484 - Association between responsibility for asthma management, asthma control, intensity of treatment and parental stress in a pediatric asthma clinic

Publication Number: 484.3833

Mathilde Botella, University of Montreal - CHU Sainte-Justine Research Center, Montreal, PQ, Canada; Eric W. Fleegler, MassGeneral Hospital for Children, Needham, MA, United States; Tamara Perez, Universite de Montreal Faculty of Medicine, Montreal, PQ, Canada; Mahisa Islam, Universite de Montreal Faculty of Medicine, Montréal, PQ, Canada; Sze Man Tse, CHU Sainte-Justine, Montreal, PQ, Canada; Jiaying Zhao, University of British Columbia, Vancouver, BC, Canada; Tracie A. Barnett, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Patricia Li, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Arvin Garg, UMass Memorial Children's Medical Center, Worcester, MA, United States; Marie-Elaine Metras, CHU Sainte-Justine, Montreal, PQ, Canada; Olivier Drouin, CHU Sainte-Justine, Montreal, PQ, Canada

Background: Managing pediatric asthma can be stressful for parents, especially when control is poor or treatment is intensive. Limited data exists on how factors like responsibility division, asthma control, and treatment intensity impact parental stress. Understanding these could enhance family support.

Objective: To explore the associations between responsibility for asthma management, asthma control, intensity of treatment, and parental stress in a Canadian pediatric asthma clinic.

Design/Methods: A prospective observational study was conducted in a tertiary care pediatric asthma clinic between September 2022 and June 2024. Participants were parents of children diagnosed with asthma and treated with at least one controller medication. The 9-item Asthma Responsibility Questionnaire assessed the division of asthma management responsibilities. Physicians assessed asthma control on a 4-point scale, and treatment intensity was categorized 1-5 using the Global Initiative for Asthma guidelines. The four-item Perceived Stress Scale assessed how parents perceived stress and their ability to manage situations in their lives. Chi-square tests compared independent variables (responsibility, perceived control, and intensity of treatment) to dependent variables, the measures of stress: control over important aspects of one's life, confidence in the ability to overcome problems, feeling that everything was going well, and the ability to overcome too many accumulated difficulties.

Results: Of the 196 participants, 143 (73%) self-identified as women, 37 (19%) had a high school degree or less, 33 (17%) reported annual household income < 50,000 Canadian dollars, and 143 (73%) self-identified as White. Chi-square tests showed no statistically significant relationships between stress variables and responsibility variables, nor between treatment intensity and stress variables (unadjusted odds ratio (uOR) 1,34, 95% C.I. [0.68; 2.62)]. However, participants with better asthma control were more likely to report an ability to overcome excessive accumulated difficulties (p = 0.0068), though no other stress variables showed significant associations (uOR 0.55, 95% C.I. [0.29; 1.06)].

Conclusion(s): The study found parental stress wasn’t significantly associated to management responsibilities or treatment intensity, but better asthma control improved resilience. Supporting parents through asthma control, shared management education, and psychological support may reduce stress, enhancing both parental well-being and children’s asthma outcomes.