| ObjectivesThis study aimed to investigate the current situation of asthma control among school-age children,to explore the influence of parenting style on asthma control,and the mediating effects of general self-efficacy and medication adherence on the relationship between parenting style and asthma control,so as to provide evidence-based reference for improving asthma control among school-age children.MethodsUsing convenient sampling method,from December 2020 to September 2021,we selected school-age asthmatic children and their parents in pediatric respiratory outpatient departments and wards of three territory hospitals in Jinan,Shandong province in this study.The measuring tools included general demographic questionnaire,Short-Egna Minnen av Barndoms Uppfostran-Chinese(s-EMBU-C),General Self-Efficacy Scale(GSES),medication adherence questionnaire and Childhood Asthma Control Test(C-ACT).SPSS 25.0 and Amos 24.0 software were used for data statistics and analysis.Results1.The score of asthma control among school-age children was(19.15±4.27),and the detection rate of uncontrolled asthma in children was 43.6%(92 cases);The scores of positive parenting style and negative parenting style were(37.64±8.31)and(49.22±7.65)respectively;The scores of father rejection,father emotional warmth and father overprotection were(8.50±1.26),(18.07±4.97)and(14.99±3.43)respectively;The scores of mother’s rejection,mother’s emotional warmth and mother’s overprotection were(8.74 ± 1.83),(19.57± 4.42)and(16.98±3.97)respectively;The scores of general self-efficacy and medication adherence were(2.82±0.51)and(12.21±2.01)respectively.2.The results of univariate analyses showed that the scores of asthma control of school-age asthmatic children were significantly different among father’s education levels(t=-2.267,P=0.024),mother’s education levels(t=-1.977,P=0.049),family history of asthma(F=3.483,P=0.033),courses of disease(F=7.918,P<0.001)and complication with allergic rhinitis(t=6.521,P=0.011).3.Correlation analysis showed that the positive parenting style was significantly positively correlated with general self-efficacy,medication adherence and asthma control(r=0.602,P<0.01;r=0.572,P<0.01;r=0.613,P<0.01);The negative parenting style was significantly negatively correlated with general self-efficacy,medication adherence and asthma control(r=-0.535,P<0.01;r=-0.598,P<0.01;r=-0.586,P<0.01);The general self-efficacy was significantly positively correlated with asthma control(r=0.773,P<0.01);The medication adherence was significantly positively correlated with asthma control(r=0.806,P<0.01);The self-efficacy was significantly positively correlated with medication adherence in children with asthma(r=0.739,P<0.01).4.Structural equation model of positive parenting style and asthma control was established:model fitting indexes including χ2/df=2.398,GFI=0.991,AGFI=0.933,NFI=0.992,CFI=0.996,IFI=0.996,SRMR=0.014,RMSEA=0.082,indicating that the model fit well.By the mediation test of Bootstrap,path 1 was obtained:(active parenting style-+general self-efficacy→asthma control),95%CI was[0.075,0.372],excluding 0,indicating that general self-efficacy had a mediating effect between positive parenting style and asthma control.Path 2(active parenting style→medication adherence→asthma control),95%CI[0.032,0.322],excluding 0,indicating that medication adherence had a mediating effect between positive parenting style and asthma control.Path 3(positive parenting style→general self-efficacy→medication adherence→asthma control),95%CI[0.076,0.295],excluding 0,indicating that general self-efficacy and medication adherence had a chain-mediated effect between positive parenting style and asthma control.5.Structural equation model of negative parenting style and asthma control was established:model fitting indexes including χ2/df=1.291,GFI=0.981,AGFI=0.953,NFI=0.979,CFI=0.995,SRMR=0.029,RMSEA=0.037,indicating that the model fit well.By the mediation test of Bootstrap,path 1 was obtained:(negative parenting style→general self-efficacy→asthma control),95%CI[-0.387,-0.103],excluding 0,indicating that general self-efficacy had a mediating effect between negative parenting style and asthma control;Path 2(negative parenting style→medication adherence→asthma control),95%CI[-0.432,-0.071],excluding 0,indicating that medication adherence had a mediating effect between negative parenting style and asthma control;Path 3(negative parenting style→general self-efficacy→medication adherence→asthma control),95%CI[-0.235,-0.020],excluding 0,indicating that general self-efficacy and medication adherence had a chain-mediated effect between negative parenting style and asthma control.Conclusions1.School-age children with asthma have poor asthma control,among which children whose parents with a better educational background or less,having family history of grade I asthma,complicating with allergic rhinitis and having a shorter course of disease are worthy of attention.2.Positive parenting style of school-age children was significantly positively correlated with general self-efficacy,medication adherence and asthma control,while negative parenting style was significantly negatively correlated with general self-efficacy,medication compliance and asthma control.3.Positive parenting can indirectly improve asthma control of school-age children by increasing their general self-efficacy and medication compliance;Negative parenting style can indirectly and negatively affect asthma control by reducing the general self-efficacy and medication compliance of children. |
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