Identifying barriers to obstructive sleep-disordered breathing care: Parental perspectives.

Autor: Jungbauer WN Jr; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Zhang K; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Melvin CL; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA., Nietert PJ; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA., Ford ME; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA., Pecha PP; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: pechap@musc.edu.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2023 Aug; Vol. 171, pp. 111621. Date of Electronic Publication: 2023 Jun 03.
DOI: 10.1016/j.ijporl.2023.111621
Abstrakt: Objective: Despite established clinical practice guidelines for pediatric obstructive sleep-disordered breathing (SDB), disparities persist for this common condition. Few studies have investigated parental experiences about challenges faced in obtaining SDB evaluation and tonsillectomy for their children. To better understand parent-perceived barriers to treatment of childhood SDB, we administered a survey to assess parental knowledge of this condition.
Materials & Methods: A cross-sectional survey was designed to be completed by parents of children diagnosed with SDB. Two validated surveys were administered: 1) Barriers to Care Questionnaire and 2) Obstructive Sleep-Disordered Breathing and Adenotonsillectomy Knowledge Scale for Parents. Logistic regression modeling was performed to assess for predictors of parental barriers to SDB care and knowledge.
Results: Eighty parents completed the survey. Mean patient age was 7.4 ± 4.6 years, and 48 (60%) patients were male. The survey response rate was 51%. Patient racial/ethnic categories included 48 (60.0%) non-Hispanic White, 18 (22.5%) non-Hispanic Black, and 14 (17.5%) Other. Parents reported challenges in the 'Pragmatic' domain, including appointment availability and cost of healthcare, as the most frequently described barrier to care. Adjusting for age, sex, race, and education, parents in the middle-income bracket ($26,500 - $79,500) had higher odds of reporting greater barriers to care than parents in the highest (>$79,500) income tier (OR 5.536, 95% CI 1.312-23.359, P = 0.020) and lowest income tier (<$26,500) (OR 3.920, 95% CI 1.096-14.020). Parents whose children had tonsillectomy (n = 40) answered only a mean 55.7% ± 13.3% of questions correctly on the knowledge scale.
Conclusion: Pragmatic challenges were the most encountered barrier that parents reported in accessing SDB care. Families in the middle-income tier experienced the greatest barriers to SDB care compared to lower and higher income families. In general, parental knowledge of SDB and tonsillectomy was relatively low. These findings represent potential areas of improvement to target interventions to promote equitable care for SDB.
Competing Interests: Declaration of competing interest W. Nicholas Jungbauer Jr, BS: NO conflicts of interest to disclose. Kathy Zhang, MD: NO conflicts of interest to disclose. Cathy L. Melvin, PhD: NO conflicts of interest to disclose. Paul J. Nietert, PhD: NO conflicts of interest to disclose. Marvella E. Ford, PhD: NO conflicts of interest to disclose. Phayvanh P. Pecha, MD: NO conflicts of interest to disclose.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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