Caregivers Recognition of Pediatric Asthma Triggers and Exacerbation Warning Signs: A Cross-Sectional Study

Hanan Raed Mushtaha⁽¹⁾ • Reneem Salhieh⁽²⁾ • Leen M Obeidat⁽²⁾ • Rama Thalji⁽³⁾ • Rawan Abu Ajjour ⁽³⁾ • Noor Abu Alrous⁽²⁾ • Rahaf A.Alkhatib⁽²⁾ • Mariam T Mashal⁽²⁾ • Jana Jaradat⁽²⁾ • Rayan Alrashdan⁽²⁾ • Osama M Aldeeb ⁽²⁾ 

Published in Cureus Journal: 10.7759/cureus.105587

PubMed Index: PMC12398324

Abstract

Background

Pediatric asthma exacerbations are frequently triggered by environmental exposures and are often preceded by identifiable warning signs. Caregivers play a central role in recognizing these triggers and early symptoms and in initiating appropriate management to prevent severe outcomes.

Objective

This study aimed to assess caregivers' recognition of pediatric asthma triggers and exacerbation warning signs, to describe caregiver response behaviors, and to identify factors associated with caregivers' responses.

Methods

A cross-sectional study was conducted between October and December 2025 among 400 caregivers of children aged ≤18 years with physician-diagnosed asthma; each caregiver reported on a single child. An anonymous, self-administered online questionnaire collected caregiver demographics, child clinical characteristics, recognition of asthma triggers and exacerbation warning signs, and caregiver response behaviors. Composite scores were calculated for trigger recognition (0-9), warning-sign recognition (0-8), and caregiver response behavior (0-10). Descriptive statistics and multivariable linear regression analyses were performed using JASP software (https://jasp-stats.org/).

Results

A total of 400 caregivers participated; 263 (65.8%) were female. Mean caregiver age was 39.3 ± 12.3 years, and mean child age was 9.0 ± 5.0 years; 170 children (42.5%) had a history of asthma-related hospitalization. Item-level recognition of asthma triggers ranged from 295 (73.8%) to 315 (78.8%) of caregivers, while recognition of exacerbation warning signs ranged from 275 (68.8%) to 297 (74.2%) of caregivers. Composite mean scores were: trigger recognition 6.7 ± 1.2, warning-sign recognition 5.9 ± 1.3, and caregiver response behavior 7.2 ± 1.4. In multivariable regression, caregiver age, trigger recognition score, warning-sign recognition score, education level, employment status, and prior hospitalization were not significantly associated with caregiver response behavior scores (model R² = 0.01, adjusted R² = −0.01; F(7,392) = 0.45, overall model p = 0.89).

Conclusions

Caregivers demonstrated moderate recognition of asthma triggers and exacerbation warning signs, but this recognition was not associated with response behaviors. These findings emphasize the need for caregiver education strategies focused on actionable asthma management skills rather than awareness alone, highlighting gaps in translating knowledge into effective action.

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