Abstract
In recent years, considerable research has been conducted to expand our understanding of health outcomes that are associated with chronic childhood illnesses and disease processes. In studies of children with asthma (Juniper, 2001; Juniper et al., 1996), health related quality of life (HRQOL) has been identified as a conceptually valid outcome measure, which attempts to quantify the child's and family's subjective experiences with the illness and treatment that are central to their everyday life. In pediatric nursing, a consideration of the family context is also a crucial aspect in the development of assessment and intervention models of care. Knafl and Gilliss (2002) describe a growing body of evidence indicating that greater family cohesion and less family conflict are linked to better adjustment in children with chronic illness (Hamlett, Pellegrini, & Katz, 1992; Morris et al., 1997; Perrin, Ayooub, & Willet, 1993). Other family variables that appear to be related to the ill child's adjustment are few family stressors and adaptability (Donnelly, 1994). The results of such research point to the need to further examine the relationship between family functioning and HRQOL in order to provide the basis for targeted family interventions which may improve the quality of life for asthmatic children and enhance family functioning. Thus, the proposed research will examine the relationship between family functioning, aspects of clinical care, and HRQOL in school age children with asthma. Hopefully, the results of this research will further explicate family functioning as a domain of overall health related quality of life in chronically ill children. It is hoped that the results of this study may lead to further funding which would support the evaluation of intervention models, such as the one now in place for the Pediatric Asthma Outreach Program at Yale New Haven Hospital.
The proposed research will examine the relationship between family functioning, aspects of clinical care, and HRQOL in school age children with asthma. Specifically, the research questions are as follows: 1) how do parental reports of family stress, adaptability, cohesion, and satisfaction with family functioning explain the asthmatic child's perceived HRQOL?; 2) how do parental reports of family stress, adaptability, cohesion, and satisfaction with family functioning explain the asthmatic child's satisfaction with family functioning?; 3) what is the relationship among demographic characteristics, asthma severity, health care utilization patterns and HRQOL in children with asthma?
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