Parents´ perception of allergic or food intolerant children in relation to disease
DOI:
https://doi.org/10.7322/jhgd.v29.9533Keywords:
qualitative analysis, milk hypersensitivity, lactose intoleranceAbstract
Introduction: Cow´s milk protein allergy (CMPA) and lactose intolerance (LI) negatively affect the quality of life of patients and their families.
Objective: To analyse the perception parents of children with CMPA or LI regarding aspects of health, emphasising their oral health and the factors involved in the treatment of allergy/food intolerance.
Methods: Qualitative research employing focus groups, with a sample of 12 parents of children with CMPA or LI (two groups), including the participation of a researcher/moderator, an observer, and six participants in each group and a plan with guiding questions. Discourses were recorded and transcribed, and textual contents were processed in software IRAMUTEQ and analysed by the descendant hierarchical classification (DHC) technique, content analysis, and word cloud.
Results: Six categories were derived from DHC-multivariate analysis: (1) infant formula, (2) oral health, (3) nutritional aspects, (4) treatment, (5) disease´s stigma, and (6) health services. The thematic axes were derived from nutritional, assistance, and care categories. Reports of different oral diseases were given by parents regarding food allergy or intolerance in their children, such as frequent caries, teeth spots, pain, and sensitive teeth.
Conclusion: Parents´ perception of CMPA/LI in their children is affected by nutritional factors and the stigma caused by the disease, with special reference to the importance given to children´s oral health and reports about difficulties in the access to health services with multi-professional teams.
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References
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14. MacKenzie H, Roberts G, van Laar D, Dean T. Teenagers’ experiences of living with food hypersensitivity: a qualitative study. Pediatr Allergy Immunol. 2010;21(4 Pt 1):595-602. DOI: http://dx.doi.org/10.1111/j.1399-3038.2009.00938.x
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20. Reinert M. Alceste une méthodologie d’analyse des donnés textuelles et une application: Aurelia de Gerard de Nerval. Bull Methodol Sociol. 1990;26(1):24-54. DOI: http://dx.doi.org/10.1177/075910639002600103
21. Queiroz AAFLN, Sousa AFL. Fórum PrEP: um debate on-line sobre uso da profilaxia pré-exposição no Brasil. Cad Saúde Pública. 2017;33(11):e00112516. DOI: http://dx.doi.org/10.1590/0102-311x00112516
22. Shimizu HE, Cruz MS, Bretas Júnior N, Schierholt SR, Ramalho WM, Ramos MC, et al. O protagonismo dos Conselhos de Secretários Municipais no processo de governança regional. Cien Saude Coletiv. 2017;22(4):1131-40. DOI: http://dx.doi.org/10.1590/1413-81232017224.28232016
23. Campos CJG, Turato ER. Análise de conteúdo em pesquisas que utilizam metodologia clínico-qualitativa: aplicação e perspectivas. Rev Latino-Am Enfermagem. 2009;17(2):259-64. DOI: http://dx.doi.org/10.1590/S0104-11692009000200019
24. Bardin L. Análise de conteúdo. São Paulo: Edições 70, 2011.
25. Camargo BV, Justo AM. IRAMUTEQ: um software gratuito para análise de dados textuais. Temas Psicol. 2013;21(2):513-18. DOI: http://dx.doi.org/10.9788/TP2013.2-16
26. Binsfeld BL, Pastorino AC, Castro APBM, Yonamine GH, Gushken AKF, Jacob CMA. Conhecimento da rotulagem de produtos industrializados por familiares de pacientes com alergia a leite de vaca. Rev Paul Pediatr. 2009;27(3):296-302. DOI: http://dx.doi.org/10.1590/S0103-05822009000300010
27. Mofidi S. Nutritional management of pediatric food hypersensitivity. Pediatrics. 2003;111(6):1645-53.
28. Mazer Papa AM, Tabchoury CP, Del Bel Cury AA, Tenuta LM, Arthur RA, Cury JA. Effect of milk and soy-based infant formulas on in situ demineralization of human primary enamel. Pediatr Dent. 2010;32(1):35-40.
