Parents of asthmatic children knowledge of asthma, anxiety level and quality of life: unveiling important associations
Main Article Content
Keywords
Children, Parents, Asthma, Quality of life, Anxiety, Jorda
Abstract
Purpose: Asthma in children affects millions around the world. Parents’ knowledge of asthma and their quality of life (QoL) may affect the management of their asthma child. The study aimed to assess the knowledge of asthma, anxiety, and QoL of parents who have children diagnosed with asthma living in Amman, Jordan. Patients and methods: This cross-sectional study was conducted over five months in Amman, Jordan. Children with asthma were recruited from outpatient respiratory clinics. Parents were interviewed while waiting to see the child’s respiratory specialist. The Consumer Asthma Knowledge Questionnaire (twelve true/false items), Parent Asthma-Related Anxiety Scale (eleven questions), and QoL Questionnaire (thirteen questions) were used. Results: Recruited parents of the children with asthma (n= 150, mean age 5.05±3.5) showed poor asthma knowledge (score= 5.8±1.75 out of 12, and the 11-item mean is 2.42). Screening of anxiety revealed an increased risk of mild anxiety among parents (score= 26.59±7.3 out of 55, and the 13-item mean is 3.55). The QoL screening showed that parents had a median QoL (score= 39.5±12.0). Conclusion: Asthma knowledge among parents of children with asthma living in Jordan is poor. Screening of anxiety and QoL showed that many parents had mild anxiety and poor QoL. These results shed light on an urgent matter that needs to be addressed as quickly as possible in Jordan and for parents of asthma children worldwide..
References
1. GINA 2020. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2020. Available from: https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf.
2. McCallum GB, Morris PS, Brown N, et al. Culture‐specific programs for children and adults from minority groups who have asthma. Cochrane Database Syst Rev. 2017;8(8):CD006580. https://doi.org/10.1002/14651858.CD006580.pub5
3. Pinnock H, Fletcher M, Holmes S, et al. Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care. Primary Care Respiratory Journal. 2010;19(1):75. https://doi.
org/10.4104/pcrj.2010.00006
4. The Global Asthma Report. The global asthma report 2014. Auckland, New Zealand. 2014;769.
5. Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma Research and Practice. 2017;3(1):1. https://doi.org/10.1186/s40733-016-0029-3
6. Guilbert TW, Bacharier LB, Fitzpatrick AM. Severe asthma in children. The Journal of Allergy and Clinical Immunology: In Practice. 2014;2(5):489-500. https://doi.org/10.1016/j.jaip.2014.06.022
7. Alith MB, Gazzotti MR, Montealegre F, et al. Negative impact of asthma on patients in different age groups. Jornal Brasileiro de Pneumologia. 2015;41(1):16-22. https://doi.org/10.1590/S1806-37132015000100003
8. Abu-Ekteish F, Otoom S, Shehabi I. Prevalence of asthma in Jordan: comparison between Bedouins and urban schoolchildren using the International Study of Asthma and Allergies in Childhood phase III protocol. Paper presented at: Allergy and Asthma
Proceedings. 2009;30(2):181-185. https://doi.org/10.2500/aap.2009.30.3208
9. Zahradnik A. Asthma education information source preferences and their relationship to asthma knowledge. Journal of Health and Human Services Administration. 2011;34(3):325-351.
10. Kroegel C. Global Initiative for Asthma (GINA) guidelines: 15 years of application. Expert Review of Clinical Immunology. 2009;5(3):239-249. https://doi.org/10.1586/eci.09.1
