A Study to Assess the Psychosocial Problems and Quality of Life of Parents with Asthmatic Children in Opd ’ s of Ramaiah Hospitals , Bengaluru

The study was undertaken to assess the level of psychosocial problems and quality of life of parents with asthmatic children in Ramaiah hospitals, Bengaluru. Statement of the problem: “A study to assess the psychosocial problems and quality of life of parents with asthmatic children in opd’s of Ramaiah hospitals, Bengaluru”. Objectives of the study: 1) To assess the level of psychosocial problems and level of quality of life of parents with asthmatic children. 2) To find the correlation between scores of psychosocial problem and quality of life among parents with asthmatic children. 3) To find the association between level of psychosocial problem and selected socio demographic variables. 4) To find the association between level of quality of life and selected socio-demographic variable. Method: A descriptive survey approach was used for the study. Purposive sampling technique was used to select 50 parents with asthmatic children. Data was collected through interview schedule by using structured rating scale to assess psychosocial problems and quality of life. Data was collected and analyzed using descriptive and Inferential statistics in terms of frequencies, Percentage, Mean, Mean percentage, Standard deviation, Karl Pearson’s correlation co-efficient and chi-square test. Findings: The major findings of the study indicated that majority of the parents with asthmatic children that is 33 (66%) were having moderate psychosocial problems and 16 (32%) were having mild psychosocial problem and 1 (2%) were having severe psychosocial problem and 38 (76%) were having good quality of life, 8 (16%) were having better quality of life and 4 (8%) were having poor quality of life. Karl Pearson’s correlation co-efficient test revealed that there is a correlation that exists between psychosocial problem and quality of life of parents with asthmatic children 0.314 weak positive correlation. How to cite this paper: Ramu, S.A., Panduranga, A. and Akarsh, S. (2018) A Study to Assess the Psychosocial Problems and Quality of Life of Parents with Asthmatic Children in Opd’s of Ramaiah Hospitals, Bengaluru. Open Journal of Pediatrics, 8, 50-57. https://doi.org/10.4236/ojped.2018.81007 Received: August 21, 2017 Accepted: March 5, 2018 Published: March 8, 2018 Copyright © 2018 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/


Introduction
Asthma is reversible obstructive process characterized by an increased responsiveness and inflammation of the lower airways.Bronchial constriction is normal reaction to foreign stimuli, but in asthmatic it is abnormal severe, producing impaired function [1].
A longitudinal study has indicated that the incidence of school age asthma cases has increased eight times during the past 20 years in Taiwan [2].The percentage of severe asthma cases also increased from 8% to 20%, according to one recent hospital based study.The recurrent signs and symptoms of asthma are child absenteeism from school, poor academic performance and psychosocial adaptation problems and also one-third of school aged asthma children have some psychosocial problems.
Pediatric asthma is a serious global problem.A conservative estimation worldwide indicates prevalence between 2.8% to 10.8% among children.Quality of life refers to a state of wellbeing of parents i.e. the ability to perform every day activities that reflects their physical, psychological, environmental and social wellbeing and parent's satisfaction.An estimated 1.9 disability adjusted life years (DALYs) is lost every year due to asthma per thousand children under 15 years of age in India [3].Children with very severe asthma tend to have worse quality of life than children with milder disease.It is also shown that not only will quality of life do not correlate with asthma control; it is very distinct component of overall health status [4].A study done in 26 Latino parents of children of asthma showed that the parents with asthma would make attempts to understand this condition, doing activities with family member, and maintaining an optimistic perspective [5].A study on mothers of children with asthma consisting of 160 mothers of 4 -15 years of old children with asthma and the control group consisted of 90 mothers of healthy children.Results indicated that levels of depression and anxiety symptoms were higher in mothers of children with asthma compared to those in the control group (p < 0.0001) [6].

Methodology
The research design selected for this study is a non-experimental descriptive research design.In this study purposive sampling technique was used to select the samples based on inclusive and exclusive criteria.Study variables are psychosocial problems and quality of life.The hospital selected for the data collection was Ramaiah hospitals, Bengaluru.The criterion for selecting this setting was feasibility for conducting the study, availability of the sample and familiarity of the investigator with the settings.Duration of study is 6 months (2015).Accordingly 50 parents with asthmatic children who fulfilled the selection criteria were selected as the sample for study.Exclusion criteria were parents with children having other medical disorders.

