An investigation of the quality of life reported by parents of children with nut allergy and the variables affecting it

Introduction: Tree nuts allergy is one of the most common allergies and one of the main causes of severe allergic reactions. Cross-sensitization among tree nuts reaches up to 90%, and when an allergic reaction develops to one tree nuts, the probability of developing a reaction to another tree nuts is almost 60%. Although tree nuts can cause IgE - mediated, non-IgE -mediated or mixed-type reactions, they are characteristically IgE -mediated. The two main topics of food allergy management are avoidance of index food and treatment of symptoms in case of accidental exposure. Food allergy has been associated with stress, anxiety and deterioration in quality of life in both children and their families. The aim of this study is to investigate the quality of life reported by parents and the variables affecting it in children aged 12 years and younger with tree nuts allergy. Methods and materials: Children aged 12 years and younger who were diagnosed with tree nut allergy in Hacettepe University Faculty of Medicine, Department of Pediatric Allergy between 2018 and 2020 were included in the study. "Food Allergy Quality of Life Questionnaire-Parent Form" (FAQLQ-PF) and State-Trait Anxiety Inventory (STAI) were used to determine the quality of life and anxiety levels of the parents, respectively. In line with the data obtained, the relationship between the quality of life of the parents and the socio -demographic and clinical characteristics of the patients was investigated using statistical methods. Results: Of the 88 patients included in the study, 31 (35.2%) were female and 57 (64.8%) were male. The most common tree nut allergy in the study groups was hazelnut (72.7% ) followed by cashew (63.6%), pistachio (58%), walnut (55.7%) and almond (28.4%). The mean FAQLQ-PF scores did not differ in regard to gender and by age groups (p=0.148).The mean score of FAQLQ-PF was significantly higher in children with a previous history of anaphylaxis due to tree nuts (p=0.008). Similarly, the scale score of the parents who needed to use adrenaline autoinjector was significantly higher than those who didn't need (p=0.005). Hazelnut allergy (B=0.791; 95% CI: 0.017-1.564; p=0.045), need to use autoinjectors (B=1.048; 95% CI: 0.225-1.870; p=0.013) and emergency department admission due to nut allergy (B=-0.816; 95% CI:-1.387--0.246; p=0.006) were found to be independent predictors for the FAQLQ-PF total score in the regression model including gender, age, tree nuts species, and anaphylaxis history. The increase in the STAI-1 State anxiety score (B=0.032; 95% CI: 0.011-0.053; p=0.003) and the STAI-2 trait anxiety score (B=0.037; 95% CI: 0.001-0.065; p=0.009) were associated with an increase in FAQLQ-PF total score. Results: We defined the demographic, clinical characteristics and quality of life perceived by parents in children aged 12 years and younger with the diagnosis of tree nut allergy. Previous negative experiences and parents' anxiety levels were found to be important predictors that negatively affect the quality of life documented by the FAQLQ-PF scale. Key words: Tree nuts, allergy, anaphylaxis, quality of life, FAQLQ-PF, anxiety