FIGURE
As NPs, we base our practice on patient education and counseling, essential foundations of nursing. When we understand the connection between mind and body in disease etiology, we can help patients deal with life stressors. A fall 2001 study of childhood asthma provides encouraging evidence of our powerful clinical interventions. Armed with the implications of this research, we have an opportunity to profoundly impact this devastating chronic disease.
Proof of Our Power
The study continued a prospective study of infants with a genetically high risk for asthma, identifying which variables had an independent association with asthma onset. 1,2
The findings showed that an elevated total immunoglobulin E (IgE) and parenting difficulties were by far the most highly predictive variables of pediatric asthma onset. The parenting risk evaluation tool assessed parents' psychiatric histories and emotional availability to the child, the presence of perinatal maternal depression, spousal relationship quality, and mothers' reports of their children's behavior (especially fearfulness and depression).
Researchers found the following factors were not independently associated with an ability to predict childhood asthma: eczema in the first year of life, a family's socioeconomic status or ethnicity, a family's stressful life events, the presence of furry animals or cigarette smoke in the home, and time spent breast-feeding.
Although some retrospective studies have found that infants exposed to increased stress have a high risk for asthma, this research dramatically and prospectively confirms an association between childhood asthma and parenting difficulties in families with 3-week-old infants.
Applying Our Role
NPs have an opportunity to play a huge role in assessing and treating their patients' family relationships. Fortifying a family's social support, assessing and treating maternal depression, teaching a mother how to increase her sensitivity and responsiveness to her infant, providing guidance on healthy parenting techniques, and providing counseling or referrals to support a couple's marital relationship are essential components of our role. We can improve a family's early emotional environment.
It's easy to become discouraged, however, when we face a family with overwhelming socioeconomic stress. This research now provides an uplifting message: Teaching parents how to provide a supportive and attentive emotional environment is more realistic than helping a family avoid external stressors (an unavoidable component of life).
Sometimes, we forget the importance and power of our impact when we treat depression or work with families on relationship issues. This research is heartening.
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