Physician perceptions of children's coping with asthma are associated with children's psychosocial and disease functioning

INTRODUCTION

Low-income, ethnic minority children disproportionately face poor asthma control, and poorly controlled asthma is related to psychosocial difficulties. This study assessed physician reports of coping in child patients and examined associations between physician reports of child coping and parent and child reports of children's coping, psychosocial, and asthma outcomes (asthma-related stress, emotional and behavioral problems, asthma control, and school missed due to asthma).

METHOD

Physicians reported on coping in their patients (N = 67) ages 5-17 with asthma. Parents reported on child coping, asthma-related stress, emotional and behavioral problems, asthma control, and school missed due to asthma. Children ages 9-17 provided self-reports.

RESULTS

Physicians' reports of primary control coping (e.g., problem solving) and secondary control coping (e.g., cognitive restructuring) were not associated with parent ratings of corresponding coping strategies, but physician reports of disengagement coping (e.g., avoidance) were correlated with parent reports of disengagement and secondary control coping. Physician perceptions of higher child primary control, and lower disengagement, were correlated with less parent-reported stress, better asthma control, and for primary control, fewer partial days of school missed. Physician reports were not correlated with child reports of coping, but physician reports of disengagement were correlated with child-reported conduct problems.

DISCUSSION

Findings suggest that physician reports of child coping provide independent information from parent and child reports of coping, and could be leveraged to identify and intervene with patients who are at elevated risk for poor outcomes. (PsycINFO Database Record

Coping with Asthma in Racially and Ethnically Diverse Urban Children: The Role of Emotional Problems in Disease Control

This study examined cross-sectional associations among coping, mental health, and asthma outcomes in racially/ethnically diverse urban children. Children (N=42; 65% female) ages 9 to 17 (M=11.9) years old and their parents reported on the child's coping, emotional and conduct problems, asthma control, and school missed due to asthma. Higher child and parent reported secondary control coping was correlated with fewer mental health problems and better child reported asthma control. Child reported emotional problems partially accounted for associations between child and parent reported secondary control coping and child reported asthma control. Secondary control coping may improve asthma by reducing emotional difficulties.

Is rural school-aged children's quality of life affected by their responses to asthma?

The unpredictable nature of asthma makes it stressful for children and can affect their quality of life (QOL). An exploratory analysis of 183 rural school-aged children's data was conducted to determine relationships among demographic factors, children's responses to asthma (coping and asthma self-management), and their QOL. Coping frequency, asthma severity, and race/ethnicity significantly predicted children's asthma-related QOL. Children reported more frequent coping as asthma-related QOL worsened (higher scores). Children with more asthma severity had worse asthma-related QOL. Post hoc analyses showed that racial/ethnic minorities reported worse asthma-related QOL scores than did non-Hispanic Whites.

An examination of the tripartite model of depressive and anxiety symptoms in African American youth: stressors and coping strategies as common and specific correlates

The purpose of the current study was to examine the tripartite model of depression and anxiety in a community-based sample of 278 African American adolescents (M age = 12.89) from low-income communities and to identify stressors and coping strategies that were associated with the specific features of each disorder. Participants reported on depression, anxiety, stressors, and coping strategies. As predicted, the three-factor structure of the tripartite model was a valid representation of anxiety and depression in African American youth. Further, stressors and coping strategies showed specific associations to features of depression and anxiety. The findings provide evidence of factors that may help to distinguish between internalizing symptoms in African American youth.

Exploring and explaining low participation in physical activity among children and young people with asthma: a review

Background

Asthma is the most common chronic illness among children and accounts for 1 in 5 of all child GP consultations. This paper reviews and discusses recent literature outlining the growing problem of physical inactivity among young people with asthma and explores the psychosocial dimensions that may explain inactivity levels and potentially relevant interventions and strategies, and the principles that should underpin them.

Methods

A narrative review based on an extensive and documented search of search of CinAHL, Embase, Medline, PsycINFO and the Cochrane Library.

