Psychosocial Components of Asthma Management in Children
Shari L. Wade
Asthma is a growing health problem that affects 4.8 million children in the US alone. This paper considers empirical studies from the past 20 years examining the relationship between psychosocial factors and asthma management and morbidity. Research indicates that psychosocial factors, including risk and protective factors in the social environment, and knowledge, attitudes and skills pertaining to asthma management, can play an important role in asthma management, adherence and morbidity. Caregiver and child mental health problems have been linked to increased asthma symptoms and poorer functional status. Family functioning, chronic stresses and social support have also been identified as potential risks and/or protective factors in the social environment. Of the asthma self-management skills, practical problem-solving skills have received increasing attention as an important, and potentially modifiable, psychosocial component. Families may also fail to adhere to medical recommendations because of concerns regarding their utility. Results from a recent individualised asthma intervention protocol provide a strategy for successfully addressing both environmental risk factors and asthma self-management skills to reduce asthma morbidity. Recommendations for healthcare providers include: (i) screening families for psychosocial risk and protective factors on an ongoing basis, including mental health concerns; (ii) engaging family members in dialogue to identify potential areas of confusion or disagreement with the treatment plan; and (iii) including non-medical specialists such as health educators and mental health practitioners as part of the treatment team.
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