[Methodological perspectives for the assessment of adaptation in chronic diseases, exemplified by asthma bronchiale in childhood]

Abstract

Background: Regarding the measurement of psychosocial adaptation due to chronic diseases in childhood and adolescence, there is a shift from a more reductionist and biomedical oriented disease-model towards a more integrated, biopsychosocial view of chronic diseases. The three paradigms in measuring psychosocial adaptation (psychopathology, coping, health related quality of life) will be discussed at the example of corresponding empirical studies in children with asthma bronchiale. The psychopathology-oriented research emphasizes the risk of the induced psychopathological comorbidity, whereas the more coping-oriented paradigm primarily includes the dynamic process of the perceived stress and the corresponding coping efforts due to a chronic disease. The third paradigm, the quality of life paradigm, sets its main focus on the subjective view of the chronically ill subject.

Conclusions: In future studies, all three paradigms--each measuring different aspects of psychosocial adaptation--should be simultaneously included to come to a more complex view of adaptation in chronic diseases in general and asthma bronchiale in particular.