Parental Illness Representations and Asthma Management

描述(由申请人提供)：与其他疾病相比，哮喘更需要医疗保健提供者、患者和家庭之间持续的合作伙伴关系，才能进行最佳治疗。为了使这一伙伴关系发挥作用，患者/家属和医疗保健提供者需要对哮喘的性质、症状、治疗目标、药物和自我管理做法有一个共同的理解。文献中报告的发病率结果和我们目前研究的数据表明，情况并非如此，患者和卫生保健专业人员对哮喘的看法截然不同。这项研究的主要目标是探索哮喘父母和专业模式之间的差异的本质，以及与这些疾病表现相关的前因和结果。具体来说，这项研究旨在：1)描述哮喘儿童父母的疾病表现；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)确定人口统计和其他背景特征对父母疾病表现、儿童的症状体验、父母/医疗保健提供者关系和预期结果的影响；5)评估父母疾病表现、儿童的症状体验和父母/提供者关系对适当的医疗寻求和药物治疗方案的充分性的独特贡献。这项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名患有哮喘的儿童(年龄5-12岁)，他们来自不同的社会人口学背景。半结构化访谈将收集有关儿童疾病严重程度、所用药物和医疗接触者的信息。访谈还将在疾病及其症状的性质(身份)、原因预期结果和药物的作用等领域评估父母疾病代表；数据分析将包括通过专业模型描述父母疾病代表VISA；描述儿童的症状经历、子组比较(基于疾病代表的背景特征、寻求健康护理和药物治疗方案的充分性)；以及评估疾病代表在预测哮喘治疗结果中的独特作用的建模。

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.