Medical Neglect as a Contributor to Poorly Controlled Asthma in Childhood
- PDF / 333,894 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 28 Downloads / 207 Views
CASE STUDY
Medical Neglect as a Contributor to Poorly Controlled Asthma in Childhood Barbara L. Knox 1,2,3
&
Francois M. Luyet 1,2 & Debra Esernio-Jenssen 4,5
# Springer Nature Switzerland AG 2019
Abstract Child maltreatment, including medical neglect, is a frequent contributor to the development of asthma as well as a barrier to its proper management. This article aims to review the role of medical neglect as a contributor to poor asthma control. Medical neglect can present as failure of the caretaker to recognize severe asthma symptoms in a child, non-adherence to medical management, failure to prevent chronic exposure to allergens or tobacco smoke, poor child nutrition leading to obesity, and allowing a young child to manage his/her illness without supervision. This article will explore the different factors leading to medical neglect (as illustrated by two cases) and suggest possible interventions aiming to prevent emergency department visits, hospitalizations, and asthma-related deaths. Keywords Asthma . Medical Neglect . Medication noncompliance . Child abuse . Neglect
Asthma is the most common chronic disease of childhood, currently affecting 8.4% of US children and 14% of children worldwide (Lohr 2017), (Lai et al. 2009). In AfricanAmericans and children living below the poverty level, the disease is more prevalent, and there is a notable trend towards more emergency department visits and increased mortality due to this condition (Thakur et al. 2014) . Chronic stress in early life, including exposures to adverse childhood experiences (ACEs), is associated with an increased risk of asthma onset (Exley et al. 2015). In a longitudinal study, Lanier et al. found that reports of child maltreatment were associated with a 74–100% greater risk of hospital treatment for asthma. There was no difference between the effects of child abuse or child neglect. Most prior work was limited to * Barbara L. Knox [email protected] 1
University of Wisconsin American Family Children’s Hospital, Madison, WI, USA
2
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
3
University of Wisconsin Department of Pediatrics, 600 Highland Avenue, H4-428 CSC, Madison, WI 53792-4108, USA
4
Lehigh Valley Reilly Children’s Hospital, Allentown, PA, USA
5
Morsani College of Medicine USF Health, Tampa, FL, USA
the health consequences of physical or sexual abuse, but Lanier’s work suggests that neglect may be an equally important stressor (Lanier et al. 2010). In a recent study following mother-child dyads to the age of 21 years, victims of any form of child maltreatment were at a significantly higher risk of developing asthma. However, in adjusted analysis, only the association between emotional abuse and asthma report persisted once the effects of higher body mass index, cigarette smoking and internalizing problems were taken into account (Abajobir et al. 2017). In that study, emotional abuse was defined as any act resulting in a child’s suffering any kind of emotional
Data Loading...
