The Relationship between Caregivers’ Post-traumatic Stress Disorder and Their Asthma Health Beliefs in an Ethnic Minority Inner-City Sample

Abstract

Objective. Caregivers’ asthma health beliefs can impact healthcare decisions. This study aimed to determine whether caregivers with a diagnosis of post-traumatic stress disorder (PTSD) had asthma illness representations less aligned with the professional model of asthma management and whether their children had worse asthma control. Methods. Participants were 120 children with asthma (age M = 9.25 ± 1.37) and their caregivers recruited from the Bronx, NY, USA. Participants were Puerto Rican (n = 55), African-American (n = 30), Afro-Caribbean (n = 22), and Mexican (n = 13). Caregivers completed: a psychiatric interview to determine diagnosis of PTSD, anxiety and depressive disorders; the Asthma Illness Representation Scale (AIRS) to assess beliefs about their children’s asthma; and the childhood asthma control test (C-ACT). Results. One in five caregivers had PTSD, and these caregivers had lower total AIRS scores, lower scores on the AIRS Emotional Aspects of Medication Use subscale, and the AIRS Nature of Symptoms subscale, indicating illness beliefs less aligned with the professional model. Caregivers with PTSD were more likely to perceive asthma as an acute, difficult to control illness and focused on the emotional aspects of medication use. There was no relationship between PTSD in caregivers and self-report of their children’s asthma control, but children with poorly controlled asthma had caregivers with lower total AIRS scores. Conclusion. Caregivers’ traumatic experiences impact their beliefs about their children’s asthma. Future interventions targeting these beliefs could improve the manner in which they understand and treat their children’s asthma.

• asthma control
• illness representations
• pediatrics
• trauma

Acknowledgment

This work was supported by the National Institutes of Health: NICHD (1R03HD053355; PI: J. Feldman).

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.