title: Pediatric asthma morbidity: the importance of symptom perception and family response to symptoms.
abstract: OBJECTIVE
  To determine whether family response to asthma symptoms mediates the relationship between child symptom perception and morbidity.
  
  
  METHODS
  A total of 122 children with asthma, aged between 7 and 17 years (47% females; 25% ethnic minorities), were recruited from three sites. Participants completed a family asthma management interview and 5-6 weeks of symptom perception assessment.
  
  
  RESULTS
  Family response to symptoms mediated the relationship between child underestimation of symptoms and asthma morbidity and partially mediated the relationship between accurate symptom perception and morbidity. In contrast, although child overestimation of symptoms and family response to symptoms were independently related to asthma morbidity, a mediational model was not supported.
  
  
  CONCLUSIONS
  Our study found support for the role of family response to symptoms in mediating the relationship between child symptom perception and morbidity, particularly with regard to underestimation of symptoms, underscoring the need for behavioral tools to accurately recognize and optimally respond to exacerbations.
authors.affiliation: Brown Medical School, Bradley Hasbro Children's Research center, Corp. West 2, 1 Hoppin St., Providence, Rhode Island 02903, USA. emcquaid@lifespan.org
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
authors.forename: Daphne
authors.initials: D
authors.lastname: Koinis Mitchell
authors.forename: Natalie
authors.initials: N
authors.lastname: Walders
authors.forename: Jack H
authors.initials: JH
authors.lastname: Nassau
authors.forename: Sheryl J
authors.initials: SJ
authors.lastname: Kopel
authors.forename: Robert B
authors.initials: RB
authors.lastname: Klein
authors.forename: Marianne Z
authors.initials: MZ
authors.lastname: Wamboldt
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Fritz
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D004493:Education; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate; D012803:Sick Role; D018434:Sickness Impact Profile; D013223:Statistics as Topic; D011795:Surveys and Questionnaires