Main Article Content
Asthma is the most common non-communicable disease among children and the prevalence of childhood asthma is increasing in Vietnam. Often, due to the stage of development of the child and the illness, control of asthma in pre-school age children depends on family caregivers. To design effective interventions for asthma control, understanding family caregivers’ perceptions of factors that influence such control is necessary. Thus, this cross-sectional study developed
and tested a model of how perceived social support, satisfaction with nursing care, access to healthcare and family management work to explain asthma control among pre-school age children. A convenience sample of 328 primary family caregivers of pre-school age children with asthma from three public hospitals in Da Nang, Vietnam was recruited. Questionnaires used were a demographic form, and Vietnamese versions of the Best Asthma Control Test for Preschoolers,
the Modified Social Support Questionnaire, the Access to Healthcare Instrument, and the Patient Satisfaction with Nursing Care Quality Questionnaire. The SPSS version 18 and the AMOS program were used to test the model.
Findings revealed that the hypothesized model fitted with the data and explained 38% of the variance in asthma control. Contextual factors had a direct effect on asthma control and an indirect through family management. Family management had a significant direct positive effect on asthma control. Among these factors, perceived social support had the strongest total effect whereas access to health care had the strongest direct effect on asthma control. Nurses
can use this finding to strengthening support from significant people to improve family management and strengthen access to health care using various strategies such as telehealth to support asthma control.
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2. Minh T. Asthma treatment is not only using medication. Ministry of Health [Internet]. 2020 Nov [cited 2021 Jan]. Available from: https://suckhoedoisong.vn/dieu-trihen-tre-em-khong-chi-la-uong-thuoc-n183193.html (in Vietnamese)
3. Ministry of Home Affair of the Socialist Republic of Vietnam. Tobacco tax policy contributes 50% of smoking rate reduction in Vietnam. [Internet] 2020 Dec [cited 2021 June].Available from: https://www.moha.gov.vn/danh-muc/chinh-sach-thue-thuoc-la-dong-gop-50-muc-giam-tyle-hut-thuoc-tai-viet-nam-45465.html (in Vietnamese)
4. Costa DD, Pitrez PM, Barroso NF, Roncada C. Asthma control in the quality of life levels of asthmatic patients’ caregivers: a systematic review with meta-analysis and meta-regression. J Pediatr. 2019, 95(4):401-9. doi: 10.1016/j.jped.2018. 10.010.
5. Elnady HG, Sherif LS, Sabry RN, Zeid DA, Atta H, Hassanain AI, et al. Relation of asthma control with quality of life among a sample of Egyptian asthmatic school children. Open Access Maced J Med Sci. 2019; 7(17):2780-5. doi: 10.3889/oamjms.2019.649.
6. Brown N, Gallagher R, Fowler C, Wales S. The role of parents in managing asthma in middle childhood: an important consideration in chronic care. Collegian. 2010; 17(2):71-6. doi:10.3316/idlapa.201008515
7. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2021. [Internet] 2021 [cited 2021 May]. Available from: www.ginasthma.org
8. Gehring JMK. Family management, risk and protective factors, and quality of life with pediatric chronic conditions [Doctoral dissertation]. [Wasington, D.C]: The Catholic University of America, 2017.
9. Almogbel Y, Sansgiry SS. Parental satisfaction with medication therapy and parenting stress among parents with asthmatic children. Value Health. 2017; 20(9):A504. doi: 10.1016/ j.jval.2017.08.597.
10. Scheckner B, Arcoleo K, Feldman JM. The effect of parental social support and acculturation on childhood asthma control. J Asthma. 2015; 52(6):606-13. doi: 10.3109/02770903.2014.991969.
11. Zhang Y, Wei M, Han HR, Zhang Y, Shen N. Testing the applicability of the family management style framework to Chinese families. West J Nurs Res. 2013; 35(7):920-42. doi: 10.1177/0193945913482051.
12. Knafl KA, Deatrick JA, Havill NL. Continued development of the family management style framework. J Fam Nurs. 2012; 18(1):11-34. doi: 10.1177/1074840711427294.
13. Knafl K, Deatrick JA, Gallo AM. The interplay of concepts, data, and methods in the development of the Family Management Style Framework. J Fam Nurs. 2008; 14(4):412-28. doi: 10.1177/1074840708327138.
14. Hines A. Parental perceptions of family management styles in families with a child with asthma [Doctoral dissertation]. [Greensboro]: University of North Carolina at Greensboro, 2011.
15. Fleming L, Knafl K, Knafl G, Riper M, V. Parental management of adrenal crisis in children with congenital adrenal hyperplasia. J Spec Pediatr Nurs. 2017; 22(4). doi: 10.1111/jspn.12190.
16. Kim I, Ekas NV, Hock R. Associations between child behavior problems, family management, and depressive symptoms for mothers of children with autism spectrum disorder. Res Autism Spectr Disord. 2016; 26:80-90. doi: 10.1016/j.
17. Nurullah AS. Recieved and provided social support: a review of current evidence and future directions. Am J Health Stud. 2012; 27(3):173-88.
18. Wacharasin C, Phaktoop M, Sananreangsak S. Examining the usefulness of a Family Empowerment Program guided by the Illness Beliefs Model for families caring for a child with thalassemia. J Fam Nurs. 2015; 21(2):295-321. doi: 10.1177/1074840715585000.
