Objectives: Pediatric allergic rhinitis (AR) is a highly prevalent chronic inflammatory airway disease that significantly impairs children’s sleep, learning performance, and quality of life. Despite standardized pharmacotherapy, long-term symptom control remains suboptimal, which is related to the poor treatment compliance of patients and the insufficient disease awareness of parents. This study aimed to evaluate the effects of parental cognitive enhancement combined with parent–child psychological support on symptom control, the quality of life, and underlying intervention mechanisms in children aged 6–14 years with moderate to severe AR. Methods: A total of 150 children aged 6–14 years with moderate to severe AR and their primary caregivers were enrolled and allocated to a study or a control group. The control group received routine home management for AR, and the study group received a combined intervention of parental cognitive enhancement and parent–child psychological support in addition to routine management. Total Nasal Symptom Score (TNSS), quality of life assessed by the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), and medication adherence assessed by the 8-item Morisky Medication Adherence Scale were compared between the two groups before and after intervention. Evaluation was also conducted on the parental cognitive level, anxiety status assessed by the Self-Rating Anxiety Scale (SAS), and parent–child relationship assessed by the Child–Parent Relationship Scale were also evaluated. The bootstrap method was used to analyze the mediating effects of parental cognition and parent–child relationship. Results: After intervention, the study group showed significantly lower TNSS, PRQLQ scores in children, parental SAS scores, and parent–child conflict than the control group (all p < 0.05) and significantly higher medication adherence, parental cognitive scores, and parent–child closeness (all p < 0.05). Mediation analysis showed that the direct effect of study grouping on TNSS was not significant (p = 0.512), whereas the indirect effects mediated through “parental cognitive level” and “parent–child relationship” were significant (95% confidence interval did not include 0), which indicates that the intervention effect was statistically mediated through these pathways. Conclusions: The combined intervention of parental cognitive enhancement and parent–child psychological support effectively improves clinical symptoms in children with moderate to severe AR, treatment adherence, and the quality of life.
Shen et al. (Thu,) studied this question.