Tải bản đầy đủ - 0trang
Figure 3. Scatterplot summarized the correlation between stress score and depression score
decreased 2.89 point for each level of education. Depressions, duration of marriage
and education level were significant predictors of parenting stress score.
4.7. Chapter summary
Among 171 participants, 79.53% were asthmatic child’s mother. Generally,
the age of participants was relative young with 77.19% were under 39 years of age.
Most of respondents (94.15%) were married and lived with their spouses. There
were 38.01% participants who had length of marriage lasted from 5 to 10 years and
36.26% had lived together with their spouses more than 10 years. The education
level of most of participants was not high with the proportions of participants who
completed elementary school or secondary schools and participants who completed
high school were 30.41% and 42.11%, respectively.
There were 65.5% asthmatic children under 5 years of ages in this study. The
age of acquiring asthma of children was mainly under 5 years as well (81.29%).
Based on severity assessment, most of children had mild intermittent and mild
persistent (65.5% and 27.49%, respectively).
Informal support was the most frequent support that participants received
with the mean score of 1.31 ± 0.59, and a range varied from 0.43 to 3.86 score.
Respondents received less supports from formal and informational sources (0.22 ±
0.33 and 0.52 ± 0.63). Consequently, the mean score of total support was only
0.68 ± 0.37.
The results showed that the mean total parenting stress score among parents
of asthmatic children was 39.17 ± 9.69 with a range varied from 21 to 58 point.
The mean depression score among parents was 10.08 ± 7.32. Based on
classification of PHQ-9, there were 27.49% parents not having depression, 38.6%
parents having depression from mild to moderate and 33.88% parents having
depression from moderate severe to severe
Only education level, duration of marriage, number of children, total
support, and depression had statistical significant associations with parenting
stress. Amultiple linear regression showed that parenting stress score increased
0.35 point for each point of depression, decreased 0.26 point for each of years of
marriage and decreased 2.89 point for each level of education. Depressions,
duration of marriage and education level were significant predictors of parenting
Chapter five.Discussion and conclusion
In this chapter, all findings of the studied would be discussed. Discussions
about demographic characteristics, social supports, parenting stress and depression
status of parents of children with asthma were displayed in next sections. The
relationship between demographic characteristics and social supports, parenting
stress, and depression were also discussed in this chapter. Furthermore, correlations
between social supports, parenting stress, and depression were mentioned as well.
Finally, a conclusion was necessary to summary what had been found in the
study.Contribution and implications of the study mentioned to demonstrate the
ability of application of the study in practical settings. Limitations those always
exist in any study would describe as well.
5.2.1. Demographic characteristic of participants and asthmatic children
5.2.Demographic characteristics of participants
Of the participants, 79.53% were mothers. The finding was consistent with
other previous studies in which mothers were the main caregiver of asthmatic
children (Howard, 2009; Kumari, Gupta, Piplani, Bhatia, & Upadhayay, 2011a; Mc
Quaid, et. al., 2001). In Vietnamese society and other cultures mothers always play
an important role in feeding, nursing and caring children, while fathers play a role
as a money earner to keep and meet daily needs in families.
Generally, the age of parents was relative young with 77.19% were under 39
years of age. This result was appropriate with the data from 2009 National
Population and Housing Census in which more than 81% male and female adults
under 39 years had married and gave births (National Statistic Division, 2009).
Many studies from different countries also documented the younger trend of
parents of asthmatic children. Kumari et al. (2011b)conducted a study in India
showed that mean age of parents of childrenof bronchial asthma was 33.48 ± 6.40
years.A Japanese study conducted by Nagano (2010)revealed that the average age
of the mothers was 36 years.
Most of respondents (94.15%) were married and lived with their spouses.
There were 38.01% participants who had duration of marriage lasted from 5 to 10
years and 36.26% had lived together with their spouses more than 10 years.
