The impact of the parental illness representation on disease management in childhood asthma.
The impact of the parental illness representation on disease management in childhood asthma.
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父母疾病表征对儿童哮喘疾病管理的影响。
DOI：
10.1097/01.nnr.0000270023.44618.a7
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发表时间：
2007
期刊：
影响因子：
2.5
通讯作者：
Anson,Elizabeth
中科院分区：
文献类型：
--
作者：
Yoos,HLorrie;Kitzman,Harriet;Henderson,Charles;McMullen,Ann;Sidora-Arcoleo,Kimberly;Halterman,JillS;Anson,Elizabeth
背景：尽管治疗方法取得了显著进展，但儿童哮喘的发病率仍在持续增加，特别是在贫困和少数族裔儿童中。目的：描述与哮喘专业模型并列的哮喘父母疾病表现，并评估这种疾病表现对儿童用药方案充分性的影响。方法：采用半结构访谈的方法，对228名哮喘儿童的父母进行疾病信念访谈。评估背景特征、父母信仰、儿童对症状的理解、父母与医疗服务提供者(HCP)的关系对儿童用药方案充分性的影响。人口风险因素(p=.005)，父母文化程度低(p<；0001)，儿童对症状的评估不准确(p=.02)，亲子关系差(p<；0001)对父母患病表象有负向影响。符合哮喘专业模型的父母疾病表现(p=.05)和更正规的哮喘教育(p=.02)对用药方案有直接的积极影响。人口风险因素(p=.006)和非正式咨询(p=.0003)对养生法产生了负面影响。父母疾病表征在人口统计风险因素的影响中起中介作用(p=.10)、父母教育(p=.07)和亲子关系(p=.讨论：父母和HCP在临床上可能会遇到明显不同的疾病表现。通过激发和承认父母的信仰与父母建立伙伴关系是改善疾病管理的一个重要组成部分。
Background:Despite significant advances in treatment modalities, morbidity due to childhood asthma has continued to increase, particularly for poor and minority children.Objectives:To describe the parental illness representation of asthma in juxtaposition to the professional model of asthma and to evaluate the impact of that illness representation on the adequacy of the child's medication regimen.Methods:Parents (n= 228) of children with asthma were interviewed regarding illness beliefs using a semistructured interview. The impact of background characteristics, parental beliefs, the child's symptom interpretation, and the parent-healthcare provider (HCP) relationship on the adequacy of the child's medication regimen were evaluated.Results:The parental and professional models of asthma differ markedly. Demographic risk factors (p=. 005), low parental education (p<. 0001), inaccurate symptom evaluation by the child (p=. 02), and a poor parent-HCP relationship (p<. 0001) had a negative effect on the parental illness representation. A parental illness representation concordant with the professional model of asthma (p=. 05) and more formal asthma education (p=. 02) had a direct positive effect on the medication regimen. Demographic risk factors (p=. 006) and informal advice-seeking (p=. 0003) had a negative impact on the regimen. The parental illness representation mediated the impact of demographic risk factors (p=. 10), parental education (p=. 07), and the parent-HCP relationship (p=. 06) on the regimen.Discussion:Parents and HCPs may come to the clinical encounter with markedly different illness representations. Establishing a partnership with parents by eliciting and acknowledging parental beliefs is an important component of improving disease management.