Skip to main content Accessibility help

Understanding the Impact of Paediatric Asthma on Families: Development of a Theoretical Model

  • Joanne Dudeney (a1), Louise Sharpe (a1) and Caroline Hunt (a1)


The experience of paediatric asthma is associated with increased stress and emotional difficulties for both the child and family. The current study aimed to qualitatively explore parents’ views of their child's asthma experience, from initial diagnosis onwards, to enhance our understanding of how families emotionally adjust and adapt to the diagnosis and management of asthma. Semi-structured interviews were conducted with 17 parents of children (<18 years) with physician-diagnosed asthma. Questionnaires were used to capture demographic information and anxiety symptom status of parents (State Trait Anxiety Inventory — Form Y [STAI-Y1/Y2]) and children (Spence Children's Anxiety Scale — Parent reported [SCAS-P]). Grounded theory was used to analyse the results. Analysis saw three themes emerge as important in understanding the impact of asthma on the family: (1) the experience of obtaining an asthma diagnosis, (2) parents’ belief in their competence to manage asthma, and (3) parents’ behaviour in response to the asthma. A model was developed that posits adaptive parental adjustment to asthma is determined in part by the circumstances around the time of diagnosis, the level of knowledge and skills, and the controllability of the asthma. This model can guide medical and allied health professionals to specific areas where intervention may reduce stress and emotional difficulties associated with asthma and its management for affected families.


Corresponding author

Address for correspondence: Joanne Dudeney PhD, School of Psychology A18, The University of Sydney, NSW 2006. Phone: +61 2 9351 4558. Fax: +61 2 9036 5223.