Results & Discussion

Children and young people with asthma are generally less active than their non-asthmatic peers. Reduced participation may be influenced by organisational policies, family illness beliefs and behaviours, health care advice, and inaccurate symptom perception and attribution. Schools can be reluctant to encourage children to take part in physical education or normal play activity due to misunderstanding and a lack of clear corporate guidance. Families may accept a child's low level of activity if it is perceived that breathlessness or the need to take extra inhalers is harmful. Many young people themselves appear to accept sub-optimal control of symptoms and frequently misinterpret healthy shortness of breath on exercising with the symptoms of an impending asthma attack.

Conclusion

A multi-faceted approach is needed to translate the rhetoric of increasing activity levels in young people to the reality of improved fitness. Physical activity leading to improved fitness should become part of a goal orientated management strategy by schools, families, health care professionals and individuals. Exercise induced asthma should be regarded as a marker of poor control and a need to increase fitness rather as an excuse for inactivity. Individuals' perceptual accuracy deserves further research attention.

Coping styles, psychological functioning and quality of life in children with asthma

BACKGROUND

Previous research suggests that children dealing with the asthma are at a greater risk for experiencing psychological maladjustment than children without asthma. Research also suggests that coping is a factor in psychological adaptation to chronic stressors such as physical illnesses. The question as to how coping relates to psychological functioning and quality of life in the paediatric asthma population has not yet been answered. The objective of the current study was to examine the relationships among coping, psychological functioning and quality of life in children diagnosed with asthma and to investigate the relationship that mothers' quality of life has with these variables.

METHODS

Forty-seven youths (aged 8-15 years) diagnosed with asthma completed measures of coping with asthma and quality of life. Each youth's mother completed measures of her child's coping, psychological functioning and her own quality of life.

RESULTS

Mothers and children with asthma both reported that children used significantly more approach coping than avoidant coping when dealing with asthma. Three regression analyses indicated that avoidant coping negatively predicted psychological functioning, child's quality of life and mother's quality of life. Bivariate analyses also indicated a positive relationship between child's quality of life and mother's quality of life.

CONCLUSIONS

Results indicate that, in children with asthma, coping style plays an important role in the child's psychological functioning and quality of life and mother's quality of life. Therefore, it is recommended that type of coping be assessed when developing comprehensive treatment plans for children with asthma. Further research is needed to determine the efficacy of focused coping interventions in improving quality of life and psychological functioning in children with asthma.

Children's asthma, internalizing problems, and social functioning: an urban perspective

PROBLEM

Asthma may serve as a risk factor for higher levels of psychosocial problems in urban school-aged children.

METHOD

Interview data were collected from 48 children (27 with asthma and 21 without asthma) and their mothers.

FINDINGS

Asthma did not function as a risk factor for psychosocial problems in this sample. Children with more symptoms of depression and anxiety experienced poorer social functioning, regardless of their health status.

CONCLUSION

These results highlight the importance of examining co-occurring difficulties in psychosocial development among urban children in order to design interventions that minimize the impact of such challenges.

Associations among risk factors, individual resources, and indices of school-related asthma morbidity in urban, school-aged children: a pilot study

This paper presents a conceptual model including examples of risk and resource factors associated with indices of school-related asthma morbidity (eg, missed sleep, participation in activities, school absences) in a group of urban, school-aged children with asthma from ethnic minority backgrounds. Specifically, the current longitudinal study examines relations between a contextual risk factor (ie, family life stressors), an asthma-related risk factor (ie, asthma symptoms), individual resources (ie, attention, children's problem-solving beliefs, and self-esteem), and aspects of asthma morbidity that have been shown to have an impact on children's academic performance. Participants of the study included 31 mother-child dyads from low-income, inner-city neighborhoods. Results of hierarchical regression analyses revealed that after controlling for risk factors (ie, asthma symptoms and family life stressors) at baseline, children's individual characteristics (ie, children's problem-solving beliefs and self-esteem) functioned as resource factors for some indices of asthma-related functioning (school absences, participation in activities, and missed sleep) at follow-up (1 year later). Results suggest that contextual and individual risk and resource factors should be further explored in studies including larger samples of urban children with asthma in order to help guide the development of preventive interventions in school-based and health care settings.