19. Barbosa CD, Balp MM, Kulich K, Germain N, Rofail D. A literature review to explore the link between treatment satisfaction and adherence, compliance, and persistence. Patient Prefer Adherence. 2012; 6:39-48. doi: 10.2147/ PPA.S24752.
20. Taylor CJ, Greca AL, Valenzuela JM, Hsin O, Delamater AM. Satisfaction with the health care provider and regimen adherence in minority youth with Type 1 Diabetes. J Clin Psychol Med Settings. 2016; 23(3):257-68. doi 10. 1007/s10880-016-9460-0.
21. Zandam HU, Muhamad HJ, Hayati KS, Anisah B. Development and validation pf perceived access to health care measurement instrument. Inter J Pub Health Clin Sci. 2017; 4(5):154-71.
22. Ryan P, Sawin KJ. The Individual and Family Self-Management Theory: background and perspectives on context, process, and outcomes. Nurs Outlook. 2009; 57(4):217-25 e6. doi: 10.1016/j.outlook.2008.10.004.
23. Normansell R, Welsh E. “Asthma can take over your life but having the right support makes that easier to deal with.” Informing research priorities by exploring the barriers and facilitators to asthma control: a qualitative analysis of survey
data. Asthma Res Pract. 2015 Dec; 1:11. doi 10.1186/ s40733-015-0011-5.
24. Bloomberg GR, Banister C, Sterkel R, Epstein J, Bruns J, Swerczek L, et al. Socioeconomic, family, and pediatric practice factors that affect level of asthma control. Pediatrics. 2009; 123(3):829-35. doi:10.1542/peds.2008-0504.
25. Gibson L. A study of the relationships among maternal caregiver family management behaviors, childhood asthma mobidity, and asthma control [Doctoral dissertation]. [Birmingham]: The University of Alabama at Birmingham, 2011.
26. Sato K, Sato Y, Nagao M, Shimojo N, Yoshihara S, Adachi Y, et al. Development and validation of asthma questionnaire for assessing and achieving best control in preschool-age children. Pediatr Allergy Immunol. 2016; 27(3):307-12. doi:10.1111/pai.12523.
27. Kline RB. Principles and practice of structural equation modeling, fourth edition. New York: Guilford publications; 2015.
28. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-culturalhealth care research: a clear and user-friendly guideline.J Eval Clin Pract. 2011; 17(2):268-74. doi:10.1111/j.13652753.2010.01434.x.
29. Knafl K, Deatrick J, Knafl GJ, Gallo A, Grey M, Dixon J, Knafl G, O’Malley J. Family management measurement. The University of North Carolina at Chapel Hill [Internet] [cited 2019 Nov]. Avaible from: https://nursing.unc.edu/ research/office-of-research-support-and-consultation/family-management-measure/
30. Santati S. Asthma management abilities causal model: an empirical test among parents caregivers of the pre-school asthmatic children [Doctoral dissertation]. [Bangkok]: Mahidol University, 2005.
31. Laschinger HK. PSNCQQ - Patient Satisfaction with Nursing Care Quality Questionnaire. Western University Canada [Internet] [cited 2019 Nov]. Available from: https://www.uwo.ca/fhs/hkl/psncqq.html.
32. Gray JR, Grove SK, Sutherland S. Burns and Grove’s the practice of nursing research: appraisal, synthesis, and generation of evidence, eighth edition. Missouri: Elsevier; 2017.
33. Hair JF, Black WC, Babin BJ, Anderson RE. Structural Equations Modeling Overview. 2014. In: Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis, seventh edition. Essex: Pearson Education Limited; 2014. pp. 541-98.
34. Jabeen U, Zeeshan F, Bano I, Bari A, Rathore AW. Adherence to asthma treatment and their association with asthma control in children. J Pak Med Assoc. 2018; 68(5):725-8.
35. del-Pino-Casado R, Frías-Osuna A, Palomino-Moral PA, Ruzafa-Martínez M, Ramos-Morcillo A. Social support and subjective burden in caregivers of adults and older adults: a meta-analysis. PLOS One. 2018; 13(1):e0189874. doi: 10.1371/journal.pone.0189874.
36. Karaca A, Durna Z. Patient satisfaction with the quality of nursing care. Nurs Open. 2019; 6(2):535-45. doi: 10. 1002/nop2.237.
37. Liam CK, Pang YK, Chua KT. Satisfaction level and asthma control among Malaysian asthma patients on Symbicort Maintenance and Reliever Therapy (SMART) in the primary care setting (SMARTEST study). Asian Pac J Allergy Immunol. 2014; 32(2):145-52. doi: 10.12932/AP03126.96.36.1993.
38. Miles C, Arden-Close E, Thomas M, Bruton A, Yardley L, Hankins M, et al. Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views. NPJ Prim Care Respir Med. 2017; 27(1):57. doi:10.1038/s41533-017-0056-4.
39. Pool AC, Kraschnewski JL, Poger JM, Smyth J, Stuckey HL, Craig TJ, et al. Impact of online patient reminders to improve asthma care: a randomized controlled trial. PloS One. 2017; 12(2):e0170447. doi: 10.1371/journal.pone.0170447.
40. Han L, Shangguan J, Yu G, Li T, Wu Y, Zhou Y, et al. Association between family management and asthma control in children with asthma. J Spec Pedi Nurs. 2020;25(2):e12285. doi: 10.1111/jspn.12285.