Research Article
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Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma

Year 2023, , 27 - 34, 27.03.2023
https://doi.org/10.26650/jchild.2023.875601

Abstract

Objective: The purpose of this study is to analyze the possible mediator effect of mindfulness in the relationship between perceived stress and quality of life in pediatric asthma. Material and Method: The sample of this study consisted of 100 asthmatic children aged between 9-12 years who applied to the outpatient clinic of Istanbul University, Istanbul Faculty of Medicine, Division of Pediatric Allergy. Sociodemographic information forms, Perceived Stress Scale in Children (8-11 years), Child and Adolescent Mindfulness Measure (CAMM), and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) were used as data collection tools. Linear hierarchical regression analysis was used during the process of analyzing data. Results: It has been identified that mindfulness has a partial mediator effect on the relationship between perceived stress and quality of life (p = 0.000). The presence of a partial mediator effect of mindfulness has been determined in the relationship between perceived stress and symptoms which is the subscale of quality of life (p = 0.000). Finally, it has been demonstrated that mindfulness has a partial mediator effect on the relationship between perceived stress and emotional function which is another subscale of quality of life (p = 0.000). The mediating role of mindfulness in the relationship between perceived stress and activity limitations could not be analyzed due to the lack of a significant correlation between activity limitations which is the subscale of quality of life and mindfulness (p=0.178). Conclusion: It can be helpful to add psychotherapy interventions involving mindfulness practices to asthma treatment for better control of the disease in children.

Thanks

We would like to thank all the collaboration by the medical doctors in İstanbul University İstanbul Faculty of Medicine’s “Division of Pediatric Allergy” and the participants.

