Parental psychological characteristics in families of school-age children with severe and moderate persistent bronchial asthma

Abstract

In children with any chronic disease the risk of psychological disadaptation disorders is significantly higher in comparison with healthy ones. In order to improve the verification of the severity of the course of bronchial asthma (BA) we investigated the psychological parameters of the patients’ families. The I group was formed by 32 children of school age with severe BA, and the II group included 30 children with moderate persistent BA. Psychological examination of parents was carried out using Parental Attitudes Questionnaire (A. Varga, V. Stolin), family relationships were investigated using Parental Attitude Research Instrument (PARI) by E.S. Schaefer and R.Q. Bell adapted by T.V. Neshcheret. The lower mother’s educational level was poorly correlated with the more severe course of the child’s BA (r=0.30, p<0.02), and the lower general level of education of the family - with a lower degree of disease control (r=0.29, p<0.05). Low / satisfactory children school educational achievements associated with severe BA (OR=2.0; 95%CI:0.9-7.8). According to PARI questionnaire of the families in group of severe BA there were more frequent: problematic aspect of mother's relation to family role (83.3±7.6% vs. 53.3±12.9%, p<0.05); excessive emotional distance with a child (16.7±7.6% vs. 0, p>0.26); excessive concentration on a child (12,5±6,8% vs. 0, p>0,15). Low scores on the scale of the socially desirable parental relationship with the maximum cooperation was noted in 40.9±10.5% in families of children with severe BA vs. 14.3±9.4% in controls (p<0.1) There was a significant difference in the proportion of children in whom parents revealed significant behavioral changes after diagnosis of BA (53.8 vs. 23.6%, OR=3.8; 95%CI:1.0-14.8), which prevailed in the group with severe BA. There was a direct correlation between the existing behavioral changes in children with more severe course (r=0.33, p<0.03) and the lower level of control of BA (r=0.35, p<0.03). Thus, excessive emotional distance in mother-child relationships and problematic aspects of mother's role in family life, as well as changes in the child’s behavior were revealed in families of patients with severe BA, which associated with more pronounced manifestations of the disease. Excessive mother’s concentration in the child correlated with the less pronounced characteristics of child’s BA.