Caregiver Dispositional Mindfulness and Health Outcomes in Pediatric Asthma-- Pathways of Effect

Abstract

Objective To assess the relationship between caregiver dispositional mindfulness and measures of pediatric asthma outcome (spirometry, health services utilization, functional morbidity, and pediatric asthma-related quality of life) and to investigate whether treatment alliance, caregiver perceived stress, and subjective symptomatology patterns might mediate those relationships. Methods Caregivers of 95 children with asthma were administered the Mindful Attention Awareness Scale (MAAS) to assess dispositional mindfulness level. Children and/or caregivers completed measures of child objective pulmonary function, asthma functional morbidity, caregiver-reported treatment alliance with healthcare provider, child- and caregiver-reported pediatric asthma symptoms, and caregiver perceived stress. Results Caregiver mindfulness scores showed no association with child objective pulmonary function and health services utilization. Higher levels of mindfulness were associated with lower functional morbidity during the six weeks of the study (r=-.287, p<.01) and during the month prior to the study (r=-.174, p<.05). Greater caregiver mindfulness was associated with higher overall asthma-related quality of life (r=.311, p<.001) and with higher levels in three quality of life subscales: symptoms (r=.344, p<.001), emotions (r=.270, p<.01), and activities (r=.213, p<.05). Multiple regressions and mediational analyses revealed that caregiver perceived stress and treatment alliance did not contribute to mindfulness' asthma outcome effects. Child-reported asthma-related panic fear was a significant mediator between mindfulness and overall quality of life (Z=2.32, p=.01) and between mindfulness and emotional quality of life (Z=2.31, p=.01). Conclusions Caregiver dispositional mindfulness is associated with enhanced pediatric quality of life. Children vulnerable to more emotional elements of asthma symptoms may benefit from the presence of caregivers high in mindfulness.