Attributions in Pediatric Asthma Self-Management Success and Failure

Abstract

“Lack of effort” attributions for failure (behavioral self-blame) have been associated with a greater sense of control over illness outcomes because the failure is attributed to internal (ie, subject to personal factors), unstable (ie, amenable to different outcomes on future occasions), and controllable (ie, subject to personal intent) causes. This study examines the causal attributions (locus, stability, control) used by children and their parents to explain success and failure in 3 asthma self-management domains: symptom monitoring, medication adherence, and environmental trigger avoidance. Participants included 65 children (9-13 years) diagnosed with asthma and their primary caregivers, recruited from urban specialty and community clinics and schools. Responses to a structured interview presenting 18 scenarios of self-management success and failure were coded along causal dimensions and causal labels using the Coding Scheme of Perceived Causality. Children attributed self-management success and failure of themselves and other children mainly to internal (84.6% to 98.1%), unstable (50.8% to 79.4%), and controllable (73% to 98.4%) causes. Compared to other children, respondents regarded their own failure in monitoring symptoms as more unstable. Parents attributed their child’s management mainly to internal (66.7% to 90.5%), unstable (52.4% to 84.1%), and controllable (54.0% to 85.5%) causes. Personal effort and intrinsic motivation were the primary causal labels provided. Understanding a child’s causal attributions for asthma self-management could help asthma educators intervene on beliefs that may be undermining management success. Further research of causal attributions for asthma self-management is required to understand the potential of this theory to inform education and treatment strategies.