Abstract
Objective
Unstructured parental comments could solicit important information about children's
asthma, yet are rarely captured in clinical asthma questionnaires. This mixed-methods
study describes parents’ written responses to an open-ended question in a validated
asthma questionnaire.
Methods
The Pediatric Asthma Control and Communication Instrument (PACCI) asthma questionnaire
was administered to parents of children with asthma symptoms presenting to 48 pediatric
primary care offices (PPCP), 1 pediatric pulmonology office, and 1 emergency department
(ED). Responses to the question, “Please write down any concern or anything else you
would like your doctor to know about your child's asthma” were analyzed using a phenomenological
approach until thematic saturation was achieved for each site. Logistic regressions
tested whether sociodemographic and clinical characteristics were associated with
responding to the open-ended question.
Results
Of 7,988 parents who completed the PACCI, 954 (12%) responded to the open-ended question—2%
in PPCP, 31% in the ED, and 50% in the pulmonary setting. More severe asthma was associated
with higher odds of responding (odds ratio, 2.01; 95% confidence interval, 1.42–2.84).
Based on responses provided, we identified 3 communication types: 1) clarifying symptoms,
2) asking questions, and 3) communicating distress. Responses also covered 5 asthma-related
themes: 1) diagnostic uncertainty, 2) understanding asthma etiology and prognosis,
3) medication management, 4) impact on child function, and 5) personal asthma characteristics.
Conclusion
Parents of children with severe asthma provided clarifying details, asked questions,
and relayed health concerns and distress. None of these topics may be easily captured
by closed-ended asthma questionnaires.
Keywords
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Article Info
Publication History
Published online: November 17, 2021
Accepted:
November 9,
2021
Received:
February 26,
2021
Footnotes
Conflict of Interest: This study was conducted by the Center for Promotion of Child Development through Primary Care and its for-profit subsidiary, Total Child Health (TCH), Inc. CHADIS, the web-tool used in the study, was developed by Dr Sturner and his spouse, Dr Howard. Dr Sturner is Director of the Center and Dr Howard is President of TCH. Both are members of the Board of Directors of Center and are paid employees or consultants to both entities. The other authors have indicated they have no financial relationships relevant to this article to disclose.
Identification
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