Parents are poor at labelling wheeze in children: a cross-sectional study

Abstract

BackgroundNoisy breathing is a common presenting symptom in children. The purpose of this study is to (a) assess parental ability to label wheeze, (b) compare the ability of parents of children with and without asthma to label wheeze and (c) determine factors affecting parental ability to label wheeze correctly.MethodsThis cross-sectional study in a tertiary hospital in Kuala Lumpur, Malaysia involved parents of children with asthma. Parents of children without asthma were the control group. Eleven validated video clips showing wheeze, stridor, transmitted noises, snoring or normal breathing were shown to the parents. Parents were asked, in English or Malay, “What do you call the sound this child is making?” and “Where do you think the sound is coming from?”ResultsTwo hundred parents participated in this study: 100 had children with asthma while 100 did not. Most (71.5 %) answered in Malay. Only 38.5 % of parents correctly labelled wheeze. Parents were significantly better at locating than labelling wheeze (OR 2.4, 95 % CI 1.64–3.73). Parents with asthmatic children were not better at labelling wheeze than those without asthma (OR1.04, 95 % CI 0.59–1.84). Answering in English (OR 3.4, 95 % CI 1.69–7.14) and having older children with asthma (OR 9.09, 95 % CI 3.13–26.32) were associated with correct labelling of wheeze. Other sounds were mislabelled as wheeze by 16.5 % of respondents.ConclusionParental labelling of wheeze was inaccurate especially in the Malay language. Parents were better at identifying the origin of wheeze rather than labelling it. Physicians should be wary about parental reporting of wheeze as it may be inaccurate.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0616-8) contains supplementary material, which is available to authorized users.

The effect of montelukast on early‐life wheezing: A randomized, double‐blinded placebo‐controlled study

“…It should also be noted that the reported wheezing by the caregiver may not always be accurate especially for those whose native tongue is not English. 31 Montelukast treatment decreased the wheezing score and reduced the need for inhaled β2-agonist medication in the first weeks of a recurrent wheezing illness for children 3-36 months of age. Further studies could better define the importance of wheezing episodes and burden of β2-agonist rescue events to caregivers and better define the optimal duration of montelukast therapy to achieve these benefits.…”

“…Larger studies will be better able to control for confounding present at baseline, including the imbalance in cys_LTs levels observed in this study. It should also be noted that the reported wheezing by the caregiver may not always be accurate especially for those whose native tongue is not English …”

Caregiver Assessment of Wheeze for Pediatric Pneumonia

“…One study of Malaysian parents found that only one third correctly labeled wheeze when shown videos of isolated respiratory sounds. 4 Another study compared parental report of wheeze with physician assessment in young children at high risk of asthma, and of the cases when parents reported wheeze, only 70% were confirmed by a physician. 5 Our findings are consistent with these studies, suggesting that parents tend to overestimate the presence of wheeze in real-life scenarios.…”

“…Accuracy of caregiver report of wheeze has predominately been evaluated through the use of videos. 3,4 While such methods have allowed for standardized assessment, they are limited in indicating how well caregivers recognize wheeze in real-life scenarios. Thus, we conducted a study of over 800 children undergoing evaluation for pneumonia in order to determine the test characteristics of parental report of wheeze compared with physician assessment.…”

Wheezing and Associated Risk Factors Among Children in Flood Prone Areas of a Central Nigerian Metropolis

“…Including children from areas free of flooding as well as a study of flood prone areas during the dry season would have provided control groups with which to better explain findings reported by this study and availed data on relative humidity of homes for the two seasons. Some studies [46][47][48] have related the presence of air pollutants such as gases, smoke, fungal spores and dust particles to development of wheezing in children. This study was, however, unable to include these kind of risk factors.…”