References

  • 1. Masoli, M, Fabian, D, Holt, S, Beasley, R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy, 2004, 59.5: 469-478. google scholar
  • 2. The Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2018 Update. google scholar
  • 3. Lai, CK, Beasley, R, Crane, J, Foliaki, S, Shah, J, Weiland, S, & ISAAC Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: phase three of the international study of asthma and allergies in childhood (ISAAC). Thorax 2009; 64(6), 476-483. google scholar
  • 4. Kurt, E, Metintas, S, Başyiğit, I, Bulut, I, Coşkun, E, Dabak, S, et al. Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children. Pediatric Allergy and Immunology 2007; 18(7), 566-574. google scholar
  • 5. Blackman, JA, & Gurka, MJ. Developmental and behavioral comorbidities of asthma in children. Journal of Developmental & Behavioral Pediatrics 2007; 28(2), 92-99. google scholar
  • 6. Grizenko, N, Osmanlliu, E, Fortier, ME, & Joober, R. Increased risk of asthma in children with ADHD: Role of prematurity and maternal stress during pregnancy. Journal of the Canadian Academy of Child and Adolescent Psychiatry 2015; 24(2), 109. google scholar
  • 7. Katon, W, Lozano, P, Russo, J, McCauley, E, Richardson, L, & Bush, T. The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared with controls. Journal of Adolescent Health 2007; 41(5), 455-463. google scholar
  • 8. Kimura, T, Yokoyama, A, Kohno, N, Nakamura, H, & Eboshida, A. Perceived stress, severity of asthma and quality of life in young adults with asthma. Allergology International 2009; 58(1), 71- 79. google scholar
  • 9. Ramratnam, S, Jaffee, K, Visness, C, & Gern, JE. (2017). Exposure to early life maternal stress and depression and risk of asthma. In C26. Asthma in infants and children. American Thoracic Society 2009; A5088-A5088. google scholar
  • 10. Rona, RJ, Smeeton, NC, Amigo, H, & Vargas, C. Do psychological distress and somatization contribute to misattribution of asthma? A Chilean study. Journal of Psychosomatic Research 2007; 62(1), 23-30. google scholar
  • 11. Bellin, MH, Kub, J, Frick, KD, Bollinger, ME, Tsoukleris, M, Walker, et al. Stress and quality of life in caregivers of inner-city minority children with poorly controlled asthma. Journal of Pediatric Health Care 2013; 27(2), 127-134. google scholar
  • 12. Boran, P, Tokuç, G, Pişgin, B, & Öktem, S. Assessment of quality of life in asthmatic Turkish children. Turkish Journal of Pediatrics 2008; 50(1). google scholar
  • 13. Türk Toraks Derneği, astım tanı ve tedavi rehberi güncellemesi. Turkish Thoracic Journal 2016. google scholar
  • 14. Kabat-Zinn, J. Mindfulness-based interventions in context: Past, present and future. Clinical Psychology: Science and Practice 2003; 10(2), 144-156. google scholar
  • 15. Snoeren, F, & Hoefnagels, C. Measuring perceived social support and perceived stress among primary school children in the Netherlands. Child Indicators Research 2014; 7(3), 473-486. google scholar
  • 16. Oral, T & Ersan, C. Çocuklarda (8-11 yaş) Algılanan Stres Ölçeği’nin Türkçeye uyarlama çalışması. Selçuk Üniversitesi Edebiyat Fakültesi Dergisi 2017; (37), 419-428. google scholar
  • 17. Greco, L, Baer, RA, & Smith, GT. Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychological Assessment 2011; 23(3), 606-614. google scholar
  • 18. Sünbül, ZA. Psychometric evaluation of child and adolescent mindfulness measure (CAMM) with Turkish sample. Online Submission 2018; 7(2), 56-59. google scholar
  • 19. Juniper, EF, Guyatt, GH, Feeny, DH, Ferrie, PJ, Griffith, LE, & Townsend, M. Measuring quality of life in children with asthma. Quality of life research 1996; 5(1), 35-46. google scholar
  • 20. Yüksel, H, Yılmaz, O, Kırmaz, C, & Eser, E. Validity and reliability of the Turkish translation of the pediatric asthma quality of life questionnaire. The Turkish Journal of Pediatrics 2009; 51(2), 154. google scholar
  • 21. Baron, RM, & Kenny, DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology 1986; 51, 1173-1182. google scholar
  • 22. Bränström, R, Duncan, LG, & Moskowitz, JT. The association between dispositional mindfulness, psychological well-being and perceived health in a Swedish population-based sample. British Journal of Health Psychology 2011; 16(2), 300-316. google scholar
  • 23. Creswell, JD, & Lindsay, EK. How does mindfulness training affect health? A mindfulness stress buffering account. Current Directions in Psychological Science 2014; 23(6), 401-407. google scholar
  • 24. Shi, L, Liang, D, Gao, Y, Huang, J, Nolan, C, Mulvaney, A, et al. Mindfulness and asthma symptoms: A study among college students. Journal of Asthma 2018; 55(1), 101-105. google scholar
  • 25. Pbert, L, Madison, JM, Druker, S, Olendzki, N, Magner, R, Reed, G, et al. Effect of mindfulness training on asthma quality of life and lung function: A randomised controlled trial. Thorax 2012; 67(9), 769-776. google scholar
  • 26. Nadiri, M, & Khanpour, F. The effect of teaching mindfulness-based stress reduction on the quality of life of patients with asthma. Depiction of Health 2019; 10(2), 144-156. google scholar
  • 27. Delgado, LC, Guerra, P, Perakakis, P, Vera, MN, Reyes del Paso, G, & Vila, J. Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy 2010; 48(9), 873-882. google scholar
  • 28. Vlemincx, E, Vigo, D, Vansteenwegen, D, Van den Bergh, O, & Van Diest, I. Do not worry, be mindful: Effects of induced worry and mindfulness on respiratory variability in a nonanxious population. International Journal of Psychophysiology 2013; 87(2), 147-151. google scholar
  • 29. Bacon, SL, Lemiere, C, Moullec, G, Ninot, G, Pepin, V, & Lavoie, KL. Association between patterns of leisure time physical activity and asthma control in adult patients. BMJ Open Respiratory Research 2015; 2(1). google scholar
  • 30. Luria, CJ, Sitarik, AR, Havstad, S, Wegienka, GR, Kim, H, Zoratti, EM, et al. Association between asthma symptom scores and increased perceived stress and trait anxiety in asthmatic adolescents. Journal of Allergy and Clinical Immunology 2016; 137(2). google scholar
  • 31. Lewandowska, K, Specjalski, K, Jassem, E, & Stominski, JM. Style of coping with stress and emotional functioning in patients with asthma. Advances in Respiratory Medicine 2009; 77(1), 31- 36. google scholar
  • 32. Borders, A, Earleywine, M, & Jajodia, A. Could mindfulness decrease anger, hostility and aggression by decreasing rumination? Aggressive Behavior: Official Journal of the International Society for Research on Aggression 2010; 36(1), 28-44. google scholar
  • 33. Cillessen, L, van de Ven, MO, & Karremans, J. C. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma. Journal of Psychosomatic Research 2017; 99, 143-148. google scholar
  • 34. Kishore, N. The impact of severe housing stress on child asthma control and pediatric asthma caregiver quality of life (PACQOL) (Doctoral Dissertation). 2014. google scholar
  • 35. Rod, NH, Kristensen, TS, Lange, P, Prescott, E, & Diderichsen, F. Perceived stress and risk of adult-onset asthma and other atopic disorders: A longitudinal cohort study. Allergy 2012; 67(11), 14081414. google scholar
  • 36. Li, Z, Thompson, LA, Gross, HE, Shenkman, EA, Reeve, BB, DeWalt, DA, et al. Longitudinal associations among asthma control, sleep problems and health-related quality of life in children with asthma: A report from the PROMIS® pediatric asthma study. Sleep Medicine 2016; 20, 41-50. google scholar
  • 37. Haselkorn, T, Jones, CA, Chen, H, Rhoa, M, Miller, DP, Peters, SP, et al. Relationship between asthma control and activity limitation: Insights from the REACT study. Journal of Allergy and Clinical Immunology 2008; 121(2), S160. google scholar
  • 38. The Global Initiative for Asthma (GINA). A pocket guide for health professionals (Updated 2019) 2019. google scholar
  • 39. Coban, H, & Aydemir, Y. The relationship between allergy and asthma control, quality of life and emotional status in patients with asthma: A cross-sectional study. Allergy, Asthma & Clinical Immunology 2014; 10(1), 67. google scholar

