KEYWORDS
asthma, child, mental health, mindfulness, quality of life
1 | INTRODUCTION
Asthma, characterized as chronic airway inflammation, is the most common chronic lung disease in childhood. Asthma often starts in childhood even though it could be observed in all stages of life. The disease often present itself in episodes. The symptoms are wheezing, tightness in chest, trouble in breathing and coughing.1 Worldwide the prevalence of childhood asthma is 9.4%.2 The prevalence of childhood asthma is 13.36% in Turkey.3
Even though there are environmental and personal factors that affect prevalence of childhood asthma episodes, recent studies have shown that psychological factors such as somatization, behavior problems, attention deficit and hyperactivity disorder (ADHD), depression, anxiety and stress also are crucial on episodes.4-9 Therefore, known psychological trigger such as stress have a negative impact on children’s quality of life.10 For instance, facing hardship in conducting physical and social activities thus leading children feeling different and inadequate from their peers.11
Children’s quality of life also is affected by asthma control. Asthma control is associated with fluctuations in asthma symptoms under treatment. It could be explained as the prevention of risks that may cause asthma symptoms and control of symptoms.12 In order to increase quality of life in children with asthma, components such as mindfulness are needed to help reduce stress levels and keep the disease under control.
Mindfulness is the awareness arising from paying attention, intentionally, in the present moment and without judgment. It has been found that there is a positive correlation between mindfulness and perceived health with physical well-being.13 They also demonstrated that in adults; as mindfulness rises, perceived stress decreases on psychological well-being.13Mindfulness-based practices improve psychological and physiological health of children and adolescent.14 Mindfulness positively affects health by reducing stress on chronic diseases.15
In a study conducted on young adults with asthma, the diagnosis and symptoms of asthma decreased in people with high mindfulness.16 The same study also found that asthmatic people have higher levels of mindfulness than non-asthmatic people.16 The mindfulness program has been proven to significantly improve the quality of life in asthmatic people and this program specifically improves the emotional functionality of patients.17 This program when used as a supplementary treatment to routine medical treatments, improves the quality of life in people with asthma.18 Mindfulness practices regulates the physiological stimulation via regulating breathing and slowing heartbeats, leading positive improvement in the progress of the disease.19-20 As perceived stress decreases, there is a correlating increase in the quality of life of patients with asthma, which has been proven to be associated with mindfulness.7
Even though there are research about mindfulness and asthma in adults, there are limited research about mindfulness in children with asthma. It was indicated that by decreasing asthma-oriented stress mindfulness increases; therefore, quality of life based on asthma has positively affected in adolescents.21 Even though mindfulness, perceived stress and quality of life on asthmatic people separately indicated in a different research; there is no study in the literature that investigates the effect of all the variables on the pediatric asthma. The purpose of this study is to demonstrate that mindfulness has a mediator effect on the relationship between perceived stress and quality of life in children with asthma.
2 | MATERIALS AND METHODS
Ethics Committee Approval was obtained from Işık University on 02.09.2019. Işık University Clinical Psychology Graduate Coordination Office has given permission to conduct research at the İstanbul University İstanbul Medical Faculty Hospital’s “Child Allergy Policlinic”.
This is a research created in a cross-sectional design. Data collection process was carried out in January, February and March 2020. Children and parent/guardian read and signed the informed consent form to indicate that they voluntarily participated in the study.
2.1 | Population and Sample
The participants resorted “Child Allergy Policlinic” at the Çapa Campus of Istanbul University Istanbul Medical Faculty Hospital. The sample of this study consists of 100 asthma patients between the ages of 9-12 who has been diagnosed according to GINA criteria by physicians. There are inclusion and exclusion criteria in the sample creation process. The inclusion criteria were being between the ages of 9-12 and diagnosed allergic asthma according to GINA criteria by physicians. The exclusion criteria were having a psychiatric diagnosis according to DSM 5, using psychiatric medicine and receiving psychological therapy. The sample selection process was random.