The Relationship Between Self-Efficacy, Quality of Life, and Oral Food Challenge
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Matthew J. Greenhawt, MD MBA MSc, Christopher E. Couch, MD, Timothy J. Franxman, MD, Audrey Dunn Galvin
Rationale: Food allergy (FA) quality of life (QoL) has been shown to be better in caregivers of children undergoing OFC vs. non-challenged children. Self-efficacy (SE) describes one’s perceived capabilities for disease self-management, and is a powerful influence on coping, motivation and achievement. The relationship between SE, QoL, and OFC is unknown.

Methods: The Food Allergy Quality of Life Parental Burden (FAQL-PB) index, Food Allergy Self-Efficacy Questionnaire (FASEQ), and a questionnaire assessing the individual’s food allergy history were administered to n=115 caregivers of peanut, tree nut, milk, and egg allergic children who underwent OFCs between 2001 and 2012 at a referral center, and n=305 unchallenged children. Questionnaire data were verified through chart review.

Results:  Mean FASEQ score was higher (worse) in the challenged vs. non-challenged population (3.81 vs. 4, p=0.02), but not significantly different based on allergen, anaphylaxis, or age. Within the OFC group, no difference in FASEQ score was noted based on challenge outcome, allergen, presenting symptoms, or age. FASEQ score was negatively correlated with FAQL-PB score (r=-0.38, p<0.001).  In an adjusted regression model, OFC and FASEQ were not associated.  However, the addition of FASEQ score to a previous model demonstrating a significant relationship between OFC and better QoL strengthened this association, while explaining an additional 9% of the total variance in QoL (adj.R2=0.3) in the population. 

Conclusions: Caregiver SE is worse in challenged vs. non-challenged populations but unaffected by OFC outcome or allergen.  In adjusted models, OFC has no significant effect on SE, but SE significantly moderates the effect of OFC on QoL.