Evaluation Anxiety Levels of Adult Patients and Parents of Adolescent Patients With Anaphylaxis

Öz

Background: Anaphylaxis is a sudden onset condition that may progress with severe systemic symptoms and may be accompanied by life-threatening respiratory failure and cardiovascular shock. Exposure to a traumatic event may cause patients and their parents to fear reliving the same event, so they try to avoid risk factors. It was aimed to determine the anxiety and stress levels in adult patients and in parents of adolescent patients diagnosed with anaphylaxis and to compare them with healthy controls.
Materials and Methods: A questionnaire-type study was conducted. Control group (group 1), adult pa-tients diagnosed with anaphylaxis (group 2), and parents (a mother or father) of adolescent diagnosed with anaphylaxis (group 3) were included in the study. The anxiety levels of participants were evaluated by State-Trait Anxiety Inventory (STAI).
Results: A total of 163 participants were included in the study. Seventy-one participants were in the con-trol group, forty-four were in group 2, thirty-eight were in group 3. STAI-T and STAI-S scores of groups 2 and 3 were significantly higher than controls. No difference was found between groups 2 and 3 for STAI-T scores (p=0.8) and STAI-S scores (p=0.74).
Conclusions: Adult patients diagnosed with anaphylaxis and parents of adolescents are more anxious than the normal healthy population. Anxiety and anaphylactic conditions are often comorbid. Psychosocial assessment should be the first step in adult patients with anaphylaxis and their parents. Physicians should prevent the harm that anxiety may cause. For this purpose, education programs, screening programs, support trainings with patient participation should be organized.

Anahtar Kelimeler

• Anaphylaxis
• anxiety
• adults
• parents

Anafilaksili Erişkin Hastaların ve Ergen Hastaların Ebeveynlerinin Kaygı Düzeylerinin Değerlendirilmesi

Öz

Amaç: Anafilaksi, ciddi sistemik semptomlarla seyredebilen ve yaşamı tehdit eden solunum yetmezliği ve kardiyovasküler şokun eşlik edebileceği ani başlangıçlı bir durumdur. Travmatik bir olaya maruz kalma, hastaların ve ebeveynlerin aynı olayı tekrar yaşamaktan korkmasına neden olabilir, bu nedenle risk faktörlerinden kaçınmaya çalışırlar. Erişkin hastalarda ve anafilaksi tanısı konan genç erişkin (ergen) hastaların ebeveynlerinde anksiyete ve stres düzeylerinin belirlenmesi ve sağlıklı kontrollerle karşılaştırılması amaçlandı. Materyal ve metod: Anket tipi bir çalışma yapılmıştır. Kontrol grubu (grup 1), anafilaksi tanısı almış erişkin hastalar (grup 2) ve anafilaksi tanısı almış ergenlerin (grup 3) ebeveynleri (anne veya baba) çalışmaya dahil edildi. Katılımcıların kaygı düzeyleri Durumluk-Sürekli Kaygı Envanteri (STAI) ile değerlendirildi. Bulgular: Çalışmaya toplam 163 katılımcı dahil edildi. Yetmiş bir katılımcı kontrol grubunda, kırk dördü grup 2'de, otuz sekizi grup 3'te idi. Grup 2 ve grup 3 STAI-T ve STAI-S puanları kontrollerden anlamlı olarak yüksekti. STAI-T skorları (p=0.8) ve STAI-S skorları (p=0.74) açısından 2. ve 3. gruplar arasında fark bulunmadı. Gruplar arasındaki STAI-S ve STAI-T puanlarındaki fark, bağımsız faktörlerden etkilenmedi. Sonuç: Anafilaksi teşhisi konan yetişkin hastalar ve genç erişkinlerin ebeveynleri normal sağlıklı popülasyondan daha endişelidir. Anksiyete ve anafilaktik durumlar sıklıkla eşlik etmektedir. Anafilaksili erişkin hastalarda ve ebeveynlerinde psikososyal değerlendirme ilk adım olmalıdır. Hekimler anksiyetenin yol açabileceği zararları önlemelidir. Bu amaçla eğitim programları, tarama programları, hasta katılımlı destek eğitimleri düzenlenmelidir.

