The social environment of asthma management in early adolescence

For adolescents with asthma, adhering to asthma regimes implies not only taking medications to relieve asthma attacks, but also adjusting their life styles in order to prevent asthma attacks. These life style modifications, such as avoiding allergens or having to limit physical activity, sometimes force adolescents to compromise their social life. On the other hand, the impact of such life style modifications on their social life may in turn force adolescents to give up adhering to asthma regimes. Indeed, adolescents are learning to be more independent while they enjoy a more complicated social life at home and at school than previously, and this rapid social development may thus be a great life challenge to adolescents with asthma. This thesis reports four studies which investigated the relationship between multi-dimensional asthma management (in medication and life style regimes) and the social life of young people with asthma at the transitional age from childhood to adolescence (or early adolescence, age 9-14), which also marks the transition from primary school to secondary school.In line with the literature on other adolescent chronic illnesses, study 1 demonstrated a downward trend of multi-dimensional asthma management in early adolescence. This developmental change was further investigated in study 2, 3 and 4, in which theories in behavioural psychology were followed to emphasise human behaviour influenced by the social activities and social relationships in the living environment, or the social environment. This was supplemented by theories in developmental psychology to identify relevant aspects of the social environment in early adolescence, especially the social relationships with parents, school staff and peers. Using quantitative and qualitative approaches, the studies not only supported the direct influence of asthma-specific social support, but also explored some mechanisms with which social relationships influenced asthma management in a more subtle and context-dependent way. By approaching asthma management behaviour with theories from behavioural and developmental psychology, it is also hoped that this thesis could be an example that shows the importance of recognising and to understanding the social life of young adolescents when adolescent behaviour is concerned.