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Asthma is a key health care issue for many Australian children and families. Until children reach an appropriate level of developmental maturation, parents are primarily responsible for the management of their child’s asthma. In order to manage their child’s asthma, parents need to be highly confident and certain that they can perform the tasks of asthma management. Asthma management self-efficacy is an important determinant of successful parent asthma management and is associated with health outcomes for primary school age children with asthma. However little is known of the parent and child factors that may be associated with parent asthma management self-efficacy.
The aim of the study was to investigate asthma management self-efficacy in parents of primary school age children with asthma, and to explore possible associations between parent asthma management self-efficacy, parent and child characteristics, asthma task difficulty and asthma management responsibility.
A cross sectional descriptive survey design was used to elicit the level of asthma management self-efficacy and influencing factors using existing self-report measures of asthma management self-efficacy, asthma task difficulty and confidence, asthma responsibility and a socio-demographic checklist. Parents (n = 113) of 5 to 12 year old children with asthma were recruited from the outpatient departments of two children’s hospitals.
The asthma management self-efficacy mean score for parents in the study was 3.43 (SD = 1.17, range 1 - 5). Self-efficacy was significantly higher (mean difference = 0.58, Cl -0.73, - 0.41, p = 0.00) for attack prevention (M = 4.37, SD = 0.58) than attack management (M = 3.79, SD = 0.85). Parents reported higher confidence and less difficulty with frequent tasks, such as medication administration. Parents had less confidence and more difficulty with infrequent tasks particularly those associated with judgment and decision making such as recognizing and managing acute exacerbations of asthma and avoiding triggers.
Parents were primarily responsible for asthma management, although child asthma responsibility increased with child age. Multivariate linear regression analysis was used to identify the independent predictors of asthma management self-efficacy. English language (β= 0.33, p = 0.02), child asthma responsibility (β= 0.23, p = 0.00), and parent education years (β= 0.04, p = 0.04) were associated with higher parent asthma management self-efficacy, while increasing child age (β = -0.12, p = 0.00) was associated with lower parent asthma management self-efficacy. The model explains 20% of the variance in parent asthma management self-efficacy (R2 = 0.20) and was statistically significant (F= 3.49, df = 7, 96, p = 0.002).
This study has identified factors that are associated with asthma management self-efficacy in parents of primary school age children, including English language, parent education, child age and child asthma responsibility. Parents in this study could benefit from an intervention to enhance their self-efficacy for asthma management. Parents have higher self-efficacy for asthma management tasks that are simple, skills based and performed frequently. Nurses and other health care professionals should tailor interventions that support the development of self-efficacy for tasks that parents find difficult.