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Family stress a factor in asthma

University of Adelaide

A new study, believed to be the first of its kind, has established an important link between the quality of life of children with asthma and the level of stress in their family environment. The study, conducted by a team of researchers from Adelaide University and the Women's & Children's Hospital in Adelaide, Australia, shows that the family environment can influence the way children feel about their asthma.

Asthma is the most common chronic medical condition of Australian children, with as many as one in five suffering from it.

"The quality of the family environment affects children's experience of their illness and the extent to which they are upset and bothered by their symptoms," says the senior author of the paper, Adelaide University's Professor Michael Sawyer (Department of Psychiatry).

"A child with asthma who lives in a family where there is often conflict and tension between family members may be more distressed by their asthma symptoms than a child who lives in a more stable family environment," he says.

The study used standard questionnaires to evaluate the experiences of 84 children aged between 7 and 12 years, and their parents, who attended the Specialist Respiratory Clinic at the Women's and Children's Hospital, the main paediatric hospital in South Australia.

It is thought to be the first such study in which reports from children themselves have been used to examine the relationship between their perceptions of their health-related quality of life and the functioning of their families.

"The novel aspect of this study was the collection of information about their quality of life directly from children," Professor Sawyer says.

"Increasing emphasis is being placed on obtaining information directly from children with chronic illness about the quality of their lives. In the past this information has generally been obtained from parents or clinicians, but they often don't agree with children about the quality of children's lives."

The study found that children were less bothered by their asthma symptoms if they lived in families where members had more clearly defined roles, rules for behaviour, greater interest and concern for the welfare of each other, and provided more emotional support.

In contrast, children who lived in poorly organised families appeared more upset by symptoms, such as coughing, tightness in their chests, irritability and feeling frightened.

So, does family friction make asthma worse, or just make it seem worse?

"The study didn't address this issue specifically," says Professor Sawyer. "Because all the information for this study was collected at one time, we can't determine whether the children's distress caused the family problems or whether the family problems caused the children's distress," he says.

"It would only be possible to learn what causes what by following children and families over time to learn which occurs first."

While Professor Sawyer stresses the need for good medical care to reduce the severity of children's asthma symptoms, he believes that approaches designed to improve the family environment may also help to reduce the extent to which children who are asthma sufferers are troubled by their complaint.

"Asthma management programs will be most effective if they provide relevant help for families as well as children," he says.


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