Parental Illness Representations and Asthma Management

描述（由申请人提供）：比任何其他疾病，哮喘需要医疗保健提供者，患者和家庭之间的持续伙伴关系，以获得最佳治疗。为了使这种伙伴关系发挥作用，患者/家庭和卫生保健提供者需要对哮喘的性质、症状、治疗目标、药物和自我管理实践有共同的理解。文献中报告的发病结果和我们目前研究的数据表明，情况并非如此，患者和医疗保健专业人员对哮喘的看法完全不同。父母疾病表征和哮喘管理研究的广泛目标是探索哮喘的父母和专业模型之间的差异的性质，以及与这些疾病表征相关的前因和结果。本研究的目的是：1）描述哮喘儿童父母的疾病表征; 2）描述儿童的症状体验; 3）确定哮喘的“专业模式”和“患者/家庭模式”之间的差异; 4）确定人口统计学和其他背景特征对父母疾病表现、儿童症状体验的影响，和父母/医疗保健提供者的关系，和期望的结果; 5）评估父母的疾病表示的独特贡献，儿童的症状经验，和父母/提供者的关系，以适当的医疗保健寻求和药物治疗方案的充分性。该研究采用横断面设计，将从城市诊所和社区儿科诊所招募215名不同社会人口学背景的哮喘儿童（5-12岁）。一个半结构化的采访将收集有关孩子的疾病严重程度，使用的药物和医疗保健联系人的信息。访谈还将评估父母的疾病代表性的领域的性质疾病及其症状的（身份），原因预期结果和药物的作用数据分析将包括通过专业模型描述父母疾病代表签证;儿童症状经历的描述，亚组比较（基于疾病表征的背景特征，寻求医疗保健和药物治疗方案的充分性;以及建模以评估疾病表征在预测哮喘管理结果中的独特作用。

DESCRIPTION (provided by applicant): More than any other illness, asthma necessitates an on-going partnership between health care provider, patient, and family for optimal treatment to take place. In order for this partnership to work, patients/families and health care providers need to have a common understanding of the nature of asthma, its symptoms, treatment goals, medications, and self-management practices. Morbidity outcomes reported in the literature and data from our current studies suggest that this is not the case, and that patients and health care professionals think about asthma in quite different ways. The broad objective of the study Parental Illness Representations and Asthma Management is to explore the nature of the discrepancies between the parental and professional model of asthma as well as antecedents and outcomes related to these illness representations. Specifically the study is designed to: 1) Describe the illness representation of parents of children with asthma; 2) Describe the child's symptom experience; 3) Identify the discrepancies between the "professional model" of asthma and the "patient/family model"; 4) Determine the impact of demographic and other background characteristics on the parental illness representation, the child's symptom experience, and the parent/health care provider relationship, and desired outcomes; 5) Evaluate the unique contributions of the parental illness representation, the child's symptom experience, and the parent/provider relationship to appropriate health care seeking and adequacy of the medication regimen. The study utilizes a cross-sectional design and will enroll 215 children with asthma (ages 5-12 years of age) of diverse sociodemographic backgrounds from an urban clinic and a community pediatric practice. A semi-structured interview will gather information about the child's illness severity, medications used, and health care contacts. The interview will also assess the parental illness representation in the domains of the nature (identity) of the disease and its symptoms, cause expected outcomes and the role of medications Data analysis will include a description of the parental illness representation visa vie the professional model; a description of the child's symptom experience, subgroup comparisons (based on background characteristics of the illness representation, health care seeking, and adequacy of the medication regimen; and modeling to evaluate the unique role of the illness representation in predicting asthma management outcomes.