Hide All
Ahmad, E., & Grimes, D.E. (2011). The effects of self-management education for schoolage children on asthma morbidity: A systematic review. The Journal of School Nursing, 27, 282292.
Akinbami, L.J., Moorman, J.E., Bailey, C., Zahran, H.S., King, M., Johnson, C.A., & Liu, X. (2012). Trends in asthma prevalence, health care use, and mortality in the United States, 2001–2010. Hyattsville, MD: National Center for Health Statistics.
American Lung Association. (2012). Trends in asthma morbidity and mortality. Retrieved from
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Beck, A.T., & Clark, D.A. (1988). Anxiety and depression: An information processing perspective. Anxiety Research, 1, 2336.
Crawford, J., Cayley, C., Lovibond, P.F., Wilson, P.H., & Hartley, C. (2011). Percentile norms and accompanying interval estimates from an Australian general adult population sample for self-report mood scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychologist, 46 (1), 314.
Crespo, C., Carona, C., Silva, N., Canavarro, M.C., & Dattilio, F. (2011). Understanding the quality of life for parents and their children who have asthma: Family resources and challenges. Contemporary Family Therapy, 33, 179196. doi: 10.1007/s10591-011-9155-5
de Groot, E.P., Nijkamp, A., Duiverman, E.J., & Brand, P.L. (2012). Allergic rhinitis is associated with poor asthma control in children with asthma. Thorax, 67, 582587.
Dudeney, J., Sharpe, L., Jaffe, A., Jones, E.B., & Hunt, C. (2017). Anxiety in youth with asthma: A meta-analysis. Pediatric Pulmonology. Advanced online publication.
Dudeney, J., Sharpe, L., Sicouri, G., Lorimer, S., Dear, B.F., Jaffe, A., Selvadurai, H., & Hunt, C. (2017). Attentional Bias in Children with Asthma with and without Anxiety Disorders. Journal of Abnormal Child Psychology. Advanced online publication.
Easter, G., Sharpe, L., & Hunt, C. (2015). Systematic Review and Meta-Analysis of Anxious and Depressive Symptoms in Caregivers of Children With Asthma. Journal of Pediatric Psychology, 40, 110.
Eysenck, M.W. (1991). Cognitive factors in clinical anxiety: Potential relevance to therapy. New concepts in anxiety (pp. 418433). UK: Macmillan Education.
Fernandes, L., Fonseca, J., Martins, S., Delgado, L., Pereira, A.C., Vaz, M., & Branco, G. (2010). Association of anxiety with asthma: Subjective and objective outcome measures. Psychosomatics: Journal of Consultation Liaison Psychiatry, 51, 3946.
Galli, E., Gianni, S., Auricchio, G., Brunetti, E., Mancino, G., & Rossi, P. (2007). Atopic dermatitis and asthma. Allergy and Asthma Proceedings, 28, 540543.
Glaser, B.G., & Strauss, A.L. (2009). The discovery of grounded theory: Strategies for qualitative research. NJ: Transaction Publishers.
Goodwin, R.D., Fergusson, D.M., & Horwood, L.J. (2004). Asthma and depressive and anxiety disorders among young persons in the community. Psychological Medicine, 34, 14651474.
Halterman, J.S., Yoos, H.L., Conn, K.M., Callahan, P.M., Montes, G., Neely, T.L., & Szilagyi, P.G. (2004). The impact of childhood asthma on parental quality of life. J Asthma, 41, 645653.
Hirsch, C.R., Hayes, S., Mathews, A., Perman, G., & Borkovec, T. (2012). The extent and nature of imagery during worry and positive thinking in generalized anxiety disorder. Journal of Abnormal Psychology, 121, 238243.
QSR International. (2016). NVivo qualitative data analysis software, version 11: Melbourne, Australia: Author.
Katon, W.J., Lozano, P., Russo, J., McCauley, E., Richardson, L., & Bush, T. (2007). The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared with controls. Journal of Adolescent Health, 41, 455463.
Kheirandish-Gozal, L., Dayyat, E.A., Eid, N.S., Morton, R.L., & Gozal, D. (2011). Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy. Pediatric Pulmonology, 46, 913918.
McCauley, E., Katon, W., Russo, J., Richardson, L., & Lozano, P. (2007). Impact of anxiety and depression on functional impairment in adolescents with asthma. General Hospital Psychiatry, 29, 214222.
Mitchell, D.K., Adams, S.K., & Murdock, K.K. (2005). Associations among risk factors, individual resources, and indices of school-related asthma morbidity in urban, school-aged children: A pilot study. Journal of School Health, 75, 375383.
Muris, P., Steerneman, P., Merckelbach, H., & Meesters, C. (1996). The role of parental fearfulness and modeling in children's fear. Behaviour Research and Therapy, 34, 265268.
Murray, L., De Rosnay, M., Pearson, J., Bergeron, C., Schofield, E., Royal-Lawson, M., & Cooper, P.J. (2008). Intergenerational transmission of social anxiety: The role of social referencing processes in infancy. Child Development, 79, 10491064.
Nauta, M.H., Scholing, A., Rapee, R.M., Abbott, M., Spence, S.H., & Waters, A.M. (2004). A parent-report measure of children's anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42, 813839.
Palmer, E.A. (2001). Family caregiver experiences with asthma in school-age children. Pediatric Nursing, 27, 7581.
Pelcovitz, D., Libov, B.G., Mandel, F., Kaplan, S., Weinblatt, M., & Septimus, A. (1998). Posttraumatic stress disorder and family functioning in adolescent cancer. Journal of Trauma and Stress, 11, 205221.
Rapee, R.M. (1997). Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review, 17, 4767.
Rapee, R.M., Schniering, C.A., & Hudson, J.L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5, 311341.
Richardson, L.P., Lozano, P., Russo, J., McCauley, E., Bush, T., & Katon, W. (2006). Asthma symptom burden: Relationship to asthma severity and anxiety and depression symptoms. Pediatrics, 118, 10421051.
Ross, C.J., Davis, T., & Hogg, D.Y. (2007). Screening and assessing adolescent asthmatics for anxiety disorders. Clinical Nursing Research, 16, 524.
Sawyer, S.M., & Fardy, H.J. (2003). Bridging the gap between doctors' and patients' expectations of asthma management. Journal of Asthma, 40, 131138.
Sicouri, G., Sharpe, L., Hudson, J.L., Dudeney, J., Jaffe, A., Selvadurai, H., Lorimer, S., & Hunt, C. (2017). Threat interpretation and parental influences for children with asthma and anxiety. Behaviour Research and Therapy, 89, 1423.
Spielberger, C.D. (1983). Manual for the State-Trait Inventory (STAI: Form Y). Palo Alto, CA: Consulting Psychological Press.
Strauss, A., & Corbin, J. (1980). Basics of qualitative research: Techniques and procedures for developing grounded theory. Newbury Park, CA: Sage.
Sullivan-Bolyai, S., Deatrick, J., Gruppuso, P., Tamborlane, W., & Grey, M. (2003). Constant vigilance: mothers' work parenting young children with type 1 diabetes. Journal of Pediatric Nursing, 18, 2129.
Vahlkvist, S., & Pederson, S. (2009). Fitness, daily activity and body composition in children with newly diagnosed untreated asthma. Allergy, 64, 16491655.
Wood, J.J., McLeod, B.D., Sigman, M., Hwang, W.C., & Chu, B.C. (2003). Parenting and childhood anxiety: Theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry, 44, 3451.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed