Martha Kirk Swartz, PhD
“Predictors of Health-Related Quality of Life and Family Life Satisfaction in School Age Children with Asthma”
Abstract: For children with asthma, their perceived health related quality of life (HRQL) is viewed as a valid outcome measure with which to evaluate care and guide clinical interventions. Numerous clinical variables have been associated with HRQL, but few studies have addressed the role of family functioning in relationship to this outcome. The current study extends the findings of an earlier meta-analysis which indicated that family functioning and illness severity were significant predictors of health related quality of life in children with asthma. Sixty children and sixty parents or guardians participated in this study of school age asthmatic children who, over the preceding year, received regular care at a pediatric respiratory clinic for their asthma symptoms. Demographic information was obtained from the adults, who also completed standard measures assessing family stress, adaptation, cohesion and parental satisfaction with family functioning. The children were interviewed by the investigator, and completed scales to assess HRQL and their satisfaction with family life or functioning. The two major outcomes of interest were the child’s HRQL and satisfaction with family functioning. The child’s level of control over symptoms and the accumulation of family demands, particularly those related to loss, transition and illness/ family care, negatively affected the child’s quality of life and satisfaction with family functioning. Multiple regression analysis further revealed that level of control and transitions within the family accounted for 25% of the variance of scores measuring HRQL. Illness and family care strains accounted for 14% of the variance of scores measuring the child’s satisfaction with family functioning. Family cohesion emerged as a potential mediating factor that may buffer the negative effects of family stress and the lack of control that an asthmatic child may experience in symptom management. An appreciation of the relationships among family stress, cohesion, HRQL and satisfaction with family life for children with asthma will directly inform nursing practice. Additional family centered clinical research that fully incorporates HRQL into a theoretical model of health outcomes will continue to refine effective nursing interventions for asthmatic children.