Accuracy of cough reporting by carers of Indigenous children

Authors

  • Matthew J Morey,

    Corresponding author
    1. Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
    • Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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  • Allen C Cheng,

    1. Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
    2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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  • Gabrielle B McCallum,

    1. Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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  • Anne B Chang

    1. Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
    2. Department of Respiratory Medicine, Queensland Children's Medical Research Institute, Royal Children's Hospital, Brisbane, Queensland, Australia
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  • Research was conducted at Menzies School of Health Research, PO Box 41096, Casuarina NT 0811; Phone: 08 8922 8196 and Fax: 08 8927 5187.
  • Conflict of interest: None declared.
  • This article should be published in the Journal of Paediatrics and Child Health because it is of importance and relevance to all Australian medical and health practitioners.
  • This manuscript content (in part or full) has not been submitted or published elsewhere.
  • This research has full ethics approval by the Human Research Ethics Committee of NT Department of Health & Families and Menzies School of Health Research.
  • All participants gave full consent and patient anonymity has been preserved.
  • All authors have contributed significantly and are in agreement with the content of the manuscript.

Correspondence: Dr Matthew Morey, University of Melbourne, PO Box 6500, Shepparton, Vic. 3632, Australia. Fax: (03) 5823 4555; email: matthewjmorey@gmail.com

Abstract

Aims

The study aims to determine the reliability of a 24-h history of reported cough presence and quality (wet/dry) compared with objectively recorded cough, and evaluate factors that may influence cough reporting.

Methods

A digital recorder (ICD-PX720, Sony, Tokyo, Japan) was attached to 47 Indigenous children for 24 h during admission at Royal Darwin Hospital. After recording, carers reported their child's cough details. Cough counts were objectively measured and details of cough reports by carer (cough present/absent, quality wet/dry, cough severity determined by visual analogue scale and verbal category descriptive score) were the main outcomes measured. Other factors examined were: carer's sex, age, education, smoking, carer's cough, parent versus non-parent, respiratory illness in child and mean parent–proxy cough-specific quality of life questionnaire. Data were entered into STATA (V.10, STATA Corp., College Station, TX, USA). Cohen's kappa (κ) coefficients and Spearman's rank correlation coefficient (rs) were used for data analysis.

Results

Reporting of cough by Indigenous carers (compared with cough monitoring) was slight when a low cough threshold (0.25 coughs/h) was used (κ = 0.17, 95% CI –0.15, 0.49) and moderate when a higher cough threshold was used (κ = 0.57, 95% CI 0.28, 0.88). Carers’ evaluation of wet cough disagreed with clinician's evaluation (κ = −0.24, 95% CI –0.58, 0.09). Subjective reporting of cough severity moderately correlated with objective cough rates (rs = 0.41 to 0.44, 95% CI 0.11, 0.67). None of the factors examined was associated with reliability of cough reporting.

Conclusions

The unreliability of reporting of cough highlights the need for community education on the importance of cough to improve health-seeking behaviour for early detection and treatment of respiratory disease.

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