11. GINA 2017. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2017. Available from: www.ginasthma.org.
12. Clatworthy J, Price D, Ryan D, et al. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Primary Care Respiratory Journal. 2009;18(4):300. https://doi.org/10.4104/pcrj.2009.00037
13. Basheti IA, Obeidat NM, Reddel HK. Inhaler technique education and asthma control among patients hospitalized for asthma in Jordan. Saudi Pharm J. 2018;26(8):1127-1136. https://doi.org/1110.1016/j.jsps.2018.1106.1002
14. Basheti IA, Obeidat NM, Reddel HK. Effect of novel inhaler technique reminder labels on the retention of inhaler technique skills in asthma: a single-blind randomized controlled trial. NPJ Prim Care Respir Med. 2017;27(1):9. https://doi.org/10.1038/
s41533-017-0011-4
15. Mancuso CA, Sayles W, Allegrante JP. Randomized trial of self-management education in asthmatic patients and effects of depressive symptoms. Annals of Allergy, Asthma & Immunology. 2010;105(1):12-19. https://doi.org/10.1016/j.
anai.2010.04.009
16. Shams MR, Bruce AC, Fitzpatrick AM. Anxiety Contributes to Poorer Asthma Outcomes in Inner-City Black Adolescents. J Allergy Clin Immunol Pract. 2018;6(1):227-235. https://doi.org/10.1016/j.jaip.2017.06.034
17. Katon WJ, Richardson L, Lozano P, et al. The relationship of asthma and anxiety disorders. Psychosomatic Medicine. 2004;66(3):349-355. https://doi.org/10.1097/01.psy.0000126202.89941.ea
18. Ortega AN, McQuaid EL, Canino G, et al. Comorbidity of asthma and anxiety and depression in Puerto Rican children. Psychosomatics. 2004;45(2):93-99. https://doi.org/10.1176/appi.psy.45.2.93
19. Bender B, Zhang L. Negative affect, medication adherence, and asthma control in children. Journal of Allergy and Clinical Immunology. 2008;122(3):490-495. https://doi.org/10.1016/j.jaci.2008.05.041
20. Bruzzese J-M, Unikel LH, Shrout PE, et al. Youth and parent versions of the Asthma-Related Anxiety Scale: development and initial testing. Pediatric Allergy, Immunology, and Pulmonology. 2011;24(2):95-105. https://doi.org/10.1089/ped.2011.0076
21. Monitoring ACfA. Asthma in Australia 2011: with a focus chapter on chronic obstructive pulmonary disease. Australian Institute of Health and Welfare; 2011.
22. Basch CE. Healthier students are better learners: A missing link in school reforms to close the achievement gap. Journal of School Health. 2011;81(10):593-598. https://doi.org/10.1111/j.1746-1561.2011.00632.x
23. Gerald JK, Sun Y, Grad R, et al. Asthma morbidity among children evaluated by asthma case detection. Pediatrics.
2009;124(5):e927-e933. https://doi.org/10.1542/peds.2008-2798
24. Saini B, LeMay K, Emmerton L, et al. Asthma disease management—Australian pharmacists’ interventions improve patients’ asthma knowledge and this is sustained. Patient Education and Counseling. 2011;83(3):295-302. https://doi.org/10.1016/j.
