The role of food allergy-related worry and self-efficacy in explaining quality-of-life in caregivers of children

Background:
Food allergy (FA) is associated with considerable worry and poorer quality of life (QOL) in caregivers. High self-efficacy for managing FA might reduce this impact but these relationships have not been examined with FA-specific measures. This study aimed to explore relationships between worry, QoL and self-efficacy using FA-specific measures and provide further validation data for a revised Worry About Food Allergy (WAFA) scale, enabling differences in worry across child age to be examined.

Methods:
Caregivers of children with a food allergy (n = 240), recruited through patient organizations, completed the Worry About Food Allergy (WAFA) scale, Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), Food Allergy Self-Efficacy scale for Parents (FASE-P) and clinical and demographic questions.

Results:
The revised WAFA demonstrated excellent reliability for the full pre-school, child and teen versions (Cronbach's alphas .95–.96) and short-form versions (Cronbach's alpha .87–.92). Caregivers of 0-5 year olds had significantly more FA-related worry and less self-efficacy for managing FA in social occasions than caregivers of 12–17 year olds (ps < .05); caregivers of 6–11 year olds reported poorer QoL than those of 12–17 year olds (p < .05). Caregiver-reported FA severity, child age, greater worry and poorer self-efficacy correlated with poorer QoL (all ps < .05–.01) and in regression models were significantly associated with QoL (all ps < .001), explaining 70% of the variance, with worry being the largest predictor.

Conclusion:
Caregivers of younger children may feel greater worry and burden of FA compared to caregivers of teenagers. Reducing FA-worry and increasing FA-self-efficacy should be prime targets to improve FA-QoL in caregivers.