Pediatrik Astımda Algılanan Stres ve Yaşam Kalitesi Arasındaki İlişkide Bilinçli Farkındalık

Year 2023, , 27 - 34, 27.03.2023
https://doi.org/10.26650/jchild.2023.875601

Abstract

Amaç: Bu çalışmanın amacı pediatrik astımda algılanan stres düzeyi ile yaşam kalitesi arasındaki ilişkide bilinçli farkındalığın olası aracı etkisini analiz etmektir. Gereç ve Yöntem: Bu çalışmanın örneklemini İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi “Çocuk Alerji Polikliniği”ne başvuran 9-12 yaş arası 100 astımlı çocuk oluşturdu. Veri toplama araçları olarak sosyodemografik bilgi formları, Çocuklarda Algılanan Stres Ölçeği (8-11 yaş) (ÇASÖ), Çocuk ve Ergen Bilinçli Farkındalık Ölçeği (ÇEBFÖ) ve Pediatrik Astım Yaşam Kalitesi Ölçeği (PAYKÖ) kullanılmıştır. Verilerin analiz edilmesi sürecinde doğrusal hiyerarşik regresyon analizi kullanılmıştır. Bulgular: Bilinçli farkındalığın, algılanan stres ile yaşam kalitesi arasındaki ilişkide kısmi medyatör etkisinin olduğu belirlenmiştir (p=0.000). Algılanan stres ile yaşam kalitesinin alt boyutu olan semptomlar arasındaki ilişkide bilinçli farkındalığın kısmi medyatör etkisinin varlığı tespit edilmiştir (p=0.000). Son olarak bilinçli farkındalığın, algılanan stres ile yaşam kalitesinin bir diğer alt boyutu olan duygusal işlev arasındaki ilişkide kısmi medyatör etkisinin olduğu gösterilmiştir (p=0.000). Bilinçli farkındalık ve yaşam kalitesinin alt boyutlarından biri olan faaliyet kısıtlanması arasında korelatif ilişki bulunmadığı için bilinçli farkındalığın algılanan stres ve yaşam kalitesi arasındaki ilişkinin üzerindeki aracı etkisi analiz edilememiştir (p=0.178). Sonuç: Bilinçli farkındalık uygulamaları içeren psikoterapi uygulamalarının çocuklarda astım tedavisine eklenmesi hastalığın daha iyi kontrol altına alınmasına yardımcı olabilir.

