Quality of Life Research

, Volume 27, Issue 4, pp 891–903 | Cite as

Longitudinal study of quality of life among children with acute respiratory infection and cough

  • Yolanda G. Lovie-Toon
  • Anne B. Chang
  • Peter A. Newcombe
  • Dimitrios Vagenas
  • Sophie Anderson-James
  • Benjamin J. Drescher
  • Michael E. Otim
  • Kerry-Ann F. O’Grady



Acute respiratory infections (ARIs), and associated symptoms such as cough, are frequently experienced among children and impose a burden on families (e.g., use of medical resources and time off work/school). However, there are little data on changes in, and predictors of, quality of life (QoL) over the duration of an ARI with cough (ARIwC) episode. We therefore aimed to determine cough-specific QoL and identify its influencing factors among children with ARIwC, at the time of presentation to a pediatric emergency department (ED), and over the following 4 weeks.


Data from 283 children aged < 15 years were included in our analyses. We used the validated parent-proxy children’s acute cough-specific QoL questionnaire (PAC-QoL) at each time-point. Linear regression and mixed effect modeling were used to identify factors influencing QoL at baseline and over the follow-up period.


Median PAC-QoL at baseline was 2.7 (IQR 2.1–3.6) and significantly improved by Day-7 (4.9, IQR 3.8–6.1) and Day-14 (6.59, IQR 5.1–7.0), both p < 0.001. The improvements in median PAC-QoL between Days-14, -21, and -28 were not significant. Regression modeling identified that day-cough severity, night-cough severity, and financial concerns had the highest impact on both baseline, and follow-up, PAC-QoL scores. There were five additional independent significant factors at baseline and six at follow-up.


Quality of life is considerably impaired at presentation to ED, but improves significantly by Days-7 and -14. As cough severity and financial concerns had the highest impact on QoL, effectively managing cough to reduce the clinical and financial burden on children and families is important.


Acute respiratory infection Cough Parent-proxy quality of life Pediatrics Children Emergency department 



The authors gratefully acknowledge the following people and departments for their assistance with this study: the RCH Emergency Department and Paediatric Emergency Research Unit; the Respiratory Physicians (particularly Prof Alan Isles, A/Prof Brent Masters, Dr Danielle Wurzel, Dr Vikas Goyal and Dr Nitin Kapur), Respiratory Scientists and administration staff at the Queensland Children’s Respiratory Centre; the Medical Records staff at the Royal Children’s Hospital and members of the Cough Asthma and Airways Research Group and Respiratory infection Outreach Research Teams, particularly Ben Arnold, Daniel Arnold, Simon Foster, Kate Shackleton, Clementine Shevill, and Jack Roberts.


Financial support for this study was received from a Queensland Children’s Health Foundation Program Grant awarded to ABC. YLT is funded by a QUT Research Training Program Stipend from the Queensland University of Technology and a top-up scholarship from the National Health and Medical Research Council’s Centre for Research Excellence in Lung Health (1040830). KFO was supported by a Queensland Government Smart Futures Fellowship (51008) and an Australian National Health and Medical Research Council (NHMRC) Career Development Award (1045157). ABC is supported by a NHMRC Practitioner Fellowship (1058213). BD was supported by a NHMRC Post-Graduate Scholarship (1075467) and a Queensland Children’s Medical Research Institute Top-Up Scholarship. SAJ was supported by an Equity Trustees postgraduate training scholarship and the Children’s Hospital Foundation through a program grant (50004) awarded to AC. The funding sources had no involvement in the study design; collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

11136_2017_1779_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 KB)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Children’s Health Research, Institute of Health and Biomedical InnovationQueensland University of TechnologySouth BrisbaneAustralia
  2. 2.Menzies School of Health ResearchCharles Darwin UniversityCasuarinaAustralia
  3. 3.Lady Cilento Children’s HospitalQueensland Children’s Hospital and Health ServicesSouth BrisbaneAustralia
  4. 4.School of PsychologyThe University of QueenslandBrisbaneAustralia
  5. 5.Directorate, Institute of Health & Biomedical InnovationQueensland University of TechnologySouth BrisbaneAustralia
  6. 6.Child Health Research CentreUniversity of QueenslandBrisbaneAustralia
  7. 7.Department of Health Services Administration, College of Health SciencesUniversity of SharjahSharjahUnited Arab Emirates

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