Parenting stress related to behavioural problems and disease severity in children with problematic severe asthma

Abstract

Introduction: Insight into psychosocial factors that influence disease progression and the psychological status of children with asthma will be helpful in the management of asthma. Our study examined parenting stress and its association with behavioural problems and disease severity in children with problematic severe asthma (PSA). Methods: In 93 children with PSA (mean age 13.4±2.7 yrs); Forced Expiratory Volume in 1 second (FEV 1 ), Fraction of exhaled Nitric Oxide (FeNO), and Asthma Control Test (ACT) scores were assessed. Parents completed the Parenting Stress Index (PSI) and the Child Behaviour Checklist (CBCL). Associations were assessed with Path analysis using Mplus 6.1. Results: As compared to previous reports in parents of healthy and ill children, parenting stress scores in mothers (n=86) and fathers (n=59) of the children with PSA were low; showing medium ( d= 0.5) to large ( d >0.8) effect-size deviations for most aspects of parenting stress. Higher parenting stress was associated with higher levels of behavioural problems in children (CBCL) and higher parenting stress in mothers was also associated with higher FeNO. The model had good fit indices: χ 2 =9.40, df =9, p =.40; RMSEA=.028; CFI=.998; TLI=.994. Conclusions: Thus, although parenting stress is low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioural problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioural problems in the child as well as parenting stress.