pec.2011.05.001
25. Juniper EF, Guyatt GH, Feeny DH, et al. Measuring quality of life in the parents of children with asthma. Quality of Life Research. 1996;5(1):27-34. https://doi.org/10.1007/BF00435966
26. El Hasnaoui A, Martin J, Salhi H, et al. Validation of the Asthma Control Test questionnaire in a North African population. Respiratory Medicine. 2009;103:S30-S37. https://doi.org/10.1016/S0954-6111(09)70025-3
27. Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. Journal of Allergy and Clinical Immunology. 2004;113(1):59-65. https://doi.org/10.1016/j.jaci.2003.09.008
28. Kritikos V, Krass I, Chan HS, et al. The validity and reliability of two asthma knowledge questionnaires. Journal of Asthma. 2005;42(9):795-801. https://doi.org/10.1080/02770900500308627
29. Endrighi R, McQuaid EL, Bartlett YK, et al. Parental Depression is Prospectively Associated with Lower Smoking Cessation Rates and Poor Child Asthma Outcomes. Ann Behav Med. 2018;52(3):195-203. https://doi.org/10.1093/abm/kax011
30. Rodríguez EM, Kumar H, Alba-Suarez J, et al. Parental coping, depressive symptoms, and children’s asthma control and school attendance in low-income, racially, and ethnically diverse urban families. J Asthma. 2017;54(8):833-841. https://doi.org/10.1
080/02770903.2016.1274402
31. Chong Y-Y, Leung D, Mak Y-W. When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma. Int J Environ Res Public Health. 2018;15(7):1372. https://doi.org/10.3390/
ijerph15071372
32. Liu C, Feekery C. Can asthma education improve clinical outcomes? An evaluation of a pediatric asthma education program. J Asthma. 2001;38(3):269-278. https://doi.org/10.1081/jas-100000114
33. Özkaya E, Cetin M, Uğurad Z, et al. Evaluation of family functioning and anxiety-depression parameters in mothers of children with asthma. Allergologia et Immunopathologia. 2010;38(1):25-30. https://doi.org/10.1016/j.aller.2009.06.004
34. Yuksel H, Sogut A, Yilmaz O, et al. Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothers. Respir Med. 2007;101(12):2550-2554. https://doi.org/10.1016/j.rmed.2007.07.025
35. Yilmaz O, Sogut A, Gulle S, et al. Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: asthma and cystic fibrosis. J Cyst Fibros. 2008;7(6):495-500. https://doi.org/10.1016/j.jcf.2008.05.002
36. Tibosch M, Reidsma C, Landstra A, et al. An asthma-related quality of life instrument is unable to identify asthmatic children with major psychosocial problems. European Journal of Pediatrics. 2010;169(12):1495-1501. https://doi.org/10.1007/s00431-
010-1250-3
37. Marsac M, Funk J, Nelson L. Coping styles, psychological functioning and quality of life in children with asthma. Child: Care, Health and Development. 2007;33(4):360-367. https://doi.org/10.1111/j.1365-2214.2006.00701.x
38. Al-sheyab NA, Alomari MA. Prevalence, associated factors, and control level of asthma symptoms among adolescents in Northern Jordan. International Journal of Adolescent Medicine and Health. 2018;32(3). https://doi.org/10.1515/ijamh-2017-0159
39. Uysal MA, Mungan D, Yorgancioglu A, et al. The validation of the Turkish version of Asthma Control Test. Quality of Life Research. 2013;22(7):1773-1779. https://doi.org/10.1007/s11136-012-0309-1
2. McCallum GB, Morris PS, Brown N, et al. Culture‐specific programs for children and adults from minority groups who have asthma. Cochrane Database Syst Rev. 2017;8(8):CD006580. https://doi.org/10.1002/14651858.CD006580.pub5
3. Pinnock H, Fletcher M, Holmes S, et al. Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care. Primary Care Respiratory Journal. 2010;19(1):75. https://doi.
org/10.4104/pcrj.2010.00006
4. The Global Asthma Report. The global asthma report 2014. Auckland, New Zealand. 2014;769.
5. Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma Research and Practice. 2017;3(1):1. https://doi.org/10.1186/s40733-016-0029-3
6. Guilbert TW, Bacharier LB, Fitzpatrick AM. Severe asthma in children. The Journal of Allergy and Clinical Immunology: In Practice. 2014;2(5):489-500. https://doi.org/10.1016/j.jaip.2014.06.022
7. Alith MB, Gazzotti MR, Montealegre F, et al. Negative impact of asthma on patients in different age groups. Jornal Brasileiro de Pneumologia. 2015;41(1):16-22. https://doi.org/10.1590/S1806-37132015000100003
8. Abu-Ekteish F, Otoom S, Shehabi I. Prevalence of asthma in Jordan: comparison between Bedouins and urban schoolchildren using the International Study of Asthma and Allergies in Childhood phase III protocol. Paper presented at: Allergy and Asthma
Proceedings. 2009;30(2):181-185. https://doi.org/10.2500/aap.2009.30.3208
9. Zahradnik A. Asthma education information source preferences and their relationship to asthma knowledge. Journal of Health and Human Services Administration. 2011;34(3):325-351.