29. Cagetti MG, Congiu G, Cocco F, Meloni G, Sale S, Campus G. Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study. BMC Public Health. 2016;16(1):1213. DOI: http://dx.doi.org/10.1186/s12889-016-3865-4
30. Carvalho CAP, Nicodemo CAZ, Mercadante DCF, Carvalho FS, Buzalaf, MAR, Sales-Peres SHC. Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride. Clin Nutr. 2013;32(3):432-37. DOI: http://dx.doi.org/10.1016/j.clnu.2012.09.006
31. Torres CP, Chinelatti MA, Gomes-Silva JM, Rizóli FA, Oliveira MAHM, Palma-Dibb RG, et al. Surface and subsurface erosion of primary enamel by acid beverages over time. Braz Dent J. 2010;21(4):337-45. DOI: http://dx.doi.org/10.1590/s0103-64402010000400009
32. Moimaz SAS, Amaral MA, Garbin CAS, Saliba TA, Saliba O. Caries in children with lactose intolerance and cow's milk protein allergy. Braz Oral Res. 2018;32:e91. DOI: http://dx.doi.org/10.1590/1807-3107bor-2018.vol32.0091
33. Edmonds-Myles S, Tamborlane WV, Grey M. Perception of the impact of type 1 diabetes on low-income families. Diabetes Educ. 2010;36(2):318-25. DOI: http://dx.doi.org/10.1177/0145721709349219
34. Luna A, Gomes M, Granville-Garcia A, Menezes V. Perception of treatment needs and use of dental services for children and adolescents with sickle cell disease. Oral Health Prev Dent. 2018;16(1):51-7. DOI: http://dx.doi.org/10.3290/j.ohpd.a39817
35. Rouf K, White L, Evans K. A qualitative investigation into the maternal experience of having a young child with severe food allergy. Clin Child Psychol Psychiatry. 2011;17(1):49-64. DOI: http://dx.doi.org/10.1177/1359104511415636
36. Teufel M, Biedermann T, Rapps N, Hausteiner C, Henningsen P, Enck P, et al. Psychological burden of food allergy. World J Gastroenterol. 2007;13(25):3456-65. DOI: http://dx.doi.org/10.3748/wjg.v13.i25.3456
37. Freitas MCS, Minayo MCS, Ramos LB, Fontes GV, Santos LA, Souza EC, et al. Escola: lugar de estudar e de comer. Cienc Saude Coletiva. 2013;18(4):979-85. DOI: http://dx.doi.org/10.1590/S1413-81232013000400010
38. Alanne S, Laitinen K, Soderlund R, Paavilainen E. Mothers' perceptions of factors affecting their abilities to care for infants with allergy. J Clin Nurs. 2011;21(1-2):170-9. DOI: http://dx.doi.org/10.1111/j.1365-2702.2010.03587.x
39. Hodge A. Challenges in child and adolescent nutrition. Public Health Nutr. 2019;22(1):1-2. DOI: https://doi.org/10.1017/S1368980018003646
40. Bischoff SC, Boirie Y, Cederholm T, Chourdakis M, Cuerda C, Delzenne NM, et al. Towards a multidisciplinary approach to understand and manage obesity and related diseases. Clin Nutr. 2017;36(4):917-38. DOI: http://dx.doi.org/10.1016/j.clnu.2016.11.007
2. National Institute for Health and Clinical Excellence. Food allergy in children and young people: diagnosis and assessment of food allergy in children and young people in primary care and community settings. London: NICE; 2011.
3. Zhu J, Pouillot R, Kwegvir-Afful EK, Luccioli S, Gendel SM. A retrospective analysis of allergic reaction severities and minimal eliciting doses for peanut, milk, egg, and soy oral food challenges. Food Chem Toxicol. 2015;80:92-100. DOI: http://dx.doi.org/10.1016/j.fct.2015.02.023
4. Luyt D, Ball H, Makwana N, Green MR, Bravin K, Nasser SM, et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy. 2014;44(5):642-72. DOI: http://dx.doi.org/10.1111/cea.12302
5. Nosan G, Jakic M, Jager M, Paro-Panjan D. Prognostic accuracy of clinical signs and diagnostic tests in cow's milk allergy in newborns. Pediatr Neonatol. 2017;58(5):449-54. DOI: http://dx.doi.org/10.1016/j.pedneo.2016.09.009
6. Fiocchi A, Brozek J, Schünemann H, Bahna SL, Berg A, Beyer K, et al. World Allergy Organization (WAO) diagnosis and rationale for action against cow’s milk allergy (DRACMA) guidelines. Pediatr Allergy Immunol. 2010; 21 (Suppl 21):1-125. DOI: http://dx.doi.org/10.1111/j.1399-3038.2010.01068.x
7. Sahi T. Genetics and epidemiology of adult-type hypolactasia. Scand J Gastroenterol Suppl. 1994;202:7-20. DOI: http://dx.doi.org/10.3109/00365529409091740
8. Mattar R, Mazo DFC. Intolerância à lactose: mudança de paradigmas com a biologia molecular. Rev Assoc Med Bras. 2010;56(2):230-6. DOI: http://dx.doi.org/10.1590/S0104-42302010000200025
