title: The relationship between patient-provider communication and quality of life for children with asthma and their caregivers.
abstract: OBJECTIVE
  This study examined whether patient-provider communication is associated with asthma-related quality of life (QOL) and asthma outcomes among children with asthma and their caregivers.
  
  
  METHODS
  Children ages 8-16 years with asthma and their caregivers (n = 296) were recruited at five pediatric practices in North Carolina. Children and caregivers reported demographic and clinical characteristics immediately after an audio-taped medical visit with their health care provider. During a home visit that took place 1 month after the medical visit, children and caregivers reported asthma-related QOL, and caregivers reported child asthma outcomes, including asthma symptom days and missed school days. Generalized estimating equations were used to determine whether patient-provider communication during the medical visit was associated with child and caregiver QOL and child asthma outcomes 1 month later.
  
  
  RESULTS
  On average, providers asked caregivers 4.5 questions and asked children 3 questions per visit, whereas caregivers and children asked less than 1 question per visit. Providers asked children more asthma-related questions, caregivers reported better QOL and fewer asthma symptom days 1 month later. Children and caregivers with higher asthma-management self-efficacy at the office visit reported better QOL 1 month later.
  
  
  CONCLUSIONS
  Mirroring national guideline recommendations, our results suggest that providers should ask children about their asthma during medical visits. Future longitudinal studies should conduct mediation analyses to determine whether asking children asthma-related questions during medical visits increases children's asthma management self-efficacy and ultimately improve outcomes, such as QOL, health care utilization, symptom days and missed school days.
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. dmcarpenter@unc.edu
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: Guadalupe X
authors.initials: GX
authors.lastname: Ayala
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Williams
authors.forename: Karin B
authors.initials: KB
authors.lastname: Yeatts
authors.forename: Stephanie
authors.initials: S
authors.lastname: Davis
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000523:psychology*; D017028:Caregivers; D002648:Child; D003142:Communication; D005260:Female; D006282:Health Personnel; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009657:North Carolina; D009819:Office Visits; D011369:Professional-Patient Relations; D011788:Quality of Life; D012424:Rural Population; D012959:Socioeconomic Factors; D013637:Tape Recording