Horner Sharon D
Author Affiliation: Professor and Associate Dean for Research, The University of Texas at Austin, School of Nursing.
Clin Nurse Spec. 2020 Sep/Oct;34(5):222-230. doi: 10.1097/NUR.0000000000000542.
Social determinants of health (SDoHs) influence how well a family manages children's asthma. The aim of this study was to examine the influence of SDoHs on family asthma management.
A cross-sectional exploratory study was conducted with 292 children in grades 2 to 5 who had current asthma and their parents to examine associations between SDoHs and the families' asthma management, quality of life, and healthcare utilization.
Data were collected from both child and parent. Social determinants of health include the child's race/ethnic group, age, gender, and asthma severity and the family's socioeconomic status and language spoken in the home, and the school was the community-level variable. Parents and children completed asthma management and quality-of-life scales and parents reported on the children's emergency department visits and hospitalizations for asthma.
Worse quality of life was reported by families with lower socioeconomic status and African American children. Asthma severity was associated with parents' asthma management but not children's asthma self-management. Families who spoke Spanish at home had the lowest socioeconomic status yet performed significantly more asthma management than English-speaking families.
The findings highlight factors the clinical nurse specialist should address in educational interventions.
健康的社会决定因素（SDoHs）会影响家庭对儿童哮喘的管理效果。本研究旨在探讨SDoHs对家庭哮喘管理的影响。
对292名患有当前哮喘的二至五年级儿童及其父母进行了一项横断面探索性研究，以检验SDoHs与家庭哮喘管理、生活质量和医疗保健利用之间的关联。
收集了儿童和父母双方的数据。健康的社会决定因素包括儿童的种族/族裔、年龄、性别和哮喘严重程度，以及家庭的社会经济地位和在家中使用的语言，学校是社区层面的变量。父母和儿童完成了哮喘管理和生活质量量表，父母报告了儿童因哮喘而去急诊科就诊和住院的情况。
社会经济地位较低的家庭以及非裔美国儿童的家庭报告的生活质量较差。哮喘严重程度与父母的哮喘管理相关，但与儿童的哮喘自我管理无关。在家中说西班牙语的家庭社会经济地位最低，但他们进行的哮喘管理显著多于说英语的家庭。
研究结果突出了临床护理专家在教育干预中应解决的因素。
