Rogulj Marijana, Vukojevic Katarina, Bruzzese Jean-Marie, Lusic Kalcina Linda
University Hospital Centre Split, Split, Croatia.
Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Split, Croatia.
World Allergy Organ J. 2023 Jan 21;16(1):100733. doi: 10.1016/j.waojou.2022.100733. eCollection 2023 Jan.
Clinical guidelines recommend the identification of asthma comorbidities, especially treatable problems such as parental behaviours and child and parent anxiety.
We aimed to (1) explore associations of asthma severity with child and parent state anxiety, trait anxiety, and asthma-related anxiety as well as with caregiver behaviours around physical activity and (2) explore if caregiver behaviours around physical activity were associated with use of inhaled β-Agonists when symptomatic, and with child and parent anxiety.
Patients ages 3-17 years with asthma (n = 72) and their parents were recruited from the Pulmonology-Allergology Pediatric clinic University Hospital Centre Split in Split, Croatia during 2021. During a clinical visit, the pharmacological regimen was assessed and spirometry was performed. Children completed the State-Trait Anxiety Inventory for Children (STAI-C) and the Youth Asthma-Related Anxiety Scale (YASS). Parents completed the State-Trait Anxiety Inventory (STAI), the Parent Asthma-Related Anxiety Scale (PASS), and the Physical Activity Parenting Practices - Short Form (PAPP).
Most patients had mild asthma (69.4%). Children with moderate to severe asthma had increased asthma-related anxiety (mean = 11.94 ± 6.1) compared with children with mild asthma (mean = 5.97 ± 6.39, p = 0.003). Parents of children with mild asthma reported behaviours allowing unsupervised physical activity outside more often when compared to parents of children with moderate or severe asthma. Physical activity facilitation parenting behaviour reduced the odds of a child's need for quick-reliever medication when symptomatic (OR = 0.376,95% CI = -1.885 to -0.072; p = 0.034); more coercive parenting increased the odds of a child's additional use of such medications (OR = 2.602; 95% CI = 0.005 to 1.908; p = 0.049). Parents of children in the highest quartile of trait anxiety showed less non-directive support (1.97 ± 1.01 vs. 2.89 ± 1.19, p = 0.031) and less autonomy support (3.14 ± 1.32 vs. 4.11 ± 1.23, p = 0.037) of physical activity in their children than those with less trait anxiety.
Asthma-related anxiety was an important construct in this sample of children, associated with their disease severity as well as their parent's behaviours around the child's physical activities. Current research, conducted during the COVID-19 pandemic, recognised the tangible ways that parents support or avoid the asthmatic children's physical activity participation. Child anxiety and recognised parental physical activity behaviours are potentially important factors to assess and target for intervention.
临床指南建议识别哮喘合并症，尤其是可治疗的问题，如父母行为以及儿童和父母的焦虑。
我们旨在（1）探讨哮喘严重程度与儿童和父母的状态焦虑、特质焦虑、哮喘相关焦虑以及照顾者围绕体育活动的行为之间的关联，以及（2）探讨照顾者围绕体育活动的行为是否与有症状时吸入β-激动剂的使用以及儿童和父母的焦虑相关。
2021年期间，从克罗地亚斯普利特大学医院中心的儿科肺科-过敏科招募了72名3至17岁的哮喘患者及其父母。在临床就诊期间，评估药物治疗方案并进行肺功能测定。儿童完成儿童状态-特质焦虑量表（STAI-C）和青少年哮喘相关焦虑量表（YASS）。父母完成状态-特质焦虑量表（STAI）、父母哮喘相关焦虑量表（PASS）和体育活动育儿实践-简表（PAPP）。
大多数患者患有轻度哮喘（69.4%）。与轻度哮喘儿童（平均=5.97±6.39，p=0.003）相比，中度至重度哮喘儿童的哮喘相关焦虑增加（平均=11.94±6.1）。与中度或重度哮喘儿童的父母相比，轻度哮喘儿童的父母报告允许孩子在户外无监督体育活动的行为更频繁。促进体育活动的育儿行为降低了孩子有症状时需要速效缓解药物的几率（OR=0.376，95%CI=-1.885至-0.072；p=0.034）；更多强制性的育儿方式增加了孩子额外使用此类药物的几率（OR=2.602；95%CI=0.005至1.908；p=0.049）。特质焦虑处于最高四分位数的儿童的父母对孩子体育活动的非指导性支持较少（1.97±1.01对2.89±1.19，p=0.031），自主性支持也较少（3.14±1.32对4.11±1.23，p=0.037）。
在这个儿童样本中，哮喘相关焦虑是一个重要因素，与疾病严重程度以及父母围绕孩子体育活动的行为相关。在新冠疫情期间进行的当前研究认识到了父母支持或避免哮喘儿童参与体育活动的具体方式。儿童焦虑和公认的父母体育活动行为可能是评估和干预的重要目标因素。
