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Exploring factors influencing asthma control and asthma-specific health-related quality of life among children

Pranav K Gandhi1, Kelly M Kenzik2, Lindsay A Thompson3, Darren A DeWalt4, Dennis A Revicki25, Elizabeth A Shenkman26 and I-Chan Huang26*

Author Affiliations

1 Department of Pharmacy Practice, School of Pharmacy, South College, Knoxville, TN, USA

2 Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA

3 Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA

4 Department of Medicine, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA

5 Outcomes Research, United BioSource Corporation, Bethesda, MD, USA

6 Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA

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Respiratory Research 2013, 14:26  doi:10.1186/1465-9921-14-26

Published: 23 February 2013

Abstract

Background

Little is known about factors contributing to children’s asthma control status and health-related quality of life (HRQoL). The study objectives were to assess the relationship between asthma control and asthma-specific HRQoL in asthmatic children, and to examine the extent to which parental health literacy, perceived self-efficacy with patient-physician interaction, and satisfaction with shared decision-making (SDM) contribute to children’s asthma control and asthma-specific HRQoL.

Methods

This cross-sectional study utilized data collected from a sample of asthmatic children (n = 160) aged 8–17 years and their parents (n = 160) who visited a university medical center. Asthma-specific HRQoL was self-reported by children using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Impact Scale. Satisfaction with SDM, perceived self-efficacy with patient-physician interaction, parental health literacy, and asthma control were reported by parents using standardized measures. Structural equation modeling (SEM) was performed to test the hypothesized pathways.

Results

Path analysis revealed that children with better asthma control reported higher asthma-specific HRQoL (β = 0.4, P < 0.001). Parents with higher health literacy and greater perceived self-efficacy with patient-physician interactions were associated with higher satisfaction with SDM (β = 0.38, P < 0.05; β = 0.58, P < 0.001, respectively). Greater satisfaction with SDM was in turn associated with better asthma control (β = −0.26, P < 0.01).

Conclusion

Children’s asthma control status influenced their asthma-specific HRQoL. However, parental factors such as perceived self-efficacy with patient-physician interaction and satisfaction with shared decision-making indirectly influenced children’s asthma control status and asthma-specific HRQoL.

Keywords:
Asthma control; Health-related quality of life; PROMIS; Satisfaction with shared decision-making; Perceived self-efficacy with patient-physician interaction; Structural equation modeling