title: Perceptions about interpersonal relationships and school environment among middle school students with asthma.
abstract: OBJECTIVE
  To examine interpersonal relationships involving peers and teachers and perceptions about school environment among middle school students with asthma in comparison to their healthy counterparts. The study also assesses asthma prevalence in a large sample of middle school students representing different geographic locations.
  
  
  METHODS
  Cross-sectional data were collected from 1059 middle school students in grades 6-8 enrolled in schools in a northeastern region of the United States. Students reported their chronic health conditions including asthma and completed questionnaires measuring perceptions about their relationships with peers and teachers as well as school environment. Analyses of covariance (ANCOVAs) were used to compare students with asthma and their healthy counterparts in the study variables.
  
  
  RESULTS
  Asthma was reported by 16.5% of the sample (n = 169). The rate was higher among minority students (23%) than their white counterparts (15%). Greater proportion of urban students (28%) reported asthma than rural (18%) and suburban (14%) students. Students with asthma reported significantly poorer relationships with peers (B = -1.74, p <.001) and teachers (B = -1.41, p =.009), and their perceptions about overall school environment (B = -1.30, p =.009) were also lower than their healthy counterparts. Race showed no significant effects on school factors.
  
  
  CONCLUSIONS
  Overall asthma prevalence was substantially higher than the national average of adolescent asthma, particularly those residing in the urban area. Poor perceptions of interpersonal relationships with peers and teachers among students with asthma may indicate compromised quality of life. Suboptimal interpersonal relationships and school environment need to be identified and adequately addressed, given their implications for asthma management at the school setting among middle school students.
authors.affiliation: a School of Nursing, University of Rochester , Rochester , NY , USA.
authors.forename: Hyekyun
authors.identifier: http://orcid.org/0000-0001-7039-3215
authors.initials: H
authors.lastname: Rhee
authors.affiliation: b Roberts Wesleyan College , Rochester , NY , USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: McQuillan
authors.affiliation: c University of North Carolina at Chapel Hill , NC , USA.
authors.forename: Ding-Geng
authors.identifier: http://orcid.org/0000-0002-3199-8665
authors.initials: DG
authors.lastname: Chen
authors.affiliation: a School of Nursing, University of Rochester , Rochester , NY , USA.
authors.forename: Shannska
authors.initials: S
authors.lastname: Atis
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000523:psychology*; D001290:Attitude; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010379:Peer Group; D015995:Prevalence; D000070777:School Teachers; D012574:Schools; D013334:Students
keywords: Asthma prevalence; peer relationship; relationship with teachers; school-based study