M Fagnano1, E Berkman, E Wiesenthal, A Butz, J S Halterman. 1. Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. maria_fagnano@urmc.rochester.edu
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.
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.
Authors: S Wade; C Weil; G Holden; H Mitchell; R Evans; D Kruszon-Moran; L Bauman; E Crain; P Eggleston; M Kattan; C Kercsmar; F Leickly; F Malveaux; H J Wedner Journal: Pediatr Pulmonol Date: 1997-10
Authors: Adriana C Lozinsky; Rosan Meyer; Katherine Anagnostou; Robert Dziubak; Kate Reeve; Heather Godwin; Adam T Fox; Neil Shah Journal: Children (Basel) Date: 2015-07-21