Life Events, Chronic Stressors, and Depressive Symptoms in Low‐Income Urban Mothers With Asthmatic Children

Abstract

Objective The purpose of this secondary data analysis was to examine the relationship of individual sociodemographic variables, life events, chronic stressors including asthma control and management and environmental stressors to maternal depression. Design Cross sectional descriptive design study consisting of baseline data from participants enrolled in a randomized clinical trial of an asthma communication educational intervention. Sample Two hundred and one mothers of children with asthma (ages 6-12) recruited from community pediatric practices and pediatric emergency departments of two urban university hospitals. Measurement: Subjects responded to a questionnaire that included sociodemographic characteristics, life events, and chronic stressors. Depressive symptoms were assessed with the CESD. Results Close to 25% of the mothers had a score of 16 or greater on the CESD. Significant bivariate relationships between low education, unemployment, feeling unsafe, and the use of quick relief asthma drugs with high depressive symptoms were found. In the multiple logistic regression models, education or unemployment (in separate models) and the use of quick relief medications for asthma were positively associated with depressive symptoms. Conclusions Implications for practice include the need to assess for the presence of maternal depression particularly in mothers of children with a chronic illness such as asthma.

Maternal psychological distress mediates the relationship between asthma and physician visits in a population-based sample of adolescents

“…A greater proportion of mothers of adolescents with asthma had psychological distress compared to control mothers; however, the prevalence was lower than previously reported findings which have suggested that at least a quarter, and up to half of mothers of children with asthma have depression [30,31]. This discrepancy may be attributable to sampling.…”

Child Asthma and Change in Elevated Depressive Symptoms Among Mothers of Children of a Birth Cohort from Quebec

“…Furthermore, this study showed that among mothers with elevated depressive symptoms at 5 months, maternal reports of childhood asthma attacks were not statistically significantly associated with elevated depressive symptoms at 17 months postpartum, although a nonsignificant tendency toward increased odds of elevated depressive symptoms was observed with wide confidence intervals. Some studies have shown a greater prevalence of depressive symptoms among parents of asthmatic children (Kub et al, 2009) and among those who visit an emergency room for child asthma attacks (Bartlett et al, 2001). In contrast, other studies have shown the absence of an association between child asthma and maternal depressive symptoms, although the severity of the child's asthma seems to be associated with maternal depressive symptoms (Klinnert et al, 2001;Shalowitz et al, 2006).…”

“…Yet, few studies have examined the association between child asthma and maternal depressive symptoms (Akcakaya et al, 2003) and even the direction remains elusive (Gustafsson, Kjellman, & Bjorksten, 2002). Studies have either shown a positive association (Kub et al, 2009), or did not find any significant association in a sample of low income mothers (Shalowitz et al, 2006). Other research focused more extensively on the impact of child asthma on parents' quality of life (Levy et al, 2004;Williams et al, 2000;Ozkaya et al, 2010;Wright, 2011) or on the impact of maternal depression on child asthma morbidity and use of health care services (Bartlett et al, 2001;Klinnert et al, 2001).…”

“…Given the anxiety that child asthma can generate in mothers and the burden due to difficult asthma management in young children, it is possible that child asthma may contribute to elevated maternal depressive symptoms (Akcakaya et al, 2003;Gustafsson, Kjellman, & Bjorksten, 2002;Kub et al, 2009;Shalowitz et al, 2006;Leao et al, 2009). Yet, few studies have examined the association between child asthma and maternal depressive symptoms (Akcakaya et al, 2003) and even the direction remains elusive (Gustafsson, Kjellman, & Bjorksten, 2002).…”

“…However, the literature has mostly examined families with low household income (Bartlett et al, 2001(Bartlett et al, , 2004Shalowitz et al, 2006;Kub et al, 2009) thus limiting the ability to address this issue. To the knowledge of the authors, only one study on exposure to maternal distress from birth to 7 years of age in a population-based low-risk cohort has reported possible differences in child asthma between low-income and high-income families but did not examine the impact of child asthma on the mother (Kozyrskyj et al, 2008).…”