Family stress and childhood asthma

Eighty-six families, each with an asthmatic child, were studied in their normal environment. The relationships between the physical severity of asthma and the families' knowledge and feelings about the asthma were measured. The mean peak expiratory flow rate recorded prospectively for one week correlated (R = 0.33) with the symptom score. In the 73 families who knew their child had asthma, there was a significant relationship (R = +0.28) between the knowledge of physical signs of attack severity and knowledge of the drugs available for emergency therapy. The mean peak expiratory flow rate was inversely related to the practical effectiveness of the inhaler technique (R = 0.62) only when the 12 families in whom the child's mean peak expiratory flow rate was less than 90 per cent of predicted were examined. The parents' feelings of worry and fear, measured independently, related to the family's knowledge of physical indications of the severity of asthma attacks. Although the families' overall knowledge scores were poor, they were apparently adjusting appropriately to asthma as a psychological stress as it appeared that they sought more information if they were worried. Their comprehension should improve if such knowledge was correctly delivered. There is a need to explore more effective techniques for the education of such families.