9. Mehta R. Allergy and asthma: food allergies. FP Essent. 2018;472:16-19.
10. Cordero RC, Prado SF, Bravo JP. Actualización en manejo de Alergia a la proteína de leche de vaca: fórmulas lácteas disponibles y otros brebajes. Rev Chil Pediatr. 2018;89(3):310-17. DOI: http://dx.doi.org/10.4067/S0370-41062018005000503
11. Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010;65(8):933-45. DOI: http://dx.doi.org/10.1111/j.1398-9995.2010.02342.x
12. Monks H, Gowland MH, MacKenzie H, ErlewynLajeunesse M, King R, Lucas JS, et al. How do teenagers manage their food allergies? Clin Exp Allergy. 2010;40(10):1533-40. DOI: http://dx.doi.org/10.1111/j.1365-2222.2010.03586.x
13. Bollinger ME, Dahlquist LM, Mudd K, Sonntag C, Dillinger L, McKenna K. The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol. 2006;96(3):415-21. DOI: http://dx.doi.org/10.1016/S1081-1206(10)60908-8
14. MacKenzie H, Roberts G, van Laar D, Dean T. Teenagers’ experiences of living with food hypersensitivity: a qualitative study. Pediatr Allergy Immunol. 2010;21(4 Pt 1):595-602. DOI: http://dx.doi.org/10.1111/j.1399-3038.2009.00938.x
15. Yonamine GH, Contim D, Castro APBM, Jacob CMA, Pastorino AC. Percepção dos familiares de pacientes com alergia ao leite de vaca em relação ao tratamento. J Hum Growth Dev. 2013;23(1):58-64. DOI: https://doi.org/10.7322/jhgd.50392
16. Iervolino SA, Pelicioni MCF. A utilização do grupo focal como metodologia qualitativa na promoção da saúde. Rev Esc Enferm USP. 2001;35(2):115-21. DOI: http://dx.doi.org/10.1590/S0080-62342001000200004
17. Turato ER. Tratado de metodologia da pesquisa clínico-qualitativa: construção teórico-epistemológica, discussão comparada e aplicação nas áreas de saúde e humanas. Petrópolis: Vozes, 2003.
18. Lebart L, Salem A. Statistique textuelle. Paris: DUNOP, 1994.
19. Ratinaud P. IRAMUTEQ: Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Un logiciel libre construit avec des logiciels libres. [cited 2017 May 19]. Available from: http://www.iramuteq.org/
20. Reinert M. Alceste une méthodologie d’analyse des donnés textuelles et une application: Aurelia de Gerard de Nerval. Bull Methodol Sociol. 1990;26(1):24-54. DOI: http://dx.doi.org/10.1177/075910639002600103
21. Queiroz AAFLN, Sousa AFL. Fórum PrEP: um debate on-line sobre uso da profilaxia pré-exposição no Brasil. Cad Saúde Pública. 2017;33(11):e00112516. DOI: http://dx.doi.org/10.1590/0102-311x00112516
22. Shimizu HE, Cruz MS, Bretas Júnior N, Schierholt SR, Ramalho WM, Ramos MC, et al. O protagonismo dos Conselhos de Secretários Municipais no processo de governança regional. Cien Saude Coletiv. 2017;22(4):1131-40. DOI: http://dx.doi.org/10.1590/1413-81232017224.28232016
23. Campos CJG, Turato ER. Análise de conteúdo em pesquisas que utilizam metodologia clínico-qualitativa: aplicação e perspectivas. Rev Latino-Am Enfermagem. 2009;17(2):259-64. DOI: http://dx.doi.org/10.1590/S0104-11692009000200019