References

  • 1. Masoli, M, Fabian, D, Holt, S, Beasley, R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy, 2004, 59.5: 469-478. google scholar
  • 2. The Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2018 Update. google scholar
  • 3. Lai, CK, Beasley, R, Crane, J, Foliaki, S, Shah, J, Weiland, S, & ISAAC Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: phase three of the international study of asthma and allergies in childhood (ISAAC). Thorax 2009; 64(6), 476-483. google scholar
  • 4. Kurt, E, Metintas, S, Başyiğit, I, Bulut, I, Coşkun, E, Dabak, S, et al. Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children. Pediatric Allergy and Immunology 2007; 18(7), 566-574. google scholar
  • 5. Blackman, JA, & Gurka, MJ. Developmental and behavioral comorbidities of asthma in children. Journal of Developmental & Behavioral Pediatrics 2007; 28(2), 92-99. google scholar
  • 6. Grizenko, N, Osmanlliu, E, Fortier, ME, & Joober, R. Increased risk of asthma in children with ADHD: Role of prematurity and maternal stress during pregnancy. Journal of the Canadian Academy of Child and Adolescent Psychiatry 2015; 24(2), 109. google scholar
  • 7. Katon, W, Lozano, P, Russo, J, McCauley, E, Richardson, L, & Bush, T. The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared with controls. Journal of Adolescent Health 2007; 41(5), 455-463. google scholar
  • 8. Kimura, T, Yokoyama, A, Kohno, N, Nakamura, H, & Eboshida, A. Perceived stress, severity of asthma and quality of life in young adults with asthma. Allergology International 2009; 58(1), 71- 79. google scholar
  • 9. Ramratnam, S, Jaffee, K, Visness, C, & Gern, JE. (2017). Exposure to early life maternal stress and depression and risk of asthma. In C26. Asthma in infants and children. American Thoracic Society 2009; A5088-A5088. google scholar
  • 10. Rona, RJ, Smeeton, NC, Amigo, H, & Vargas, C. Do psychological distress and somatization contribute to misattribution of asthma? A Chilean study. Journal of Psychosomatic Research 2007; 62(1), 23-30. google scholar
  • 11. Bellin, MH, Kub, J, Frick, KD, Bollinger, ME, Tsoukleris, M, Walker, et al. Stress and quality of life in caregivers of inner-city minority children with poorly controlled asthma. Journal of Pediatric Health Care 2013; 27(2), 127-134. google scholar
  • 12. Boran, P, Tokuç, G, Pişgin, B, & Öktem, S. Assessment of quality of life in asthmatic Turkish children. Turkish Journal of Pediatrics 2008; 50(1). google scholar
  • 13. Türk Toraks Derneği, astım tanı ve tedavi rehberi güncellemesi. Turkish Thoracic Journal 2016. google scholar
  • 14. Kabat-Zinn, J. Mindfulness-based interventions in context: Past, present and future. Clinical Psychology: Science and Practice 2003; 10(2), 144-156. google scholar
  • 15. Snoeren, F, & Hoefnagels, C. Measuring perceived social support and perceived stress among primary school children in the Netherlands. Child Indicators Research 2014; 7(3), 473-486. google scholar
  • 16. Oral, T & Ersan, C. Çocuklarda (8-11 yaş) Algılanan Stres Ölçeği’nin Türkçeye uyarlama çalışması. Selçuk Üniversitesi Edebiyat Fakültesi Dergisi 2017; (37), 419-428. google scholar
  • 17. Greco, L, Baer, RA, & Smith, GT. Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychological Assessment 2011; 23(3), 606-614. google scholar
  • 18. Sünbül, ZA. Psychometric evaluation of child and adolescent mindfulness measure (CAMM) with Turkish sample. Online Submission 2018; 7(2), 56-59. google scholar
  • 19. Juniper, EF, Guyatt, GH, Feeny, DH, Ferrie, PJ, Griffith, LE, & Townsend, M. Measuring quality of life in children with asthma. Quality of life research 1996; 5(1), 35-46. google scholar
  • 20. Yüksel, H, Yılmaz, O, Kırmaz, C, & Eser, E. Validity and reliability of the Turkish translation of the pediatric asthma quality of life questionnaire. The Turkish Journal of Pediatrics 2009; 51(2), 154. google scholar
  • 21. Baron, RM, & Kenny, DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology 1986; 51, 1173-1182. google scholar
