Workplace Supports for Parents of Children with Asthma

Background and Purpose:

This paper reports findings from the first phase of a NICHD funded study to understand and develop workplace strategies to overcome the conflicting demands when low income, working parents simultaneously try to maintain employment and care for their children with asthma. Unattended, these conflicts can undermine the caregivers' well-being, job status and the effectiveness of care they provide to their children. The study's objective is to describe the work/caregiving conflict involved with providing adequate care to an asthmatic child while meeting work expectations. Understanding the specific ways that work/caregiving conflict is experienced helps to identify the workplace support needed to reduce the conflict. Based on a model of caregiving and stress (Pearlin, Mullan, Semple & Skaff, 1990), the study tests the hypothesis that formal support that helps parents fulfill work expectations while meeting caregiving demands, reduces work/caregiving conflict, increases parents' sense of self-efficacy and positively affects well-being, caregiving effectiveness and job satisfaction.

Methods:     

As part of a randomized control experiment, an in-depth telephone interview was conducted with 98 single, largely minority, low income working parents with children with asthma randomly selected from claims records of a union benefit fund serving hospital workers in New York City. The interview asked about the experience of work/caregiving conflict, the factors that affected the conflict and consequences of the conflict on perceived health, well-being, job satisfaction and caregiving effectiveness. It also collected information about the individuals' characteristics, work status and characteristics of their children with asthma to evaluate under what circumstances, and for whom, workplace support is needed and has the most positive impact. Case examples were provided through the case management intervention in which a case manager and parent jointly identified accommodation options to reduce work/caregiving conflict. Descriptive statistics profile respondents, their children and their work. Multivariate regression analysis specifies and interprets the conditions under which hypothesized relationships occur. Data from case management consultation was analyzed using qualitative techniques.

Results:

Results indicate that the less responsive the workplace to caregiving issues, the greater the work/caregiving conflict, the lower the perceived self-efficacy and the more negative the ratings of health, well-being, caregiving effectiveness and job satisfaction. Strategies most helpful to alleviate conflict included help with: 1) assessing how asthma management responsibilities interfere with the individual's job, 2) identifying workplace resources and benefits that would help overcome the specific barrier at work that interferes with asthma management, 3) understanding and activating social supports in the workplace important to accessing resources, negotiating accommodation or alleviating stress; 4) managing disclosure of the problem to supervisors and co-workers; 5) learning how to communicate the need for support in the workplace and 6) coordinating healthcare, childcare/school and employment systems.

Conclusions and Implications:

Findings help to develop workplace strategies important to individuals who are often without resources to maintain their own health and well-being, and better manage the demands of their children's illness while meeting the necessity of maintaining productive work to ensure an income, availability of health insurance and access to services.