Caregiver stress in the context of pediatric asthma: associations with youth quality of life and caregiver–child communication patterns

Objective Caregivers of children with a chronic illness often experience stress that can impact their child’s health and influence the parent–child relationship dynamic through changes in communication patterns. Within a pediatric asthma sample, we examined the associations between medical factors and caregiver stress on parent–child communication patterns and youth quality of life (QOL).Methods Youth with asthma (n = 70; Mage = 13.99; 43% female) and their caregivers (94% female; 46% White) were recruited from a pediatric pulmonary clinic. Hierarchical regression models examined the unique contributions of medical factors and caregiver stress (Pediatric Inventory for Parents, PIP) on caregiver–child communication patterns (Revised Family Communication Pattern Instrument, RFCP; openness vs. conforming to family ideals) and youth QOL (Pediatric Asthma Quality of Life Questionnaire, PAQLQ).Results On a scale of 42–210, in which higher scores indicate greater frequency or difficulty of problems contributing to caregiver stress, caregivers reported an average frequency score of 83.91 (SD = 30.226) and an average difficulty score of 79.00 (SD = 32.767). More emergency room visits in the past 12 months (B = .327, p = 0.006) were related to greater endorsement of parent–child communication conformity orientation, explaining 21.1% of variance, F(3,61) = 5.45, p = 0.002; caregiving stress was only associated at the bivariate level. Higher caregiving stress difficulty (B = −0.389, p = 0.001) was related to lower youth QOL, explaining 17.0% of variance, F(2,64) = 6.55, p = 0.003.Conclusions Caregivers of youth with asthma reported low-moderate caregiving stress in both frequency and difficulty of problems faced. Nevertheless, caregiving stress difficulty was a predictor of their child’s QOL above and beyond medical factors. Healthcare providers should screen for caregiving stress and continue to monitor caregiver well-being throughout the illness trajectory.