  • 22. Bränström, R, Duncan, LG, & Moskowitz, JT. The association between dispositional mindfulness, psychological well-being and perceived health in a Swedish population-based sample. British Journal of Health Psychology 2011; 16(2), 300-316. google scholar
  • 23. Creswell, JD, & Lindsay, EK. How does mindfulness training affect health? A mindfulness stress buffering account. Current Directions in Psychological Science 2014; 23(6), 401-407. google scholar
  • 24. Shi, L, Liang, D, Gao, Y, Huang, J, Nolan, C, Mulvaney, A, et al. Mindfulness and asthma symptoms: A study among college students. Journal of Asthma 2018; 55(1), 101-105. google scholar
  • 25. Pbert, L, Madison, JM, Druker, S, Olendzki, N, Magner, R, Reed, G, et al. Effect of mindfulness training on asthma quality of life and lung function: A randomised controlled trial. Thorax 2012; 67(9), 769-776. google scholar
  • 26. Nadiri, M, & Khanpour, F. The effect of teaching mindfulness-based stress reduction on the quality of life of patients with asthma. Depiction of Health 2019; 10(2), 144-156. google scholar
  • 27. Delgado, LC, Guerra, P, Perakakis, P, Vera, MN, Reyes del Paso, G, & Vila, J. Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy 2010; 48(9), 873-882. google scholar
  • 28. Vlemincx, E, Vigo, D, Vansteenwegen, D, Van den Bergh, O, & Van Diest, I. Do not worry, be mindful: Effects of induced worry and mindfulness on respiratory variability in a nonanxious population. International Journal of Psychophysiology 2013; 87(2), 147-151. google scholar
  • 29. Bacon, SL, Lemiere, C, Moullec, G, Ninot, G, Pepin, V, & Lavoie, KL. Association between patterns of leisure time physical activity and asthma control in adult patients. BMJ Open Respiratory Research 2015; 2(1). google scholar
  • 30. Luria, CJ, Sitarik, AR, Havstad, S, Wegienka, GR, Kim, H, Zoratti, EM, et al. Association between asthma symptom scores and increased perceived stress and trait anxiety in asthmatic adolescents. Journal of Allergy and Clinical Immunology 2016; 137(2). google scholar
  • 31. Lewandowska, K, Specjalski, K, Jassem, E, & Stominski, JM. Style of coping with stress and emotional functioning in patients with asthma. Advances in Respiratory Medicine 2009; 77(1), 31- 36. google scholar
  • 32. Borders, A, Earleywine, M, & Jajodia, A. Could mindfulness decrease anger, hostility and aggression by decreasing rumination? Aggressive Behavior: Official Journal of the International Society for Research on Aggression 2010; 36(1), 28-44. google scholar
  • 33. Cillessen, L, van de Ven, MO, & Karremans, J. C. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma. Journal of Psychosomatic Research 2017; 99, 143-148. google scholar
  • 34. Kishore, N. The impact of severe housing stress on child asthma control and pediatric asthma caregiver quality of life (PACQOL) (Doctoral Dissertation). 2014. google scholar
  • 35. Rod, NH, Kristensen, TS, Lange, P, Prescott, E, & Diderichsen, F. Perceived stress and risk of adult-onset asthma and other atopic disorders: A longitudinal cohort study. Allergy 2012; 67(11), 14081414. google scholar
  • 36. Li, Z, Thompson, LA, Gross, HE, Shenkman, EA, Reeve, BB, DeWalt, DA, et al. Longitudinal associations among asthma control, sleep problems and health-related quality of life in children with asthma: A report from the PROMIS® pediatric asthma study. Sleep Medicine 2016; 20, 41-50. google scholar
  • 37. Haselkorn, T, Jones, CA, Chen, H, Rhoa, M, Miller, DP, Peters, SP, et al. Relationship between asthma control and activity limitation: Insights from the REACT study. Journal of Allergy and Clinical Immunology 2008; 121(2), S160. google scholar
  • 38. The Global Initiative for Asthma (GINA). A pocket guide for health professionals (Updated 2019) 2019. google scholar
  • 39. Coban, H, & Aydemir, Y. The relationship between allergy and asthma control, quality of life and emotional status in patients with asthma: A cross-sectional study. Allergy, Asthma & Clinical Immunology 2014; 10(1), 67. google scholar
There are 39 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Research Articles
Authors

