Department of Psychology, Arizona State University, Tempe, AZ, USA; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, 23284-2018, VA, USA.
Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, 23284-2018, VA, USA.
J Adolesc. 2020 Apr;80:254-263. doi: 10.1016/j.adolescence.2019.12.007. Epub 2020 Mar 26.
Many families living in low-income, urban areas experience a number of stressors (e.g., poverty, neighborhood stress, family functioning) that place adolescents at risk for worse asthma outcomes. Adolescents may face additional challenges (e.g., peer pressure, school stress) that add to their overall stress and influence their disease care and health outcomes. The current study examined the impact of a cumulative risk model of stressors including poverty, neighborhood stress, school stress, peer pressure, and caregiver-adolescent conflict on asthma outcomes (e.g., emergency department [ED] visits, asthma control, quality of life [QOL]) among urban adolescents (13-17 years).
Data were collected from 61 urban families of adolescents with asthma (54.1% female; 93.4% African American) in the United States. Caregivers and adolescents completed questionnaires assessing stressors and asthma outcomes separately during a research session.
Cumulative risk was significantly associated with worse adolescent QOL and asthma control, and more ED visits. The cumulative risk index was also a more robust predictor of QOL and asthma control than any one individual predictor. Poverty, neighborhood stress, and school stress emerged as individual predictors of ED visits. Further, adolescents with well-controlled asthma had significantly lower neighborhood and school-related stress scores.
Findings suggest that beyond the risk conferred by individual risk factors, an accumulation of stress can have an especially negative impact on asthma outcomes for urban adolescents. Future intervention work aimed at improving asthma outcomes should consider incorporating strategies for minimizing overlapping sources of stress in adolescents' daily lives.
许多居住在低收入城市地区的家庭面临着许多压力源（例如贫困、邻里压力、家庭功能障碍），这些压力源使青少年面临更糟糕的哮喘结果的风险。青少年可能面临额外的挑战（例如同伴压力、学校压力），这些挑战会增加他们的整体压力，并影响他们的疾病护理和健康结果。本研究考察了包括贫困、邻里压力、学校压力、同伴压力和照顾者-青少年冲突在内的压力源累积风险模型对城市青少年（13-17 岁）哮喘结果（例如急诊部[ED]就诊、哮喘控制、生活质量[QOL]）的影响。
数据来自美国 61 个有哮喘青少年的城市家庭（54.1%女性；93.4%非裔美国人）。在研究期间，照顾者和青少年分别完成了评估压力源和哮喘结果的问卷。
累积风险与青少年 QOL 和哮喘控制较差以及更多 ED 就诊相关。累积风险指数也是 QOL 和哮喘控制的更强大预测指标，而不是任何一个单一预测指标。贫困、邻里压力和学校压力是 ED 就诊的个体预测指标。此外，哮喘控制良好的青少年的邻里和学校相关压力得分显著降低。
研究结果表明，除了个体危险因素带来的风险之外，压力的积累会对城市青少年的哮喘结果产生特别负面的影响。未来旨在改善哮喘结果的干预工作应考虑纳入策略，以最大程度地减少青少年日常生活中重叠的压力源。
