Depression among caregivers of children with asthma and its impact on communication with health care providers
M Fagnano, E Berkman, E Wiesenthal, A Butz, J S Halterman, M Fagnano, E Berkman, E Wiesenthal, A Butz, J S Halterman
Abstract
Background: Caregiver depression is common, can negatively influence one's ability to communicate with health care providers, and may hinder appropriate care for children with asthma.
Objective: To evaluate the impact of caregiver depression on communication and self-efficacy in interactions about asthma with their child's physician.
Study design: Cross sectional analysis using data from the Prompting Asthma Intervention in Rochester-Uniting Parents and Providers study.
Methods: We enrolled caregivers of children (2-12 yrs) with persistent asthma prior to their health care visit. Caregivers were interviewed via telephone after the visit to assess depression, self-efficacy, and provider communication at the visit. Caregiver depression was measured using the Kessler Psychological Distress scale. We assessed caregiver self-efficacy using items from the Perceived Efficacy in Patient-Physician Interactions scale; caregivers rated their confidence for each item (range 0-10). We also inquired about how well the provider communicated regarding the child's asthma care. Bivariate and multivariate analyses were used.
Results: We interviewed 195 caregivers (response rate 78%; 41% Black, 37% Hispanic), and 30% had depressive symptoms. Caregiver rating of provider communication did not differ by depression. Most caregivers reported high self-efficacy in their interactions with providers; however depressed caregivers had lower scores (8.7 vs. 9.4, p = .001) than non-depressed caregivers. Further, depressed caregivers were less likely to be satisfied with the visit (66% vs. 83%, p = .014), and to feel all of their needs were met (66% vs. 85%, p = .007). In multivariate analyses, depressed caregivers were >2× more likely to be unsatisfied with the visit and to have unmet needs compared to non-depressed caregivers.
Conclusions: Depressed caregivers of children with asthma report lower confidence in interactions with providers about asthma and are less likely to feel that their needs are met at a visit. Further study is needed to determine the best methods to communicate with and meet the needs of these caregivers.
Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Source: PubMed