Health-Related Decision-Making in Early Adolescents With Poorly Controlled Asthma

Abstract

Objective: Caregiver-adolescent collaborative decision-making is a key component of effective self-management, although there is limited understanding of this relationship in pediatric asthma. The current study examined the association between parent and youth decision-making and asthma self-management behaviors. Method: Participants included 33 youth ages 12-15 years (M age ϭ 13.18, SD ϭ 1.16) with poorly controlled, persistent asthma and their caregivers. Participants completed the Family Asthma Management System Scale interview to assess core aspects of asthma management. The Decision Making Involvement Scale was administered to evaluate caregiver and adolescent behaviors during asthma-related decision-making. Results: Seventy percent of dyads reported discussing the adolescent's asthma in the past 2 weeks. Forty-seven percent of families reached a final decision during the discussion, and 18% made a partial decision. Either the caregiver (41%) or the dyad together (27%) made the final decision. Youth whose parents made the final decision reported poorer responses to acute asthma symptoms (p ϭ .03, d ϭ 0.99). Higher parental expression of information was associated with better family response to acute asthma symptoms, p ϭ .045, R 2 ϭ 0.69. Conclusions: Findings indicate that joint caregiver-youth collaborative decision-making and parent involvement in asthma-care decision-making were associated with better response to asthma exacerbations. A significant portion of families is not discussing their adolescent's asthma, and future research is needed to identify what families are at risk for reduced communication regarding asthmacare decision-making. Health professionals should assess both caregiver and adolescent decision-making involvement when addressing asthma self-management. Implications for Impact StatementThis study advances the idea that caregiver and youth collaboration during healthrelated decision-making is important for fostering disease management within pediatric asthma. Findings also highlight the need for disease management interventions targeting increased caregiver-youth communication surrounding the adolescent's asthma care.

Factors contributing to decision-making dilemmas faced by parents of children with severe asthma in PICU during the development of discharge care plans: a phenomenological study

“…A higher level of parental expression of information is associated with an improved family response to acute asthma symptoms. However, only 47% of families face the risk of reduced communication and have not made a nal decision regarding the management plan for childhood asthma 20 . Fiks and his colleagues conducted a randomized controlled trial to assess the impact of the MyAsthma online decision support tool on the intervention group 21 .…”

Factors Involved in Decision-Making Dilemmas Faced by Parents of Children with Severe Asthma in PICU During the Development of Discharge Care Plans: A Phenomenological Study

“…However, up to 47% of families face the risk of reduced communication and have not made a final decision regarding the management plan for childhood asthma. 21 Fiks et al conducted a trial to assess the impact of the MyAsthma online decision aid platform on the experiment group. 22 This platform not only provides decision support and clarifies family values but also dynamically tracks asthma treatment program and goals, as well as children’s asthma symptoms and outcomes.…”