Rolke Laura J, Griffin Sarah F, Hamilton Joel, Mayo Rachel, Williams Joel E, Rennert Lior, Sease Kerry K
College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC, USA.
Texas A&M AgriLife Research, Dallas, TX, USA.
J Patient Exp. 2022 Apr 18;9:23743735221089458. doi: 10.1177/23743735221089458. eCollection 2022.
Determinants of pediatric asthma management include child, family, healthcare, and community factors. The purpose of this study is to investigate how parents/guardians are impacted by and act on these factors to aid in their child's asthma self-management. Interviews were conducted in Fall 2020 with 12 female parents/guardians of Black/African American children who participated in a community paramedic pilot study with their child in South Carolina. Children in the initial study had an asthma diagnosis of moderate persistent asthma, had Medicaid insurance, and were determined high-risk for emergency room presentation. Inductive and deductive qualitative analysis identified that child management self-efficacy and independence, parent/guardian health literacy, parent and child negative experiences related to asthma diagnosis and management, asthma management tools, and social support from multiple sources impact child self-management. Findings from this study highlight the importance of clear asthma education and management tool recommendations from healthcare and community providers, particularly for parents/guardians with low health literacy. Health literacy impacted parental responses and likely how families comprehend Medicaid and clinical asthma guidance.
儿童哮喘管理的决定因素包括儿童、家庭、医疗保健和社区因素。本研究的目的是调查父母/监护人如何受到这些因素的影响并据此采取行动，以帮助他们的孩子进行哮喘自我管理。2020年秋季，对12名黑人/非裔美国儿童的女性父母/监护人进行了访谈，这些儿童与他们的孩子一起参与了南卡罗来纳州的一项社区护理人员试点研究。初始研究中的儿童被诊断为中度持续性哮喘，拥有医疗补助保险，并且被确定为急诊室就诊的高危人群。归纳和演绎定性分析表明，儿童管理自我效能感和独立性、父母/监护人的健康素养、父母和孩子与哮喘诊断及管理相关的负面经历、哮喘管理工具以及来自多个来源的社会支持会影响儿童自我管理。本研究结果强调了医疗保健和社区提供者提供明确的哮喘教育和管理工具建议的重要性，特别是对于健康素养较低的父母/监护人。健康素养影响了父母的反应，也可能影响家庭对医疗补助和临床哮喘指导的理解。
