.07) kg/m2. Among fathers, those who had children with AD were younger than those whose children did not have AD (41.26 vs 42.72 years), drank less monthly (43.37% vs 49.11%), fewer mothers considered themselves obese (19.04% vs 25.03%), and most of the parents had a high educational level (93.64% vs 88.64%).

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In the authors’ first model, which adjusted for parental age only, stress and suicidal ideation were significantly increased among mothers of children with AD compared with those whose children did not have AD, by 47% (odds adjusted ratio [aOR], 1.47; 95% CI, 1.23-1.75; P <0.01) and 39% (aOR, 1.39; 95% CI, 1.087-1.77; P < .01) higher, respectively. For the second model that adjusted for age, sex, education level, occupation, and marital status, stress and suicidal ideation had similarly elevated rates for mothers, at 46% (aOR, 1.46; 95% CI , 1.22-1.74; P <0.001) and 40% (aOR, 1.40; 95% CI, 1.10-1.79; P < .01).

“Parents of children with AD did not show a significant difference on all items from those of children without AD,” the authors added.

Results regarding quality of life assessed using the EuroQol-5 Dimension Index (EQ-5D) and the EuroQol Visual Analogue Scale (EQ-VAS) show significantly lower results for mothers of children living with AD compared to children without AD:

  • EQ-5D: 0.96 vs. 0.97 (P < .01)
  • EQ-VAS: 74.54 vs. 76.35 (P = .01)

Speaking of how their findings add to the current literature, the authors of the present study note that they echo previous literature showing increased parenting stress only among mothers. Possible reasons for the increased stress include time spent on housework, which the authors say is 4 times more for women than men in Korea; feel more guilt about your child’s symptoms; and the time needed to care for children with AD. Also, among younger children with AD, sleep deprivation and emotional stress are reported, the authors noted.

“It is significant that analysis of the results for mothers and fathers separately showed the need to focus more on mothers, who are the primary caregivers in Korean society, with regard to parental stress management,” the researchers concluded. authors. “The findings have important implications for clinical practice regarding the need for assessment, management, and support for parents, especially mothers, of children with AD.”

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Lee HJ, Lee GN, Lee JH, et al. Psychological stress in parents of children with atopic dermatitis: a cross-sectional study of the Korean National Health and Nutrition Examination Survey. Acta Derm Venereol. 2023;103:adv00844. doi:10.2340/actadv.v103.2242