Caregiving load and pediatric asthma morbidity: conflict matters

Asthma is one of the most prevalent chronic illnesses among children in the United States and it disproportionately affects members of minority groups living in low-income and urban environments. In these environments, illness-related stressors are often experienced alongside a variety of family and social stressors, and parents may carry significant additional caregiving responsibilities over and above their child's asthma management. Participants in the current study included 23 girls and 22 boys, all diagnosed with asthma and living in low-income, urban neighborhoods; 85% of participants were members of ethnic minority groups. This study utilized a family systems framework to examine links among parents' caregiving responsibilities, parent-child conflict, and asthma morbidity. Caregiving load refers to the number of children and adults for whom the parent endorsed caregiving responsibilities. Two indicators of asthma morbidity were assessed, including asthma-related restrictions in the family's activities and the child's asthma quality of life. The findings of this study suggested a pivotal role of parent-child conflict in predicting children's and families' asthma-related morbidity. Higher levels of parent-child conflict were directly associated with higher levels of family activity restriction. Interestingly, under conditions of high parent-child conflict, higher caregiving load was associated with lower pediatric quality of life, but under conditions of low parent-child conflict, higher caregiving load was associated with higher quality of life. Implications of these findings for asthma treatment programs are discussed.