Psychological, socioeconomic burdens and coping mechanisms of caregivers of children with bronchoasthma in Kakamega County, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20233751Keywords:
Childhood asthma, Caregivers, Social economic, Psychological, Coping, DemographicAbstract
Background: Childhood bronchoasthma consistently pose diverse caregiving burdens yet, magnitude of these and coping mechanisms adopted by caregivers are infrequently assessed during routine care only focused on index patients.
Methods: A partially mixed descriptive cross-sectional study was conducted for a minimum of 408 respondents. The results were presented in form of tables and text.
Results: A total of 408 caregivers were surveyed, with a mean age of 33 years (SD=9.86). Majority (78.7%) were actual parents of whom 73.5% were married. Primary-level education was the highest attained by 64% of caregivers while those earning <10,000 KES per month were 76% with about 3 out 4 being self-employed. Significant psychological concerns include sleep disturbance on the night previous to the interview, caregivers’ concern about the child's asthma medication and side effects. Work absenteeism; reduced total annual income; lost job; discontinued child schooling and delayed family investment/cut budgets were significant social/economic burdens. Most caregivers used escape-avoidance coping mechanisms with a significant majority being involved in substance abuse (72.3%); feeling helpless or downplayed the severity of symptoms because of myths and stigma. Young age (p=0.002); being widowed (p=0.040), and being of low level of education (p<0.001) were associated with poor coping mechanisms.
Conclusions: There was considerable prevalence of psychological burden and socio-economic status among caregivers with significant majority using adversarial coping mechanisms, particularly among socio-economically disadvantaged.
References
McCormick S. Life Stress, Social Problem‐Solving and Asthma. J Consulting Clin Psychol. 2019;458(61):932-46.
Global Asthma Network. The Global Asthma Report Asthma affects. World Aller Organ J. 2018;64(6):476-83.
WHO. Global asthma prevalence in adults: Findings from the cross-sectional world health survey. World Heal Organ Library. 2019;12(1):204.
Eassey D, Reddel HK, Ryan K, Smith L. The impact of severe asthma on patients’ autonomy : A qualitative study. Health Expectations. 2019;222(11):528-36.
MoH. Guidelines for Asthma Management in Kenya. Ministry of Health, Kenya. 2019;64(15):769- 874.
Waters DM, Olson AM, Fousheé N, Shelef DQ, Stewart L, Yadav K, et al. Perceptions of stress, coping, and intervention preferences among caregivers of disadvantaged children with asthma. J Child Family Stud. 2017;26:1622-34.
Dowell JA. Social interactions and children with asthma. J Child Health Care. 2016;20(4):512-20.
Clark RD. Emotional aspects in the etiology of bronchial asthma. Clin Experimental Aller. 2018;330(43):1058‐66.
Ekim A, Ocakci AF. Caregiver Burden in Pediatric Asthma: A Systematic Review. Heal Sci J. 2017;10(6):1-7.
Johnston H. Caring for caregivers: challenges facing informal palliative caregivers in Western Kenya. 2017.
Kosisochi CA, Ayogu EE, Ngwoke BA, Okonta EO. Knowledge, attitudes and quality of life of caregivers towards asthma in their children: a Nigerian perspective. J Heal Sci 2020;10(1):47-57.
Chalise SP, Bhatta NK, Singh RR. Global Initiative for Asthma: Pocket Guide for Asthma Management and Prevention. Thorax. 2016;46(1):1-8.
Kopel LS, Petty CR, Gaffin JM, Sheehan WJ, Baxi SN, Kanchongkittiphon W, et al. Caregiver stress among inner-city school children with asthma. The Journal of Allergy and Clinical Immunology: In Practice. 2017;5(4):1132-4.
Juma K, Juma PA, Mohamed SF, Owuor J, Wanyoike A, Mulabi D. First Africa non-communicable disease research conference 2017: sharing evidence and identifying research priorities. J Global Heal. 2019;8(2).
Simba J, Marete I, Waihenya R, Kombe Y, Mwangi A, Mburugu P, et al. Knowledge and perceptions on childhood asthma among care-takers of children with asthma at a National Referral Hospital in Western Kenya: a descriptive study. Afri Health Sci. 2018;18(4):965-71.
