Quality-of-life assessment in Chinese families with food-allergic children


Ting Fan Leung, Department of Paediatrics, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong. E-mail:


Background Caucasian families with food-allergic children have a compromised quality of life (QoL) for fear of life-threatening food reactions. Such data are limited in Asian children. Based on our recent questionnaire-based survey, 8.1% of young children recruited from local nurseries and kindergartens had parent-reported adverse food reactions (AFRs).

Objective This study tested the robustness of the Chinese Food Allergy Quality of Life-Parental Burden questionnaire (FAQL-PB) and assessed QoL in families with childhood AFR. The correlations among FAQL-PB items were evaluated by factor analysis.

Methods Two hundred and ninety-eight of 3677 children aged 2–7 years had parent-reported AFR, and 197 (66.1%) of them completed the 17 items of our self-administered FAQL-PB. Six hundred and thirty-nine (18.9%) children without AFR returned this questionnaire. Factor analysis was used to delineate the inter-relationship among the FAQL-PB items.

Results Cronbach α for our Chinese FAQL-PB was 0.976, and the median (interquartile range) FAQL-PB scores of children with and without parent-reported AFR were 0.10 (0.02–0.32) and 0 (0–0.18), respectively (P<0.001). Factor analysis confirmed excellent correlations between FAQL-PB items. The 17 items were clustered into two factors, which explained 79.7% of the total variance. Among children with AFR, FAQL-PB scores increased with increasing numbers of foods that caused AFRs (P<0.001 for trend). Thirty (15.2%) children had impaired QoL, defined as average item FAQL-PB score geqslant R: gt-or-equal, slanted0.5. Impaired QoL was associated with AFR that was caused by >3 foods (P=0.001), current food avoidance (P=0.005) and AFR caused by peanut (P=0.003), egg (P=0.011) and cow's milk (P=0.028), and current flexural dermatitis (P=0.011).

Conclusions FAQL-PB is a robust measure of AFR-specific parental QoL, which is impaired in Chinese children with parent-reported AFR. Flexural dermatitis, current food voidance and AFR caused by multiple foods are independent risk factors for lower parental QoL.