Anahtar Kelimeler

• Anafilaksi
• kaygı
• yetişkinler
• ebeveynler.
• Anaphylaxis
• anxiety
• adults
• parents

Kaynakça

1. 1. Brown SG. Anaphylaxis: clinical concepts and research priorities. Emerg Med Australas. 2006;18:155-69.
2. 2. Walker S, Sheikh A. Managing anaphylaxis: effective emergency and long-term care are necessary. Clin Exp Allergy. 2003;33:1015-8.
3. 3. Cardona V, Ansotegui IJ, Ebisawa M, El-Gamal Y, Fernandez Rivas M, Fineman S,et al. World allergy organization anaphylaxis guidance 2020. World Allergy Organ J. 2020;13:100472.
4. 4. Lee Y, Chang HY, Kim SH, Yang MS, Koh YI, Kang HR, et al. A Prospective Observation of Psychological Distress in Patients With Anaphylaxis. Allergy Asthma Immunol Res. 2020;12:496-506.
5. 5. Vieweg WV, Julius DA, Fernandez A, Beatty-Brooks M, Hettema JM, Pandurangi AK. Posttraumatic stress disorder: clinical features, pathophysiology, and treatment. Am J Med. 2006;119:383-90.
6. 6. Monga S, Manassis K. Treating anxiety in children with life-threatening anaphylactic conditions. J Am Acad Child Adolesc Psychiatry. 2006;45:1007-10.
7. 7. Lebovidge JS, Stone KD, Twarog FJ, Raiselis SW, Kalish LA, Bailey EP,et al. Development of a preliminary questionnaire to assess parental response to children's food allergies. Ann Allergy Asthma Immunol. 2006;96:472-7.
8. 8. Mandell D, Curtis R, Gold M, Hardie S. Anaphylaxis: how do you live with it? Health Soc Work. 2005;30:325-35.

9. 9. Öner N, LeCompte WA: Durumluk-sürekli kaygı envanteri el kitabı: Boğaziçi Üniversitesi Yayınları; 1985.
10. 10. Spielberger C: Manual for the State-Trait Anxiety Inventory; Palo Alto, CA, Ed. In.: Consulting Psychologists Press, Inc.: Columbia, MO, USA; 1983.
11. 11. Sampson HA, Muñoz-Furlong A, Bock SA, Schmitt C, Bass R, Chowdhury BA, et al. Symposium on the definition and management of anaphylaxis: summary report. J Allergy Clin Immunol. 2005;115:584-91.
12. 12. Findeis S, Craig T. The relationship between insect sting allergy treatment and patient anxiety and depression. Allergy Asthma Proc. 2014;35:260-4.
13. 13. Cummings AJ, Knibb RC, Erlewyn-Lajeunesse M, King RM, Roberts G, Lucas JS. Management of nut allergy influences quality of life and anxiety in children and their mothers. Pediatr Allergy Immunol. 2010;21:586-94.
14. 14. Beken B, Celik V, Gokmirza OP, Sut N, Gorker I, Yazicioglu M. Maternal anxiety, and internet-based food elimination in suspected food allergy. Pediatr Allergy Immunol. 2019; 30(7): 752-759.
15. 15. Herbert LJ, Dahlquist LM. Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults. J Clin Psychol Med Settings. 2008;15:261-9.
16. 16. McLean-Tooke AP, Bethune CA, Fay AC, Spickett GP. Adrenaline in the treatment of anaphylaxis: what is the evidence? Bmj. 2003;327:1332-5.
17. 17. Sampson MA, Muñoz-Furlong A, Sicherer SH. Risk-taking and coping strategies of adolescents and young adults with food allergy. J Allergy Clin Immunol. 2006;117:1440-5.
18. 18. Lyons AC, Forde EM. Food allergy in young adults: perceptions and psychological effects. J Health Psychol. 2004;9:497-504.
19. 19. Bahrami F, Yousefi N. Females are more anxious than males: a metacognitive perspective. Iran J Psychiatry Behav Sci. 2011;5:83-90.
20. 20. King RM, Knibb RC, Hourihane JO. Impact of peanut allergy on quality of life, stress, and anxiety in the family. Allergy. 2009; 64: 461‐468.