chapter  3
40 Pages

A family asthma management approach to behavioral assessment and treatment in children with asthma

ByMary D. Klinnert, Bruce G. Bender

Research over the past 10 years has led to a redefinition of asthma as a ‘chronic inflammatory disorder of the airways’ (National Institutes of Health, 1997). New guidelines for the assessment and treatment of asthma in adults and children necessarily focus on symptom measurement, environmental control, and medication management. Improving

patient health care behavior also receives significant emphasis in these revised guidelines. They include education, techniques for improving treatment adherence, and a suggestion about appropriate referral for mental health services. Patient education should be a continuous process, and one that is integrated into a ‘partnership’ between patient and health caregiver. Adherence may be enhanced through improved communication, sensitivity to the patient’s perceptions and concerns, and the promotion of involvement of other family members. While not a central focus of the guidelines, psychological assessment and treatment are recommended when other efforts from the health care provider do not lead to improved outcomes and ‘when stress seems to unduly interfere with daily asthma management’ (National Institutes of Health, 1997).