Traditionally, Vietnamese families often maintain their core structure including
mother, father and children in long period of time. However, recently the
proportions of divorced or separated couples in younger age groups have been
increasing. For example, 2009 National Population and Housing Census showed
that the proportions of divorced or separated coupled in age group of 25-29 was
0.34% in male and 0.9% in female, but these figure have increased up to 1.5% in
male and 3.06% in female regarding age group of 40-44 (National Statistic
The education level of most of participants was not high with the
proportions of participants who completed elementary school or secondary schools
and participants who completed high school were 30.41% and 42.11%,.
respectively. It was supposed that participants who were living in Ho Chi Minh
city, but they may original come from other provinces where had high education
background.This finding was consistent with education distribution in general
population. A national surveys in 2010 showed that 28.1% people living in Ho Chi
Minh city had completed elementary school and 25% had completed high school
(Misnistry of Education and Training, 2010).
It could be said that workers and officers were two main occupations in this
study (32.75% and 22.22%, respectively), while housewives, manual labor
occupied 27.49%. Since Ho Chi Minh is a big city with lot of industrial parks and
office buildings, a large of labor force are gathering in Ho Chi Minh to find
opportunities for jobs. Furthermore, there is still a small portion of people work as
manual labor such as goods carriers and street vendors. All of these unique
characteristics make of a diverse occupational distribution in this study.
Regarding number of children, 33.33% respondents had one child and
53.22% had two children. This result was similar with the rate of reproduction in
general population. In fact, the 2013 National Population and Housing Census
showed that each Vietnamese woman in reproductive age have an average of 2.09
children(National Statistic Division, 2013). However, there were differences
between provinces in number of children that each woman giving births.
Particularly, Northern mountainous areas has overwhelmed rate of giving births
(2.56 children per woman), while Southeastern areas including Ho Chi Minh city
have decreased rate of giving births (1.56 children per woman)(National Statistic
Division, 2013). Especially, the rate of production Ho Chi Minh city is now
declining significantly (1.48 children per woman)(Branch Division of Population
and Family Planning, 2015).
Regarding family income, the results showed that almost participants had
monthly family income over 2.5 million VDN (91%). According to Ho Chi Minh
People Committee, people who had family income less than 1.5 million VDN was
classified as poor family, while people having family income from 1.5 to 2.5
million VDN and over 2.5 million VND were classified as average and above
average families. Therefore, it could be said that the economic status of
participants was well enough for caring their children.
In Vietnam and Ho Chi Minh as well, Buddhism and Catholic were two most
popular religions among others. The number of Buddhism in the country was
6,812,318, Catholic was 5,677,086 and HoaHao, a unique religion in Vietnam, was
1,433.252 (Wikipedia, 2015a). The finding in this study was similar with data from
general population in which the proportion of Buddhism participants was 67.84%
and Catholic participants were21.64%.
5.2.2. Characteristics of asthmatic children
There were 65.5% asthmatic children under 5 years of ages in this study and
34.5% asthmatic children over 5 years. It did mean that Vietnamese children may
acquire asthma as they are younger. Indeed, the age of acquiring asthma of children
in this study was mainly under 5 years (81.29%).Many Vietnamese studies on
children aged from 6 to 15 years showed that the proportion of children with
asthma was relative low. For example, a study in Thai Nguyen, a Northern
province, showed that only 14% children aged from 6 to 15 years had
asthma(Khong, 2009). One study in Ha Noi and two studies in HaiPhong showed
that the proportions of asthma among children with the same age group were
12.56%, 10.46% and 9.3%, respectively(H. Q. Pham & Dinh, 2002; L. T. Pham,
2005; Phung, Nguyen, & Pham, 2013). On the other hand, the statistics of Ministry
of Health showed that asthma was one of the most common respiratory diseases
among children under 5 years of age (Ministry of Health, 2011).Compared to
oversea studies on asthmatic children, asthma may occur in later phase of
children’s development. Kumari(2011b)showed that mean age of children with
bronchial asthma was 6.65 ± 2.36. Nagano (Nagano, et. al., 2010)conducteda study
in Japan and found that the median of thechildren’s age was 6 (4-8) years.
