Quality of Life and Adjustment in Youths with Asthma: The Contributions of Family Rituals and the Family Environment

Abstract

This cross-sectional study explored the relationships among family ritual meaning, cohesion, conflict, and health-related quality of life (both specific to chronic health condi- tions and in general), and the emotional and behavioral problems reported by youths with asthma. Participants included 149 Portuguese children and adolescents between the ages of 8 and 18 who had been diagnosed with asthma and attended outpatient services at three public hospitals. The results showed that stronger family ritual meaning predicted a more positive family environment (i.e., higher cohesion levels and lower conflict levels), better health-related quality of life, and fewer emotional and behavior problems in youths. Fur- thermore, family cohesion and conflict mediated the links between family ritual meaning and health-related quality of life, and emotional and behavioral problems. These results did not change after controlling for participant age, gender, and asthma severity. The find- ings of this study suggest that family ritual meaning contributes to the adaptation of youths with asthma via its positive association with the family environment. The implica- tions for multicontextual interventions with families are briefly discussed with regard to the positive role of family rituals and of their potential as a modifiable factor in families with increased health challenges.