Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Self-Efficacy in Managing Chronic Respiratory Disease: Parents' Experiences

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Self-Efficacy in Managing Chronic Respiratory Disease: Parents' Experiences

Article excerpt


Progress in health care expertise and improved technology has contributed to an increase in the survival rate of children living with chronic diseases in developed countries (Katz, 2002b; van der Lee, Mokkink, Grootenhuis, Heymans, & Offringa, 2007). The rise in the rate of chronic disease and the cost for societies and health sectors has led to chronic disease being described as 'the health care challenge of this century' (World Health Organization, 2005). In order to effectively meet the needs of those with chronic disease, health systems need to provide a better coordinated, person-centred and proactive health system that is supported by evidence-based models and cost-effective interventions (World Health Organisation, 2008).

To date the most common chronic disease among children in both developed and developing countries is asthma (Svavarsdottir, McCubbin, & Kane, 2000). Asthma has increased in prevalence over the last 20-30 years and has become a costly chronic childhood health problem worldwide, placing a significant burden on individuals and families (Craig, Jackson, & Yeo Han, 2007; Gau et al., 2010; World Health Organization, 2006, 2009). While the most common inherited chronic lung disease in children and young adults is cystic fibrosis (CF), affecting around 70,000 people worldwide (Cystic Fibrosis Association of New Zealand, 2011; Lomas & Fowler, 2012). This life-threatening disease has no cure and a life expectancy of approximately 37.4 years which is dependent on parental efficacy related to medical care access and monitoring (Hodgekinson & Lester, 2002; Ziere & Hadjiliadis, 2011).


The involvement of parents and family in the care of their hospitalised child is strongly advocated and viewed as best practice (Espezel & Canam, 2003; Polly, 2004; Ygge & Arnetz, 2004). Health care organisations are expected to have a family focused philosophy whereby all facilities accommodate families, and health professionals recognise the expert role parents play in the care and management of their child (Coyne, 1995). The foundation of this philosophy is grounded in the belief that health professionals should treat families with dignity and respect, and that a child's emotional and developmental needs are best met when families are given choices regarding involvement in, and provision of, services and planning of care (Dunst, Trivette, & Hamby, 2007; Shields, Pratt, Davis, & Hunter, 2009). It is proposed that a family centred care (FCC) philosophy can improve patient and family outcomes, enhance patient and family satisfaction, build on child and family strengths, boost professional fulfilment, reduce health care costs and lead to a more effective use of health care resources (Neff et al., 2003; Shields, Young, & McCann, 2008). Furthermore, a meta-analysis undertaken by Dunst and Trivette (2009) identified that FCC has a direct effect on parental self-efficacy beliefs, parental psychological health which in turn affects child psychological health.

Children with chronic diseases usually live at home with their parents as the main providers of physical, psychological, social and financial support, including the management of their child's disease (Cashin, Small, & Solberg, 2008; Hovey, 2006; Katz, 2002a). Parents acquire new roles and responsibilities as they handle the physical and emotional demands of their child's disease in addition to maintaining and recreating family routines and other commitments in their lives (Morawska, Stelzer, & Burgess, 2008). Some parents develop resources and skills to monitor their child's condition, medications and potential triggers while eliciting their child's cooperation in order to be successful managers (Brown, Gallagher, Fowler, & Wales, 2010; Dolinar, Kumar, Coutu-Wakulczyk, & Rowe, 2000). Key to the ability to develop partnerships and skills in managing their child's disease and medications is self-efficacy (Kieckhefer, Trahms, Churchill, & Simpson, 2009). …

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