Growing up with asthma
Adaptation processes and outcomes in children and adolescents with asthma and their parents
Asthma is the most common chronic condition among children and adolescents, with prevalence rates over 11% in the Portuguese pediatric population (DGS, 2000). This chronic inflammatory disorder of the airways is characterized by recurrent episodes of wheeze, shortness of breath, chest tightness and cough (GINA, 2008) and exerts substantial burden on pediatric patients and their families, including recurrent hospitalizations, the direct costs of medical treatments, the number of missed days from school/work, and the effects on their physical and psychosocial functioning (Sennhauser, Braun-Fahrländer, & Wildhaber, 2005). However, research has revealed a wide variability in patient-reported outcomes (e.g., quality of life [QoL]), which may be a result of specific methodological challenges in pediatric outcomes assessment, but may also reflect the complex interplay between the risk and resistance factors mapping the adaptation processes.
In this context, this study aimed:
- To compare the QoL of children with asthma and their parents with healthy controls;
- To clarify the utility of generic and condition-specific measures and to examine parent-child agreement;
- To identify psychosocial risk and resistance factors and the processes through which they operate to explain the differential adaptation trajectories of children and their parents.
The results highlight the need of incorporating routine QoL assessment in pediatric clinical and research contexts, preferably adopting a modular approach including generic and condition-specific measures and “giving voice” to both children and their parents. Our findings also emphasize the role of positive dimensions of caregiving (i.e., uplifts), emotion-focused coping strategies (e.g., acceptance, positive reframing), and adaptive family relationships as family resources/protective factors against the deleterious effects of clinical, socio-economic and stress-related risks. The identification of modifiable variables associated with better individual and family adaptation may contribute to operationalize strength-based interventions in pediatric asthma clinical settings.
