Asthma and Participation: A Scoping Review

Abstract

Asthma is a widespread pediatric chronic disease, but there is limited understanding of its impact on participation (other than physical activity) and the conceptualization of participation. We conducted a scoping review to explore the evidence on the relationship between pediatric asthma and participation in several domains of occupation outlined in the Occupational Therapy Practice Framework 4th Edition. A structured literature search was implemented in PubMed/MEDLINE, Elsevier EMBASE, CINAHL, SCOPUS, Clarivate Web of Science Core Collection, and APA PsycINFO. Data were extracted by occupational domain and analyzed using a stoplight categorization. Of the 3444 identified articles, 10 met inclusion criteria, five of which were categorized as green (addressing specific occupational activities). No article explicitly defined participation. Asthma’s influence on nonphysical activity occupations remains unclear. Future research must clarify both the meaning and measures that best capture participation, and further explore the relationship between asthma and participation.

Plain Language Summary

Review of research on the impact of pediatric asthma on participation in occupation illuminates inconsistency in findings and meaning of participation

Why was the study done? Asthma is one of the most common chronic diseases among children, but little is known on its relationship with children’s participation in occupations. To date, most research on pediatric asthma has focused on physical activity and sports participation. Currently, there are no reviews published or underway that investigate pediatric asthma and participation. What did the researchers do? With the aim of exploring the research on the relationship between pediatric asthma and participation in occupations (organized into domains by the Occupational Therapy Practice Framework 4th Edition), the research team searched several major databases for articles on this subject. Given the varying definitions and uses of the term “participation,” the research team constructed a definition based on existing research as well as a system to organize articles into three categories: red (nonspecific occupational activities), yellow (semi-specific occupational activities), and green (specific occupational activities). What did the researchers find? Of the 10 articles included in the review, three were categorized as red, two as yellow, and five as green. In the yellow and green articles, the occupational activities addressed fell into domains of education, play, leisure, and social participation. Results between studies were inconsistent. Activity limitations were frequently discussed in the context of physical activities, such as physical education, running during recess, and sports. None of the articles clearly defined and measured participation. What do the findings mean? These findings illuminate the lack of understanding around the relationship between pediatric asthma and participation beyond physical activities. There is need for consensus around the meaning of participation in order for occupational therapy to best promote it for their pediatric patients with asthma.