The Tool Used in the Present Study Consisted of
Section A: Socio demographic variables such as age, gender, educational status, occupation, family income, type of family, religion, place of residence, number of children, duration of child's illness, money to be spent on child's illness.
Section B: Structured questionnaires related to psychosocial problems.
Section C: Questionnaires related to quality of life.

Statistical Analysis
The data obtained was analyzed in terms of the objective of the study using descriptive and inferential statistics *Descriptive statistics Frequency and percentage distribution was used to describe the socio demographic variables.
Mean, mean percentage and standard deviation was used to describe the level of knowledge on prevention of infection in neonates.

*Inferential statistics
Chi-square test was used to determine the association between level of psychosocial problems and quality of life and selected socio demographic variables.

Results
The data collected were analyzed according to the plan for data analysis, which includes both descriptive and inferential statistics.The findings have been organized and presented under 3 sections.

Section A: Socio Demographic Variables of Parents with Asthmatic Children
Frequency

Association between Level of Psychosocial Problems and Sociodemographic Data of Parents with Asthmatic
Children n = 50 This showed that the association between the levels of psychosocial problem and selected socio demographic variables.The calculated ×2 values was less than table value in selected socio demographic variables such as age, gender, education, occupation, place of residence, income, occupation, number of children, gender of child, age of child, duration of illness and number of hospitalization in a year.The calculated ×2 value was more than table value in selected socio demographic variable such as religion.Hence null hypothesis was accepted and stated as there is no significant association between level of psychosocial problem and socio demographic variable, except socio demographic variable like age.

Association between Level of Quality of Life and Socio Demographic Data of Parents with Asthmatic Children n = 50
The table shows that the association between levels the quality of life and se-Open Journal of Pediatrics lected socio demographic variables.the calculated ×2 values was less than table value in selected socio demographic variables such as age, gender, education, occupation, place of residence, income, occupation, number of children, gender of child, age of child, duration of illness and number of hospitalization in a year.
The calculated ×2 values were more than table value in selected socio demographic variable such as religion.Hence null hypothesis was accepted and stated as there is no significant association between level of psychosocial problem and socio demographic variable, except socio demographic variable like family, income, gender of the child.

Discussion
The findings obtained from the study are discussed under the following objectives.
Objective 1: To assess the level of psychosocial problems and level of quality of life of parents with asthmatic children. The has better quality of life and 8% (40) has poor quality of life.
A study on mothers of children with asthma consisting of 160 mothers of 4 -15 years of old children with asthma and the control group consisted of 90 mothers of healthy children.Results indicated that levels of depression and anxiety symptoms were higher in mothers of children with asthma compared to those in the control group (p < 0.001) [7].
Objective 2: To find the correlation between scores of psychosocial problem and quality of life among parents with asthmatic children.
The results showed that there is no statistically significant correlation between psychosocial problem and quality of life.Hence the null hypothesis there is no significant correlation between psychosocial problem and quality of life is retained, but a weak positive correlation between psychosocial problem and quality of life of parents with asthmatic children using karlpearson's correlation analysis (p = 0.314).
A supportive study was conducted to find the correlation between correlations of depression and sleep quality in mothers of children with and asthma on 148 subjects during 2008-2010.Data were collected using a questionnaire for demographic characteristics, sleep quality and depression scale (HADS).Result of the study showed high levels of depression and poor sleep quality requiring clinical intervention were seen in 37.2%, 29.1% and 39% of mothers, respectively.A significant correlation was detected between sleep quality and depression (p-value < 0.005).A total of 20% of mothers suffering from depression and a history of cigarette smoking (p-value < 0.005).The study concluded that significant correlation between sleep quality and depression in mothers of children suffering Open Journal of Pediatrics from asthma [8].
Objective 3: To find the association between level of psychosocial problem and selected socio demographic variables.
The result shows that there is no statistically significant association found between the selected socio demographic variables and psychosocial problem.
Hence the null hypothesis stated that there is no significant association between psychosocial problem and socio demographic variable was retained.
A supportive study was done in Italy at department of public health and community medicine, concluded that mothers who had experienced stress were associated with the duration of asthma in children.
Objective 4: To find the association between level of quality of life and selected socio-demographic variable.
The result shows that there is no statistically significant association found between the selected socio demographic variables and quality of life.Hence the null hypothesis stated that there is no significant association between psychosocial problem and socio demographic variable.
The study examines the effect of asthma severity of children aged 7 -17 years and socio-demographic characteristics on the caregivers quality of life.For parents of asthmatic children, there was an association between overall asthma severity and quality-of-life score.Measuring parental quality of life development of effective asthma programs [9].

