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.