Ayşe Sena Ayhan 0000-0002-1192-2575

Zekeriya Deniz Aktan 0000-0003-1757-2024

Zeynep Ülker Tamay 0000-0002-3200-5493

Publication Date March 27, 2023
Published in Issue Year 2023

Cite

APA Ayhan, A. S., Aktan, Z. D., & Tamay, Z. Ü. (2023). Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma. Çocuk Dergisi, 23(1), 27-34. https://doi.org/10.26650/jchild.2023.875601
AMA Ayhan AS, Aktan ZD, Tamay ZÜ. Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma. Çocuk Dergisi. March 2023;23(1):27-34. doi:10.26650/jchild.2023.875601
Chicago Ayhan, Ayşe Sena, Zekeriya Deniz Aktan, and Zeynep Ülker Tamay. “Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma”. Çocuk Dergisi 23, no. 1 (March 2023): 27-34. https://doi.org/10.26650/jchild.2023.875601.
EndNote Ayhan AS, Aktan ZD, Tamay ZÜ (March 1, 2023) Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma. Çocuk Dergisi 23 1 27–34.
IEEE A. S. Ayhan, Z. D. Aktan, and Z. Ü. Tamay, “Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma”, Çocuk Dergisi, vol. 23, no. 1, pp. 27–34, 2023, doi: 10.26650/jchild.2023.875601.
ISNAD Ayhan, Ayşe Sena et al. “Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma”. Çocuk Dergisi 23/1 (March 2023), 27-34. https://doi.org/10.26650/jchild.2023.875601.
JAMA Ayhan AS, Aktan ZD, Tamay ZÜ. Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma. Çocuk Dergisi. 2023;23:27–34.
MLA Ayhan, Ayşe Sena et al. “Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma”. Çocuk Dergisi, vol. 23, no. 1, 2023, pp. 27-34, doi:10.26650/jchild.2023.875601.
Vancouver Ayhan AS, Aktan ZD, Tamay ZÜ. Mindfulness in the Relationship Between Perceived Stress and Quality of Life in Pediatric Asthma. Çocuk Dergisi. 2023;23(1):27-34.