Mayo AM, Siegle K, Savell E, Bullock B, Preston GJ, Peavy GM. Lay caregivers' experiences with caring for persons with dementia: A phenomenological study. J Gerontological Nursing. 2020;46(8):17-27.
Prather SL, Foronda CL, Kelley CN, Nadeau C, Prather K. Barriers and facilitators of asthma management as experienced by African American caregivers of children with asthma: an integrative review. J Pediatr Nursing. 2020;55:40-74.
Juniper EF, Guyatt GH, Ferrie DH, Ferrie PJ, Griffith LE, Townsed M. Measuring quality of life in the parents of children with asthma. Quality Life Res. 1996;5(1):27-34.
Robinson B. Validation of a Caregiver Strain Index. J Gerontol. 1983;38:344-8.
Kenya National Bureau of Statistics web. 2019.
Azeem MW, Dogar IA, Shah S, Cheema MA, Asmat A, Akbar M. Anxiety and depression among parents of children with intellectual disability in Pakistan. J Can Acad Child Adolesc Psychiatr. 2013;22(4):290.
Minichil W, Getinet W, Derajew H, Seid S. Depression and associated factors among primary caregivers of children and adolescents with mental illness in Addis Ababa, Ethiopia. BMC Psychiatr. 2019;19(1):1-9.
Adib-Hajbaghery M, Ahmadi B. Caregivers of Children and Adolescents. Int J Community Based Nurs Midwifery. 2019;7(4):258-269.
Cipolletta S, Morrison V, Vilchinsky N. Editorial: Caregiving and Social Support in the Context of Health and Illness. Frontiers Psychol. 2020;11:620357.
Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma Research and Pract. 2017;3(1).
Katana PV, Katana PV, Abubakar A, Nyongesa MK, Ssewanyana D, Mwangi P, et al. Economic burden and mental health of primary caregivers of perinatally HIV infected adolescents from Kilifi, Kenya. BioMed Central Publ Heal. 2020;20:504.
Kuerten BG, Brotkin S, Bonner MJ, Ayuku DO, Njuguna F, Taylor SM, Puffer ES. Psychosocial Burden of Childhood Sickle Cell Disease on Caregivers in Kenya. J Pediatr Psychol. 2020;45(5):561-72.
Laurenzi CA, Hunt X, Skeen S, Sundin P, Weiss RE, Kosi V, et al. Associations between caregiver mental health and young children’s behaviour in a rural Kenyan sample. Global Heal Action. 2021;14:1.
Margolis R. Relationship between caregiver social support, depressive symptoms, and child asthma outcomes in Low- income, urban, African American Families. Social Work University of Maryland, Baltimore. 2020.
Ross MK, Okelo SO, Bui AA. Towards Personalized and Comprehensive Pediatric Asthma Management: Understanding the Role of Social Determinants and Environmental Factors. Academic Pediatr. 2019;19(6):599-601.
Real FJ, Beck AF, DeBlasio D, Zackoff M, Henize A, Xu Y, et al. Dose matters: a smartphone application to improve asthma control among patients at an urban pediatric primary care clinic. Games Heal J. 2019;8(5):357-65.
Ramsey RR, Plevinsky JM, Kollin SR, Gibler RC, Guilbert TW, Hommel KA. Systematic review of digital interventions for pediatric asthma management. J Aller Clin Immunol. 2020;8(4):1284-93.
Hassan SES, Esmat OM, Mohamed HM. Discharge Plan for Mothers to Cope with their children suffering from Bronchial Asthma. J Nursing Heal Sci. 2018;7(2):24-37.
Fawcett R, Porritt K, Stern C, Carson-Chahhoud K. Experiences of parents and carers in managing asthma in children: a qualitative systematic review. JBI Evidence Synthesis, 2019;17(5):793-984.
Akpan-Idiok PA, Ehiemere IO, Asuquo EF, Chabo J, Osuchukwu EC. Assessment of burden and coping strategies among caregivers of cancer patients in sub-Saharan Africa. World J Clin Oncol. 2020;11(12):1045-63.
