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 anxiety 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 anxiety, 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 anxiety across child age to be examined. Methods Caregivers of children with a food allergy (n=240), recruited through patient organisations, 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 0-5year olds had significantly more FA-related worry and less self-efficacy for managing FA in social occasions than caregivers of 12-17year olds (ps<0.05); caregivers of 6-11year olds reported poorer QoL than those of 12-17 year olds (p<0.05). Caregiverreported FA severity, child age, greater worry and poorer self-efficacy correlated with poorer QoL (all ps<0.05-0.01) and were significant predictors of QoL (all ps<.001), explaining 70% of the variance, with worry being the largest predictor. Conclusion Caregivers of younger children may feel greater anxiety and burden of FA compared to caregivers of teenagers. Reducing FA-anxiety and increasing FA-self-efficacy should be prime targets to improve FA-QoL in caregivers.