Children's Food Allergies: Development of the Food Allergy Management and Adaptation Scale

Klinnert, Mary D.; McQuaid, Elizabeth L.; Fedele, David A.; Faino, Anna; Strand, Matthew; Robinson, Jane; Atkins, Dan; Fleischer, David M.; Hourihane, Jonathan; Cohen, Sophia; Fransen, Hannah

doi:10.1093/jpepsy/jsv009

Cited by 31 publications

(22 citation statements)

References 34 publications

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“…(21) Three children were accompanied to the study only by their fathers. The more homogenous sample of mothers and their children ( n = 57) was used for reported analyses.…”

Section: Resultsmentioning

confidence: 99%

“…(21) Ratings for FAMAS subscales are based on parents and children’s verbal responses and emotional reactions throughout the interview. Table 1 lists the FAMAS subscales; the FAMAS interview is available on-line.…”

Section: Methodsmentioning

confidence: 99%

“…Table 1 lists the FAMAS subscales; the FAMAS interview is available on-line. (21) FAMAS interviews were video recorded to allow subsequent ratings to be made independently by study personnel using a standard scoring manual. Independent ratings of the interviews demonstrated excellent inter-rater reliability (ICCs 0.94– 0.98 across scales).…”

Section: Methodsmentioning

confidence: 99%

“…(20) Since no previous measures have simultaneously addressed the affected child and family’s functioning in the three domains of FA adaptation, we developed and validated the Food Allergy Management and Adaptation Scale (FAMAS). (21) The FAMAS is a semi-structured interview designed for families of 6 to 12 year-old children with FA, with rating scales that assess both child and family FA management skills and FA-related anxiety, and the family’s overall balanced integration (Table 1). …”

Section: Introductionmentioning

confidence: 99%

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Patterns of adaptation to children's food allergies

Fedele

McQuaid

Faino

et al. 2016

Allergy

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Background Families with food allergy (FA) are at risk of reduced quality of life and elevated anxiety. A moderate level of anxiety may be beneficial to sustain vigilance for food avoidance; however, excessive anxiety may increase risk for burden and maladjustment. The current study presents a framework for understanding patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention. Methods Participants included 57 children, 6 to 12 years old with documented FA, and their mothers. Families were assessed using the Food Allergy Management and Adaptation Scale. Families also completed measures of quality of life, anxiety, FA management, and psychosocial impairment. Results A hierarchical cluster analysis revealed that 56 of the 57 families of food allergic children were categorized into four groups that differed on their adequacy of family FA management, levels of anxiety, and balanced psychosocial functioning: Balanced Responders (n = 23; 41%), High Responders (n = 25; 45%), and Low Responders (n = 3; 5%). The fourth group, Anxious High Responders (n = 5; 9%), was characterized by extremely high maternal FA anxiety scores and low scores for balanced integration of FA management and psychosocial functioning. Families in clusters differed across illness and psychosocial outcome variables. Conclusion Families with FA were characterized by patterns of FA management, anxiety, and ability to integrate FA demands into daily life. Identified adaptation patterns correspond with clinical impressions and provide a framework for identifying families in need of intervention.

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“…(21) Three children were accompanied to the study only by their fathers. The more homogenous sample of mothers and their children ( n = 57) was used for reported analyses.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patterns of adaptation to children's food allergies

Fedele

McQuaid

Faino

et al. 2016

Allergy

Self Cite

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“…Parents are understandably motivated to protect their own child to the greatest possible extent in their role as parents, but the allergy literature is now full of reports of disproportionate parental anxiety impacting adversely on family life, interpersonal relationships, and general social functioning 19, 20, 24. Instructions to use an autoinjector device, irrespective of severity and especially when symptoms are actually absent, are likely to add to parental and patient anxiety; this is maladaptive and counterproductive, in that it results in lower self-efficacy and competence in emergency care,25, 26 in turn leading to a greater adverse impact on food allergy-related quality of life.…”

Section: Can Using Epinephrine Autoinjectors For Mild Allergic Symptomentioning

confidence: 99%

The Emperor Has No Symptoms: The Risks of a Blanket Approach to Using Epinephrine Autoinjectors for All Allergic Reactions

Turner

DunnGalvin

Hourihane

2016

The Journal of Allergy and Clinical Immunology: In Practice

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Fatal anaphylaxis in humans is rare and unpredictable. We note a trend to provide allergic individuals with care plans that recommend immediate use of epinephrine autoinjectors if allergen ingestion is suspected, even in the absence of any allergic symptoms, without any supporting evidence base. Instructions to use an autoinjector device, irrespective of reaction severity and especially when symptoms are actually absent, are likely to add to parental and patient anxiety. Of greater concern is the possibility of epinephrine being administered “too early” to treat initial, mild symptoms that then progress to severe anaphylaxis. It is not hard to visualize a scenario where one or both epinephrine autoinjectors have been deployed for mild symptoms, yet the reaction progresses to a severe reaction and no further epinephrine is available for administration. Epinephrine needs to be available as a rescue treatment for anaphylaxis, potentially buying valuable minutes while emergency medical services are activated to attend. Food-allergic individuals and their carers need to be provided with more constructive strategies and support than merely being told to “use your pen.”

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