Illness Representations Among Mexican Mother of Children with Asthma: A Factor in Children's Health Outcomes?

Background: Parents' illness representations (IR) and asthma management strategies impact children's health outcomes. IRs are critical in determining whether a parent follows through with the prescribed medication regimen; important when managing a chronic illness that might require lifetime medication use. Parents and healthcare providers (HCPs) think about asthma differently. Parents describe asthma as acute, not readily controllable, and view daily medication use negatively. These are commonly referred to as “lay models” of IR. Gaps exist in the evidence of ethnic differences in IRs and parents' treatment decisions. Methods: Purposeful sample of 20 Mexican mothers of children with asthma completed in-depth, semi-structured interviews. Recruited from two school-based health clinics in Phoenix, AZ. Interview guide assessed: asthma IRs, cultural beliefs/folk practices, asthma knowledge, impact of asthma, HCP relationship, and healthcare utilization. Results: Mothers did not view asthma as a chronic illness; child only had asthma when symptoms were present. Asthma is unpredictable and dangerous; may be controlled but not cured. Daily medication use may result in addiction or loss of effectiveness. Mothers did not differentiate between causes and triggers of asthma. Asthma may be inherited, enter through the feet, be caused by worry/stress, dust, exercise, laughing, or mold. Conclusions: HCPs can best treat children's asthma if they understand parents' beliefs about the causes and symptoms of asthma, course of action (chronic versus episodic), medications/folk therapies, and expectations for symptom resolution. Parents' beliefs which are discordant with the HCPs' beliefs should be addressed when devising the management plan to improve children's asthma outcomes.