10. Kroegel C. Global Initiative for Asthma (GINA) guidelines: 15 years of application. Expert Review of Clinical Immunology. 2009;5(3):239-249. https://doi.org/10.1586/eci.09.1
11. GINA 2017. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2017. Available from: www.ginasthma.org.
12. Clatworthy J, Price D, Ryan D, et al. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Primary Care Respiratory Journal. 2009;18(4):300. https://doi.org/10.4104/pcrj.2009.00037
13. Basheti IA, Obeidat NM, Reddel HK. Inhaler technique education and asthma control among patients hospitalized for asthma in Jordan. Saudi Pharm J. 2018;26(8):1127-1136. https://doi.org/1110.1016/j.jsps.2018.1106.1002
14. Basheti IA, Obeidat NM, Reddel HK. Effect of novel inhaler technique reminder labels on the retention of inhaler technique skills in asthma: a single-blind randomized controlled trial. NPJ Prim Care Respir Med. 2017;27(1):9. https://doi.org/10.1038/
s41533-017-0011-4
15. Mancuso CA, Sayles W, Allegrante JP. Randomized trial of self-management education in asthmatic patients and effects of depressive symptoms. Annals of Allergy, Asthma & Immunology. 2010;105(1):12-19. https://doi.org/10.1016/j.
anai.2010.04.009
16. Shams MR, Bruce AC, Fitzpatrick AM. Anxiety Contributes to Poorer Asthma Outcomes in Inner-City Black Adolescents. J Allergy Clin Immunol Pract. 2018;6(1):227-235. https://doi.org/10.1016/j.jaip.2017.06.034
17. Katon WJ, Richardson L, Lozano P, et al. The relationship of asthma and anxiety disorders. Psychosomatic Medicine. 2004;66(3):349-355. https://doi.org/10.1097/01.psy.0000126202.89941.ea
18. Ortega AN, McQuaid EL, Canino G, et al. Comorbidity of asthma and anxiety and depression in Puerto Rican children. Psychosomatics. 2004;45(2):93-99. https://doi.org/10.1176/appi.psy.45.2.93
19. Bender B, Zhang L. Negative affect, medication adherence, and asthma control in children. Journal of Allergy and Clinical Immunology. 2008;122(3):490-495. https://doi.org/10.1016/j.jaci.2008.05.041
20. Bruzzese J-M, Unikel LH, Shrout PE, et al. Youth and parent versions of the Asthma-Related Anxiety Scale: development and initial testing. Pediatric Allergy, Immunology, and Pulmonology. 2011;24(2):95-105. https://doi.org/10.1089/ped.2011.0076
21. Monitoring ACfA. Asthma in Australia 2011: with a focus chapter on chronic obstructive pulmonary disease. Australian Institute of Health and Welfare; 2011.
22. Basch CE. Healthier students are better learners: A missing link in school reforms to close the achievement gap. Journal of School Health. 2011;81(10):593-598. https://doi.org/10.1111/j.1746-1561.2011.00632.x
23. Gerald JK, Sun Y, Grad R, et al. Asthma morbidity among children evaluated by asthma case detection. Pediatrics.
2009;124(5):e927-e933. https://doi.org/10.1542/peds.2008-2798
24. Saini B, LeMay K, Emmerton L, et al. Asthma disease management—Australian pharmacists’ interventions improve patients’ asthma knowledge and this is sustained. Patient Education and Counseling. 2011;83(3):295-302. https://doi.org/10.1016/j.