Summary
This study deals with the conclusion, health education and recommendations drawn for the study."A study to assess the psychosocial problems and quality of life of parents with asthmatic children in opd's of Ramaiah hospitals, Bengaluru".The present study assessed the psychosocial problem and quality of life.Study concludes that among 50 parents, 25% are having moderate psychosocial problem, 25% are having mild and mean of 28.82 and standard deviation ±0.50508.
With regards to association between level of psychosocial problem and selected socio demographic variables, there is no association between both the variables, except religion.

*
More knowledge should be provided to students regarding managing strategies in patients with asthmatic children *Students should be made aware about the career opportunities in the field of parental management and family management *Educators should emphasize more on preparing students to impart information to the family supportive care *Facilities should be made available for students to have direct experience in paediatric pulmonology and supportive family care

Section B 3.2.1. Assess the Level of Psychosocial Problem of Parents with
The majority of respondents 21 (42%) belong to the age group 32 -36 years whereas belongs to the age group, 11 (22%) belongs to the age group of 27 -31 years, 37 -41 years 22 -26 years of age and 4 (8%) belong to the age group of 42 -46 years.With regard to gender, majority of respondents 35 (70%) were fe- and percentage distribution with regard to age, gender, religion, education of the parents, family, residence, income, occupation of the parents, number of children, age, gender, duration of illness, No of hospitalization of the child of the parents with asthmatic children n = 50.In relation to the number of children 30 (60%) of parents are having two children, 15 (30%) of parents are having 1 child and 5 (10) are having 3 children.In relation to the gender of the child 30 (60%) are male child and 20 (40%) are female child.withregard to the age of the child with asthma, majority 27 (54%) are in the age group of 6 -10 years, 19 (38%) are in age group 11 -15 years 4 (8%) are in the age group of 1 -5 years.In relation to 27 (54%) of the child with asthma were in the 1 -3 years of duration, 19 (38%) were having 4 -6 years of duration of illness, 4 (8%) were 7 and above.3.2.

Mean and Standard Deviation to Assess the Level of Psychosocial Problem with Asthmatic Children n = 50
The table shows the maximum score of psychosocial problems was 41 with mean psychosocial problem 25.28 the standard deviation were ±8.567 the results indicate that most of the subjects had moderately psychosocial problem.

3. Percentage and Frequency Distribution of Level of Quality of Life of Parents with Asthmatic Children
n = 50The table shows the level of quality of life of parents with asthmatic children.

Mean, Mean Percentage and Standard Deviation to Assess the Level of Psychosocial
Problem with Asthmatic Children n = 50The table shows the maximum score of quality of life was 41 with the mean psychosocial problem 28.34 the standard deviation were ±8.588 the results indicate that most of the subjects had good quality of life.

Correlation between Level of Psychosocial Problem and Quality of Life of Parents with Asthmatic Children n = 50
The table shows that there is a weak positive correlation between psychosocial problem and quality of life of parents with asthmatic children using karlpearson's correlation analysis is 0.314.
result shows the level of psychosocial problem on parents with asthmatic children.Out of 50 subjects, 32% (16) had mild psychosocial problem, 66% (33) had moderate level of psychosocial problem and 2% (1) had severe psychosocial problem.The results indicate that most of the subjects had moderately psychosocial problem.Out of 50 subjects 76% (38) had good quality of life, 16%