Measuring quality of life for young children with asthma and their families.

In assessing therapeutic interventions in asthma we have become increasingly aware of the importance of measuring outcomes which relate to patient experience of illness and its impact on their lives. These patient oriented assessments are usually defined as "quality of life" measures. There are good reasons for wanting to measure the impact of disease on people with asthma. Quality of life is likely to be related to health behaviour, such as adherence to therapy and use of health resources. Quality of life may be a stronger predictor of these behaviours than objective symptoms. Thus, in evaluating health-related interventions, quality of life is an important dimension of outcome measurement. Adult measures are now frequently used but there has been less development of measures suitable for children. Important issues in measuring quality of life for children include the development of age-appropriate scales, measurement of the impact of illness on the whole family, and the relationship between child's report and proxy report. Recently developed asthma specific scales for children include the Child Asthma Questionnaire (CAQ), and the Paediatric Asthma Quality of Life Questionnaire (PAQLQ). The PAQLQ comprises a form directly assessing child quality of life and a form assessing paediatric care-givers (usually a parent). The impact of child asthma on the family as a whole may be particularly important not only for comparing benefits of different interventions, but also for predicting outcomes, such as medical help-seeking.