pec.2011.05.001
25. Juniper EF, Guyatt GH, Feeny DH, et al. Measuring quality of life in the parents of children with asthma. Quality of Life Research. 1996;5(1):27-34. https://doi.org/10.1007/BF00435966
26. El Hasnaoui A, Martin J, Salhi H, et al. Validation of the Asthma Control Test questionnaire in a North African population. Respiratory Medicine. 2009;103:S30-S37. https://doi.org/10.1016/S0954-6111(09)70025-3
27. Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. Journal of Allergy and Clinical Immunology. 2004;113(1):59-65. https://doi.org/10.1016/j.jaci.2003.09.008
28. Kritikos V, Krass I, Chan HS, et al. The validity and reliability of two asthma knowledge questionnaires. Journal of Asthma. 2005;42(9):795-801. https://doi.org/10.1080/02770900500308627
29. Endrighi R, McQuaid EL, Bartlett YK, et al. Parental Depression is Prospectively Associated with Lower Smoking Cessation Rates and Poor Child Asthma Outcomes. Ann Behav Med. 2018;52(3):195-203. https://doi.org/10.1093/abm/kax011
30. Rodríguez EM, Kumar H, Alba-Suarez J, et al. Parental coping, depressive symptoms, and children’s asthma control and school attendance in low-income, racially, and ethnically diverse urban families. J Asthma. 2017;54(8):833-841. https://doi.org/10.1
080/02770903.2016.1274402
31. Chong Y-Y, Leung D, Mak Y-W. When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma. Int J Environ Res Public Health. 2018;15(7):1372. https://doi.org/10.3390/
ijerph15071372
32. Liu C, Feekery C. Can asthma education improve clinical outcomes? An evaluation of a pediatric asthma education program. J Asthma. 2001;38(3):269-278. https://doi.org/10.1081/jas-100000114
33. Özkaya E, Cetin M, Uğurad Z, et al. Evaluation of family functioning and anxiety-depression parameters in mothers of children with asthma. Allergologia et Immunopathologia. 2010;38(1):25-30. https://doi.org/10.1016/j.aller.2009.06.004
34. Yuksel H, Sogut A, Yilmaz O, et al. Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothers. Respir Med. 2007;101(12):2550-2554. https://doi.org/10.1016/j.rmed.2007.07.025
35. Yilmaz O, Sogut A, Gulle S, et al. Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: asthma and cystic fibrosis. J Cyst Fibros. 2008;7(6):495-500. https://doi.org/10.1016/j.jcf.2008.05.002
36. Tibosch M, Reidsma C, Landstra A, et al. An asthma-related quality of life instrument is unable to identify asthmatic children with major psychosocial problems. European Journal of Pediatrics. 2010;169(12):1495-1501. https://doi.org/10.1007/s00431-
010-1250-3
37. Marsac M, Funk J, Nelson L. Coping styles, psychological functioning and quality of life in children with asthma. Child: Care, Health and Development. 2007;33(4):360-367. https://doi.org/10.1111/j.1365-2214.2006.00701.x
38. Al-sheyab NA, Alomari MA. Prevalence, associated factors, and control level of asthma symptoms among adolescents in Northern Jordan. International Journal of Adolescent Medicine and Health. 2018;32(3). https://doi.org/10.1515/ijamh-2017-0159
39. Uysal MA, Mungan D, Yorgancioglu A, et al. The validation of the Turkish version of Asthma Control Test. Quality of Life Research. 2013;22(7):1773-1779. https://doi.org/10.1007/s11136-012-0309-1
Article Sidebar
Published
Sep 27, 2023
Article Details
How to Cite
1.
Parents of asthmatic children knowledge of asthma, anxiety level and quality of life: unveiling important associations. Pharm Pract (Granada) [Internet]. 2023 Sep. 27 [cited 2025 Mar. 19];21(3):1-10. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/2843
Section
Original Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
How to Cite
1.
Parents of asthmatic children knowledge of asthma, anxiety level and quality of life: unveiling important associations. Pharm Pract (Granada) [Internet]. 2023 Sep. 27 [cited 2025 Mar. 19];21(3):1-10. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/2843