Electronic Theses and Dissertations

Identifier

6087

Author

Cori C. Grant

Date

2017

Date of Award

12-2-2017

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Public Health

Concentration

Epidemiology

Committee Chair

Fawaz Mzayek

Committee Member

Vikki G Nolan

Committee Member

George Relyea

Committee Member

Cyril F Chang

Abstract

Community-acquired pneumonia (CAP) is the third leading cause of hospitalization among children in the U.S. This research is comprised of three studies of children with CAP. The data were collected for the CDCs Etiology of Pneumonia in the Community (EPIC) study. Study one aimed to examine the association of clinical factors with potentially unnecessary hospitalizations, as defined by a length of stay (LOS) in the hospital ≤ 24 hours. Study two aimed to validate the Canadian Acute Respiratory Illness and Flu Scale (CARIFS) questionnaire among an inpatient pediatric population with CAP. This study also examined the utility of the CARIFS questionnaire in predicting LOS in the hospital. Study three examined factors that could influence parental consent for their child to participate in research. Participants were children, 0-18 years old, classified into five age categories, who were hospitalized with CAP at one of three sites: Le Bonheur Children's Hospital, Monroe Carell Jr. Children's Hospital at Vanderbilt and Primary Children'sHospital.A short length of stay, ≤ 24 hours, was associated across all ages with higher oxygen saturation level at admission. Study two, the CARIFS survey, had high internal reliability among this population (Cronbach's alpha = 0.89). The 18 CARIFS questions loaded onto four domains (physical function, parental impact, subjective symptoms and objective symptoms). Except for infants, the more severe the symptoms of physical function, the longer the LOS. In study three, households with less education were more likely to give consent for their child to participate than those with a college degree (OR = 4.78, 95% CI = 1.75, 13.05). Desire to learn more about their child's illness (OR = 1.59, 95% CI = 1.06, 2.39) and altruism (OR = 3.64, 95% CI =2.20, 6.02) was also associated with higher participation, while concern about the nose and throat swab (OR = 0.48, 95% CI = 0.36, 0.65) was associated with lower participation. These findings show clinical presentation of CAP does not adequately predict LOS, while parent-reported markers of a child's physical function may predict LOS. Detailed explanation of potential benefits and reducing invasive procedures could improve participation in research.

Comments

Data is provided by the student.

Library Comment

dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.

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