In this study, asthma severity was measured by using questions about the
frequency of their adolescent’s asthma symptoms, frequency of nighttime
symptoms, exacerbations, missed days of school and emergency room visits
(Howard, 2009). A large portion of children had asthmatic symptoms two times a
week or less (63.16%) and two times a week or more- but less than one time each
day (29.24%). For frequency of nighttime symptoms, 62.57% children had the
symptoms two times a month or less (62.57%) and 23.39% had symptoms more
than two times a month (23.39%). About exacerbations, 81.29% children had brief
(a few hours to a few days) exacerbations with varying intensity. There were
39.77% children had no missed days of school; however, it was also noted that
25.73% children had to stay at home ten or more days due to asthma. Regarding to
emergency room visits, 39.77% children did not have any hospitalizations in the
last years and 46.78% children had admitted hospitals from 1 to 3 times last year.
Based on those data, most of children had mild intermittent and mild persistent
(65.5% and 27.49%, respectively).Howard (2009) also documented that over
70% of the adolescents had mild intermittent asthma. Nagano (2010), on the
contrast, showed that moderate or more severe disease classification by JPGL 2000
accounted for 46%. The differences between findings in this study and those of
other studies may be due to differences in classification of asthma severity.
5.3. Social support for parents of asthmatic child
The Carolina Parent Support Scale (CPSS) (Bristol, 1979) was used as a
measureof social support in this study. Three subscales were assessed including
Informal Supports those parents received from their spouses, relative and friends,
Formal Supports those parents received from professionals institutions and
agencies, and Informational support those parents received from books, video, or
The informal support score among participants was 8.16 ± 4.12. Among
sources of informal supports, husbands or wives were the most common informal
support that participants received in their family (3.18 ± 1.19). That was obviously
since most of participants had been married with the duration of marriage from 5 to
10 years. Besides their spouses, respondents also confirmed that their spouses’
relatives and their relatives help them much in caring asthmatic children (1.99±
1.33 and 1.59 ± 1.45). In Vietnam, although there is currently an increasing shift
from traditional family structure including parents, children and grandparents to
core family structure including parents and children or single family structure
which consists of mother or father and their children, the traditional familystructure
are still predominant(Mai, 2010). In traditional family, grandparents play important
role in taking care of children. They could feed and nurse babies, taking children to
kindergartens or schools. As children get sick or illnesses, grandparents with their
experience may support children’s mothers in caring children.
In general, participants received little supports from formal sources such as
public health services, private social services and public social services. Some
participants reported that babysitting help them in taking care of asthmatic
children, therefore the mean formal support score of babysitting was 0.56± 1.06.
Similarly, private doctors and public health services also two sources of
information toward few parents of asthmatic children, so the mean score were 0.51
± 0.88 and 0.50± 1.01. Frequently, as parents and asthmatic children visit private
doctors or public hospitals, they are often diagnosed and then received treatments
while health consultations are rarely available. For private social services, few
participants used psychological consultations from private psychological centers,
so the mean score was nearly equal to zero. In the same vein, few participants used
public social services as the formal source of supports in caring asthmatic children.
In fact, there are branches of Women Association, those could be considered as
public social services for women, in every commune across the country. The main
responsibilities of those branches are to protect women from family violence,
provide financial supports and train women for jobs(Wikipedia, 2015b).
Therefore, parent’s asthmatic child may not receive supports in caring suffered
child from those branches of Women Association. Since the use of formal source as
caring supports of asthmatic childe was not high, the mean formal supports score
was merely 1.77 ± 2.65.
For informational supports, the main finding was that participants received
not much from those social supports. In particular, the mean score of receiving
supports from magazine and newspaper was 0.89 ± 1.04, television was 0.81 ±
1.04, and books was 0.77 ± 1.02. In several Vietnamese magazines and
newspapers, there are health corners in which health articles could be published, so
parents of asthmatic children may learn ways of caring their children from those
articles. Furthermore, some TV channels also have health shows in which doctors
are invited to provide health information about a variation of illnesses, so parents
of children with asthma learn from those TV shows as well. However, the
frequency of health articles and TV shows related to asthma may not high;
therefore parents receive not much help from those sources in caring their children.
From three subscales Informal Supports, Formal Support and Informational
Supports, the total support score of participants was not high (13.05± 7.71).No
studies or data in Vietnam revealed about social support for parents of asthmatic
children. However it could be said that parents of asthmatic children received little
supports from formal sources, especially doctors.The finding suggested that there