University of Rochester, School of Nursing, Rochester, New York 14642, USA.
J Adolesc Health. 2010 Nov;47(5):472-8. doi: 10.1016/j.jadohealth.2010.03.009. Epub 2010 May 14.
Asthma morbidity in children is associated with family psychosocial functioning. Although the family plays a pivotal role in maintaining optimal asthma care, the mechanism of how family support influences asthma outcomes is not well understood. The purpose of this study was to examine the role of barriers to adherence in mediating the effect of family support on asthma outcomes in adolescents.
The sample included 126 adolescents with asthma aged 13-20 years, living in the Northeast United States. The sample consisted of 49% Whites and 51% minorities, including primarily Blacks (38%) followed by Hispanic (11%). Adolescents provided self-reported data. Structural equation modeling was performed to examine the direct and indirect relationships between family support and asthma outcomes.
Family support was positively associated with asthma control and quality of life. These significant associations were mediated by barriers to adherence. Particularly, family support was found to reduce barriers concerning adolescents' negative attitudes toward medication and healthcare providers, which in turn improved asthma control and quality of life symptoms, emotional functioning, and activity domains. Adolescents' cognitive difficulty also tended to mediate the relationship between family support and emotional functioning.
This study highlights the beneficial effects of family support in improving asthma outcomes in adolescents. Family support exerts the positive effect by ameliorating barriers to treatment adherence in adolescents, particularly the barriers associated with negative attitudes and cognitive challenges. The findings underscore the importance of incorporating family assessment and intervention in caring for adolescents with asthma.
儿童哮喘发病率与家庭心理社会功能有关。尽管家庭在维持最佳哮喘护理方面起着关键作用，但家庭支持如何影响哮喘结果的机制尚不清楚。本研究的目的是探讨遵医行为障碍在多大程度上介导家庭支持对青少年哮喘结果的影响。
该样本包括 126 名年龄在 13-20 岁、居住在美国东北部的青少年哮喘患者。该样本包括 49%的白人和 51%的少数族裔，其中主要是黑人（38%），其次是西班牙裔（11%）。青少年提供了自我报告的数据。结构方程模型用于检验家庭支持与哮喘结果之间的直接和间接关系。
家庭支持与哮喘控制和生活质量呈正相关。这些显著的关联是通过遵医行为障碍来介导的。特别是，家庭支持被发现可以减少青少年对药物和医疗保健提供者的负面态度以及认知困难方面的遵医行为障碍，从而改善哮喘控制和生活质量症状、情绪功能和活动领域。青少年的认知困难也倾向于调节家庭支持与情绪功能之间的关系。
本研究强调了家庭支持在改善青少年哮喘结果方面的有益作用。家庭支持通过改善青少年治疗遵医行为障碍来发挥积极作用，特别是与负面态度和认知挑战相关的障碍。研究结果强调了在照顾青少年哮喘患者时纳入家庭评估和干预的重要性。
