239436 Expanding the concept of caregiver stress: A qualitative understanding of stressors defined by caregivers of children with asthma in low-income families

Monday, October 31, 2011: 8:45 AM

Natalie Sampson, MPH , Department of Heath Behavior Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Edith A. Parker, DrPH , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Rebecca Cheezum, MPH , School of Public Health, University of Michigan, Ann Arbor, MI
Toby Lewis, MD , Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI
Ashley O'Toole, MPH, MSW , School of Public Health, University of Michigan, Ann Arbor, MI
Jean Patton , Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI
Thomas Robins , Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
Carla Keirns, MD, PhD, MSc , Center for Medical Humanities, Compassionate Care & Bioethics, Stony Brook University, Stony Brook, NY
     
Background: Low-income caregivers of children with asthma experience multiple, often overlooked sources of stress. Among low-income families, the interactions between these stressors and childhood asthma management are understudied and potentially contribute to disparities in caregiver and child health outcomes.

Purpose: This study set out to understand the daily experiences of low-income adults, typically mothers and grandmothers, caring for children with asthma.

Methods: As part of Community Action Against Asthma's community-based participatory research partnership, researchers conducted 40 qualitative interviews and quantitative surveys with caregivers of children with asthma in Detroit, Michigan. During 60-90 minute semi-structured interviews, researchers asked participants to describe experiences with their child's asthma, including its relationship to family life and their own mental and physical health.

Results: After interviews were systematically coded and analyzed, findings revealed that stress from asthma diagnosis and management coincides frequently with a host of chronic stressors, many related to low-income status or lack of social support. These chronic stressors include a lack of childcare support; day-to-day economic insecurity; unplanned or non-traditional caregiving responsibilities; and high levels of morbidity or mortality within a caregiver's social network.

Discussion: Discussed in the context of stress and health literature, these findings assist 1) researchers to improve commonly used constructs for assessing asthma's effects on family life, 2) practitioners to design interventions that consider non-health influences on compliance and effectiveness of asthma management strategies, and 3) advocates to promote public health programs and policies that consider non-traditional family structure (e.g., grandparents raising grandchildren, single parents) .

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
List stressors identified by caregivers with children with asthma in low income families; compare these stressors to those in current asthma literature, including items on various psychometric measures Evaluate the implications of these stressors for family health

Keywords: Stress, Caregivers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a current doctoral candidate in the field of health behavior, I conducted data collection and analysis for this study. Also, I have worked with communities for nearly a decade on related collaborative research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Maternal and Caregiver Health
See more of: Maternal and Child Health