A systematic review of parent-child communication in pediatric asthma

Objective: Parent-child communication is integral to pediatric asthma management. This review evaluates parent-child communication among youth with asthma and their caregivers. It aims to characterize the type of communication according to a unifying framework (Murphy, L. K., Murray, C. B., & Compas, B. E., Guest Editors: Cynthia A. Gerhardt, Cynthia A. Berg, Deborah J. Wiebe and Grayson N. Holmbeck (2017). Topical review: Integrating findings on direct observation of family communication in studies comparing pediatric chronic illness and typically developing samples. Journal of Pediatric Psychology, 42, 85-94. https://doi.org/10.1093/jpepsy/jsw051), assess sociodemographic factors associated with communication, and examine the relationship between parent-child communication and youth psychosocial and health-related outcomes.

Methods: A systematic literature search was conducted using PubMed, PsycINFO, CINAHL, Web of Science, Cochrane Library, and Embase databases (June 2021; updated May 2024). Included studies reported original, peer-reviewed research on the relationship between parent-child communication and youth psychosocial or health outcomes among pediatric patients (mean age <18 years) with asthma and their primary caregiver(s). Study quality was evaluated using the Study Quality Assessment Tools of the NHLBI.

Results: Sixty-six articles were included with data from 5,373 youth with asthma. Studies assessed both positive (warm and structured) and negative (hostile/intrusive and withdrawn) communication. Most studies used questionnaires and cross-sectional designs. Associations between sociodemographic and communication variables were largely nonsignificant. Greater positive and less negative communication was associated with better youth psychosocial and asthma outcomes overall.

Conclusion: Parent-child communication may be an important target for interventions aimed at improving youth outcomes. More research is needed to develop communication-focused interventions that aim to enhance parents' and youths' communication skills (i.e., increase their use of positive communication approaches and/or reduce their use of negative communication approaches) and evaluate their impact on youth outcomes. Future research should also use more discussion tasks and longitudinal designs.