24. Bardin L. Análise de conteúdo. São Paulo: Edições 70, 2011.
25. Camargo BV, Justo AM. IRAMUTEQ: um software gratuito para análise de dados textuais. Temas Psicol. 2013;21(2):513-18. DOI: http://dx.doi.org/10.9788/TP2013.2-16
26. Binsfeld BL, Pastorino AC, Castro APBM, Yonamine GH, Gushken AKF, Jacob CMA. Conhecimento da rotulagem de produtos industrializados por familiares de pacientes com alergia a leite de vaca. Rev Paul Pediatr. 2009;27(3):296-302. DOI: http://dx.doi.org/10.1590/S0103-05822009000300010
27. Mofidi S. Nutritional management of pediatric food hypersensitivity. Pediatrics. 2003;111(6):1645-53.
28. Mazer Papa AM, Tabchoury CP, Del Bel Cury AA, Tenuta LM, Arthur RA, Cury JA. Effect of milk and soy-based infant formulas on in situ demineralization of human primary enamel. Pediatr Dent. 2010;32(1):35-40.
29. Cagetti MG, Congiu G, Cocco F, Meloni G, Sale S, Campus G. Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study. BMC Public Health. 2016;16(1):1213. DOI: http://dx.doi.org/10.1186/s12889-016-3865-4
30. Carvalho CAP, Nicodemo CAZ, Mercadante DCF, Carvalho FS, Buzalaf, MAR, Sales-Peres SHC. Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride. Clin Nutr. 2013;32(3):432-37. DOI: http://dx.doi.org/10.1016/j.clnu.2012.09.006
31. Torres CP, Chinelatti MA, Gomes-Silva JM, Rizóli FA, Oliveira MAHM, Palma-Dibb RG, et al. Surface and subsurface erosion of primary enamel by acid beverages over time. Braz Dent J. 2010;21(4):337-45. DOI: http://dx.doi.org/10.1590/s0103-64402010000400009
32. Moimaz SAS, Amaral MA, Garbin CAS, Saliba TA, Saliba O. Caries in children with lactose intolerance and cow's milk protein allergy. Braz Oral Res. 2018;32:e91. DOI: http://dx.doi.org/10.1590/1807-3107bor-2018.vol32.0091
33. Edmonds-Myles S, Tamborlane WV, Grey M. Perception of the impact of type 1 diabetes on low-income families. Diabetes Educ. 2010;36(2):318-25. DOI: http://dx.doi.org/10.1177/0145721709349219
34. Luna A, Gomes M, Granville-Garcia A, Menezes V. Perception of treatment needs and use of dental services for children and adolescents with sickle cell disease. Oral Health Prev Dent. 2018;16(1):51-7. DOI: http://dx.doi.org/10.3290/j.ohpd.a39817
35. Rouf K, White L, Evans K. A qualitative investigation into the maternal experience of having a young child with severe food allergy. Clin Child Psychol Psychiatry. 2011;17(1):49-64. DOI: http://dx.doi.org/10.1177/1359104511415636
36. Teufel M, Biedermann T, Rapps N, Hausteiner C, Henningsen P, Enck P, et al. Psychological burden of food allergy. World J Gastroenterol. 2007;13(25):3456-65. DOI: http://dx.doi.org/10.3748/wjg.v13.i25.3456
37. Freitas MCS, Minayo MCS, Ramos LB, Fontes GV, Santos LA, Souza EC, et al. Escola: lugar de estudar e de comer. Cienc Saude Coletiva. 2013;18(4):979-85. DOI: http://dx.doi.org/10.1590/S1413-81232013000400010
38. Alanne S, Laitinen K, Soderlund R, Paavilainen E. Mothers' perceptions of factors affecting their abilities to care for infants with allergy. J Clin Nurs. 2011;21(1-2):170-9. DOI: http://dx.doi.org/10.1111/j.1365-2702.2010.03587.x
39. Hodge A. Challenges in child and adolescent nutrition. Public Health Nutr. 2019;22(1):1-2. DOI: https://doi.org/10.1017/S1368980018003646
40. Bischoff SC, Boirie Y, Cederholm T, Chourdakis M, Cuerda C, Delzenne NM, et al. Towards a multidisciplinary approach to understand and manage obesity and related diseases. Clin Nutr. 2017;36(4):917-38. DOI: http://dx.doi.org/10.1016/j.clnu.2016.11.007
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2019-12-12
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