The Effect Of Family Functioning On Asthma Control In Children

ObjectiveThe purpose of this study is to explore the influence mechanism of family functioning on child’s asthma control,to verify the intermediary role of caregiver anxiety and child’s behavior problems in the relationship between family functioning and child’s asthma control level,and to put forward specific countermeasures and suggestions to promote child’s asthma control level.MethodsFrom December 2018 to January 2020,a sample questionnaire survey was conducted among 4.5-10-year-old asthmatic child and their caregivers who were hospitalized in the respiratory department of a top three hospital in Chengdu,Sichuan Province.The survey includes the basic information of child with asthma and their parents,as well as the family functioning(family relationship and disease economic burden),caregiver anxiety,child’s behavior problems and the level of asthma control.Through single factor analysis and multiple factor stepwise regression,the variables that affect the control level of child’s asthma were selected and included in the structural equation model as control variables.To test the correlation between asthma control and family functioning(family relationship and disease economic burden),caregiver anxiety and child’s behavior problems.The mediating effects of caregiver anxiety and child’s behavior problems on the control level of child’s asthma were analyzed.A structural equation model was constructed to verify the path relationship among family functioning,caregiver anxiety,child’s behavior problems and child’s asthma control level.Stata 14.0 software was used for statistical description,single factor analysis,multi factor stepwise regression analysis,intermediary effect analysis and correlation analysis.Amos was used to build structural equation model for path analysis and bootstrap intermediary effect test.Based on the above analysis,the specific countermeasures and suggestions are put forward to improve the asthma control level of child with asthma.Results1.The child’s asthma control test(C-ACT)score in the study sample was 22.2± 3.60,the uncontrolled group accounted for 19.27%,part of the control group accounted for 20.8%,and the complete control rate was 59.94%.According to Spearman rank correlation analysis,family relationship in family functioning is positively correlated with childhood asthma control level(r = 0.13,P <0.05);disease economic burden in family functioning is negatively correlated with childhood asthma control level(r =-0.19,P <0.01);caregiver anxiety is negatively correlated with childhood asthma control level(r =-0.22,P <0.01);child behavior problems are negatively correlated with childhood asthma control level(r =-0.11,P <0.05).2.Based on regression analysis,we found that carer anxiety plays a complete mediating role in the influence of family relationship on child’s asthma control level when there is no control variable;carer anxiety plays a part of mediating role in the influence of disease economic burden on child’s asthma control level;child’s behavioral problems play a part of mediating role in the influence of disease economic burden on child’s asthma control level effect.3.Structural equation model analysis found that,after adding control variables,caregiver anxiety completely mediates the relationship between family relationship and child’s asthma control level;caregiver anxiety partially mediates the relationship between disease economic burden and child’s asthma control level;behavior problems partially mediates the relationship between disease economic burden and child’s asthma control level,which is consistent with the results of intermediary effect analysis.At the same time,it was found that the influence of family functioning(family relationship and disease economic burden)on child’s asthma control level was chain like,that is,caregiver anxiety and child’s behavior problems continuously mediated the influence of family functioning on asthma control level.Bootstrap test was used to examine the mediating effects of anxiety and behavioral problems on the control level of child’s asthma.Among them,caregiver anxiety and child’s behavior problems explain 100% of the total effect of family relationship on child’s asthma control level,and caregiver anxiety and child’s behavior problems also explain 31.3% of the total effect of disease economic burden on child’s asthma control level.ConclusionFamily functioning(family relationship and disease financial burden)will affect the level of asthma control in child,and caregiver anxiety and child’s behavioral problems continuously mediate the effect of family functioning on the level of asthma control.The results suggest that in the process of home care for child with asthma,the importance of family functioning for the management of disease in child with asthma should be emphasized.This article puts forward specific suggestions to promote the improvement of asthma control in asthmatic child from the perspectives of improving the family relationship of asthmatic child,reducing the economic burden of asthma,paying attention to the psychological status of caregivers of asthmatic child,and alleviating the behavioral problems of asthmatic child.