Asthma management in school-aged children, particularly controller medication use, is best conceptualized as parent-child shared management. Controller medication nonadherence is common, and leads to higher disease morbidity such as cough, sleep disruption, poor activity tolerance, and asthma exacerbation. The purpose of this study was to describe asthma illness representations of both school-aged children (6-11 years) with persistent asthma and their parents, and to examine their interdependence. The Common Sense Model of Self-regulation, modified to include Parent-Child Shared Regulation, provided the framework for this descriptive, cross-sectional study. Thirty-four parent-child dyads independently reported on asthma control, controller medication adherence, and asthma illness representations by completing the Childhood Asthma Control Test, Medication Adherence Report Scale for Asthma, Brief Illness Perception Questionnaire, and Beliefs about Medicines Questionnaire. Using intraclass correlations, moderate agreement was evident between the parent and child timeline (perceived duration) illness representation domain (ICC= .41), and there was a weak association between the parent and child symptoms domain (ICC = .13). The remaining controllability and consequences domains showed no agreement. Hierarchical regression analyses were used to test parent and child illness representation domain variables as predictors of parent or child estimates of medication adherence. With parent-reported medication adherence as the dependent variable, regression models used parent illness representation variables followed by the corresponding child variable. Parent beliefs about medication necessity versus concerns was a significant predictor of parent-reported treatment adherence (β = .55, p < .01). Child-reported treatment control was also predictive of parent-reported treatment adherence (β -.50, p < .01). When child-reported medication adherence was the dependent variable, the child illness representation variable was entered first followed by the parent variable. Child beliefs about medication necessity versus concerns was the only significant predictor of child-reported adherence (child β .50, p < .01), none of the parent variables reached significance. Findings from this study indicate that although there are similarities between parent and child asthma illness representations, parental illness representations do not predict children's estimation of controller medication adherence. These findings indicate that school-aged children develop illness representations somewhat independent from their parents and, therefore, are critical participants in both asthma care as well as research.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/594958 |
| Date | January 2015 |
| Creators | Sonney, Jennifer Tedder |
| Contributors | Insel, Kathleen C., Insel, Kathleen C., Insel, Kathleen C., Gerald, Lynn, Moore, Ida M., Segrin, Chris |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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