A Life Course Perspective on Stress and Health Among Caregivers of Children With Asthma in Detroit

Abstract

Low-income caregivers raising children with asthma experience many obstacles to their own health, including stress. To understand and describe their daily experiences, researchers conducted 40 qualitative interviews supplemented with descriptive quantitative surveys in Detroit, Michigan, as part of a community-based participatory research partnership of Community Action Against Asthma. Prevalence of chronic illness is noticeably higher among participants than the general US population. Caregivers identified stress processes that may influence disproportionate health outcomes and risk-related behaviors over their lifetime. Applying a life course perspective, findings suggest that public health interventions should address family-level comorbidities, increase instrumental social support, and acknowledge practical coping mechanisms.

When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma

“…It reveals that they experience significant psychological distress managing their children’s asthma, which they do in many different ways. Consistent with the findings of other studies [ 16 , 25 ], the mothers of children with asthma in this study expressed feelings of uncertainty and fear when seeking emergency care services, and worried extensively about the recurrence of asthma attacks. They also worried about the impact of asthma on their child’s learning and future development [ 26 ], the side effects of medications [ 27 ], and the risk of drug dependence [ 28 ].…”

Stress and Quality of Life in Urban Caregivers of Children With Poorly Controlled Asthma: A Longitudinal Analysis

“…The burden of asthma exacerbations likewise reverberates throughout families who describe substantial psychosocial, caregiving, and financial stresses (Crespo, Carona, Silva, Canavarro, & Dattilio, 2011; Sampson et al, 2013a; Sampson et al, 2013b), beyond the fear of seeing their child struggling to breathe. Not surprising, caregivers of children with poorly controlled asthma report more missed work compared to caregivers of children with controlled asthma (31% vs. 16%) (Dean, et al 2009), decreased work productivity, with an average of 4.1 hours of productivity loss over a 40 hour work week during their child's asthma episode (Dean, et al, 2010), and higher perceived financial burden than caregivers of children with well controlled asthma (Patel, Brown, & Clark, 2013).…”

“…However, other research suggests caregiver perception of stress due to asthma management demands is a more profound predictor of caregiver QOL compared to the degree of symptoms (Annett, Bender, DuHamel, & Lapidus, 2003; Crespo et al 2011). Caregiving stress, conceptualized as hardship experienced in relation to managing a child's health condition (Sampson, et al, 2013a), has also been shown to disproportionately impact low-income caregivers (Fiese, Wamboldt, & Anbar, 2005). …”

Characterization of Stress in Low-Income, Inner-City Mothers of Children with Poorly Controlled Asthma

“…Although correlations among stress and depressive symptomology have long been established, less is known about how elevated rates of life stress are associated with health conditions in low-income mothers of children with asthma. However, in a mixed-method study with 40 low-income caregivers of children with asthma, nearly all participants were found to have a health condition of their own [14]. The lack of longitudinal data for caregiver sociodemographics presents other limitations.…”

“…Concerns about neighborhood safety [11], violence exposure [12], and residence in poor housing conditions characterized by pest infestation (rodents, cockroaches) and mold [13] were previously identified as significant hardships experienced by inner-city caregivers of children with frequent Emergency Department (ED) utilization for asthma. Extreme poverty [14], single-parent households [15], and general neighborhood disadvantage [16] further contribute to chronic stress in this population, beyond the burden of caring for a child with high-risk asthma. Additionally, in cross-sectional research with 201 mothers of inner-city children (6-12 years) with asthma, Kub and colleagues [17] observed utilities insecurity and housing instability as sources of life stress.…”