Association between parental expectation, parenting stress, and parents' adherence intention to medication therapy for children with asthma

Introduction: Taking care of children with asthma, especially those who cannot take their medications according to treatment regimens, can be burdensome for parents and lead to additional parenting stress. Understanding the care process of parents with asthmatic children and helping parents better manage their children's asthma medication use is critical to health care providers. This study aimed to explore how parental factors, namely parental expectation, parental perceived performance, parental confirmation, parental satisfaction, and parenting stress impact parents' intention to adhere to asthma medications (PIAAM) for their children. Methods: A cross-sectional online Qualtrics survey was administered to parents of children aged between 2 and 12 who were visiting participating asthma/pediatric clinics. The survey assessed the above-mentioned factors adapted from the expectation confirmation theory (ECT), along with parents' health literacy, number of asthma medications used by the children, and socio-demographic characteristics of both parents and children. Spearman's correlation, multiple regression, and path analyses were conducted to determine the relationship between model variables with parents' and children's characteristics. Results: The findings from a total of 261 surveys indicated that PIAAM was significantly correlated with all parental factors (P < 0.05). Path analyses indicated an indirect effect of parenting stress on PIAAM. Multiple regression and path analyses both suggested that parental expectation (β = 0.369, P < 0.05) and number of asthma medications (β = 0.659, P < 0.05) were significant predictors for PIAAM after controlling for other covariates. Conclusions: Reducing parenting stress can enhance parental expectation of asthma medications, and hence improve PIAAM. Understanding parents' perspectives may enable health care providers to provide better care for children with asthma.