Academic journal article Health and Social Work

Coping with Childhood Asthma: Caretakers' Views

Academic journal article Health and Social Work

Coping with Childhood Asthma: Caretakers' Views

Article excerpt

Childhood asthma is a chronic health condition that affects more than 1 million school-age children and their families. Asthma is the leading cause of school absences and accounts for a substantial amount of activity limitation in children. A small pilot study of caretakers of African American and Hispanic school-age children with asthma explored the effects of the illness on families and the coping strategies used by caretakers. Large and significant correlations were found between the perceived impact in the areas of financial burden, social and familial isolation, and personal strain. Caretakers reported using active coping, planning, religion, and acceptance of the illness most frequently. The authors suggest the value of making conceptual distinctions between the burden imposed by the illness and the coping skills used by caretakers.

Childhood asthma affects more than 1 million school-age children and their families (Jurenec, 1988). Because asthma is a chronic condition, parents and other primary caretakers of children with asthma are exposed to a variety of stresses over extended periods of time, including fears for the child's well-being, practical problems of physical care and discipline, and loss of income and time from work or other activities (Cosper & Erickson, 1985; Creer, Marion, & Creer, 1983). Stress may also result from the fact that in most instances guidelines for parents tend to focus on behavioral aspects of medical management of asthma with less attention to the developmental, social, and emotional needs of the child. Caretakers are often unsure in making day-to-day parental decisions about such issues as discipline, school attendance, and the child's participation in peer and athletic activities (Schwamm, 1987). Families may differ in the way they perceive and cope with the stressors associated with rearing a child with asthma.

This article discusses family issues related to childhood asthma and presents data from a pilot study of primary caretakers of African American and Hispanic school-age children with chronic asthma. Two factors examined by the study were the impact of the illness on the family as reported by the caretakers and the coping strategies used by them to respond to the child's illness. Four questions were asked:

1. Does the impact of the child's asthma in a specific area of family life affect other areas?

2. Do caretakers use particular coping strategies more often than others?

3. Is the frequency of use of a particular coping strategy associated with the frequency of use of other coping strategies?

4. Is the perceived impact of the child's asthma in particular areas of family life associated with the frequency of use of specific coping strategies?

Childhood Asthma

Asthma varies in age of initial onset, course of illness, intensity, and responsiveness to medical intervention. Symptoms include repeated episodes of difficulty in breathing, wheezing, and coughing. Renne and Creer (1985) noted that although no universally accepted definition of asthma exists, the condition can be described along three dimensions: (1) intermittence (attacks may occur throughout the year or seasonally), (2) severity (from chronic debilitation to occasion sensations of tightening in the chest or slight wheezing), and (3) reversibility (airway obstruction reverses spontaneously or with treatment).

Asthma is the most common chronic illness of childhood, affecting 1.2 million school-age children (Jurenec, 1988). Although rates vary according to the criteria used for diagnosis, the overall prevalence of asthma among children is 6.7 percent and is higher among African American children (9.4 percent). The prevalence is slightly greater in boys than girls (7.8 percent versus 5.7 percent) and is greater in children from urban compared to rural areas (7.1 percent versus 5.7 percent) (Gergen, Mullaly, & Evans, 1988). …

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