ABSTRACT
Asthma is the most common chronic lower respiratory disease in childhood throughout the world; it is characterized by bronchial hyperreactivity and variable airway obstruction. Asthma is a disorder involving autonomic nervous system, immunologic, and psychologic factors in individuals. This work sought to describe the relationship among stress, coping, and disease control in children with asthma between 6 and 12 years of age. This was a cross-sectional correlational quantitative study with the participation of 280 children with asthma admitted to outpatient consultation and to a hospitalization service at a tier IV health institution in the city of Bogotá. An inverse correlation was found between stress and coping (r = -0.581; p < .05); between stress and asthma control (r = -0.545¸ p < .05); and a direct correlation between coping and asthma control (r = 0.759; p < .05). The results show that children with low stress levels have greater control of their disease and assume functional coping against their health status. The theory of Adaptation to Chronic Health Conditions permitted analyzing children's conduct and behaviors against a health situation. These findings provide evidence for promoting interventions directly to patients with asthma, focusing on patients, families, and schools. Thus, it is possible to improve the quality of health care and strengthen primary health care.
ABSTRACT
La enfermedad crónica representa una cadena de acontecimientos y resultados en la vida de quien la afronta y su familia; el asma es una enfermedad que afecta en mayor proporción a la población infantil. "Quizás no se pueda considerar el asma una enfermedad única, sino la expresión común de una serie de factores genéticos y ambientales que en su conjunto producen una reacción inflamatoria, que origina la disminución del calibre bronquial y una respuesta exagerada frente a estímulos de carácter diverso (SEPAR, 1998)" (Fernández, 1997, p. 11). Existen factores tangibles e intangibles que se deben contemplar e indagar, con el fin de generar un cuidado holístico para los niños que viven con asma. Desde esta perspectiva y con esta meta, se busca un acercamiento desde la visión integrativa del mundo para conocer de manera objetiva un contexto específico de determinar cómo se relacionan el nivel de estrés, el estilo de afrontamiento y el control de la enfermedad. Objetivo: Describir la relación entre el estrés, el afrontamiento y el control de la enfermedad en el niño con asma entre los 6 y los 12 años, quien se encuentra asistiendo a consulta externa o está hospitalizado en el Hospital Infantil Universitario San José Infantil. Método: La investigación es un estudio cuantitativo de tipo correlacional. La población considerada para el presente estudio estuvo constituida por 280 niños con asma del Hospital Infantil Universitario de San José, en la ciudad de Bogotá, y se contemplaron dos grupos: el primero integrado por niños que ingresaron a consulta externa y el segundo, con niños que se encontraban hospitalizados, ambos grupos con diagnóstico de asma. De esta manera se logró describir y comparar el comportamiento y relación de las variables en cada grupo. Resultados y conclusiones: En conclusión, se evidenciaron las relaciones de las tres variables de interés y, desde la perspectiva de los niños, se puede decir que hay una correlación inversa entre estrés y afrontamiento (r=-.581), entre estrés y control del asma (r=-.545) y una relación directa entre afrontamiento y control del asma (r=.759). De manera general, se puede inferir que los niños con bajos niveles de estrés tienen un mayor control de su enfermedad y asumen un afrontamiento funcional frente a su estado de salud. De otro lado, se concluye que algunas características sociodemográficas y de salud de la población estudiada pueden constituir un factor determinante y están presentes en el niño con asma, se destacan el bajo peso al nacer, el consumo de cigarrillo en el hogar, el grado escolar que cursa el niño y el tiempo de la enfermedad.
Chronic disease represents a chain of events and outcomes in the life of those who face it and their families; Asthma is a disease that affects the child population in greater proportion. "Asthma may not be considered a unique disease, but the common expression of a series of genetic and environmental factors that together produce an inflammatory reaction, which causes the reduction of the bronchial caliber and an exaggerated response to Stimuli of diverse character (Separ, 1998) "(Fernandez, 1997, p. 11). There are tangible and intangible factors that must be considered and investigated to generate a holistic care for children living with asthma. From this perspective and with this goal, an approach is sought from the integrative vision of the world to know in an objective way a specific context, how the level of stress, the style of coping and the control of the disease are related. Objective: To describe the relationship between stress, coping and control of the disease in the child with asthma between 6 and 12 years of age, who is attending external consultation or is hospitalized in the children's Hospital Universitario San Jose Infantil. Method: Research is a quantitative study of correlational type. The population considered for the present study consisted of 280 children with asthma from the University children's Hospital of San José, in the city of Bogotá, and two groups were contemplated: the first composed of children who entered the external consultation and the second, with children who were hospitalized, both groups diagnosed with asthma. In this way, it was possible to describe and compare the behavior and relation of the variables in each group. Results and conclusions: In conclusion, the relationships of the three variables of interest were evident and, from the perspective of the children, one can say that there is a reverse correlation between stress and coping (r =-. 581), between stress and asthma control (r =-. 545) and a direct relationship between coping and asthma control (r =. 759). In general, it can be inferred that children with low levels of stress have greater control of their disease and assume a functional coping with their health status. It is concluded that some sociodemographic and health characteristics of the population studied can be a determining factor and are present in the child with asthma. It highlights the low birth weight, the consumption of cigarette by a family member, the school degree that the child and the time of the disease.