Original articleTales of pediatric asthma management: family-based strategies related to medical adherence and health care utilization☆
Section snippets
Participants
Eighty families with a child with asthma were drawn from a larger longitudinal study on family functioning and asthma,11 with approval from the Institutional Review Board. The families were selected from the larger pool, excluding those cases in which the child was >15 years. The families ranged from lower to upper class, with a Hollingshead12 mean score of 42.04 (SD = 13.3). In terms of ethnic diversity, 65% were white, 17% black, 15% Hispanic, and 2% Asian. More than half (60%) of the parents
Results
We found that the interviews could be reliably coded into one of the three categories, with 14% classified as reactive, 53% coordinated care, and 33% family partnerships. The three categories were not distinguishable by asthma severity, marital status, race, socioeconomic status, word count, or reading level. Child age differed across interview classifications (F[2,77] = 5.97, P<.004), with the families who expressed reactive strategies having older children with asthma (mean = 11.27, SD = 1.48) than
Discussion
We set out in this study to determine whether verbal accounts of family management strategies were related to health care utilization and adherence rates in cases of pediatric asthma. We found that the stories that parents told about how asthma affected their lives could be reliably coded, were unrelated to linguistic markers and demographic background, and were concurrently and prospectively predictive of medical adherence.
There are several limitations to this study that deserve attention. We
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Supported in part by grants from the National Institutes of Health (R01 MH51771-01) and the W. T. Grant Foundation to B. H. F. and from the National Institutes of Health (R01-HL53391 and M01-RR0051) to F. S. W.