Sulforaphane Supplementation Did Not Modulate NRF2 and NF-kB mRNA Expressions in Hemodialysis Patients.

BACKGROUND: Patients with chronic kidney disease (CKD) have reduced expression of erythroid nuclear factor-related factor 2 (NRF2) and increased nuclear factor κB (NF-κB). "Food as medicine" has been proposed as an adjuvant therapeutic alternative in modulating these factors. No studies have investigated the effects of sulforaphane (SFN) in cruciferous vegetables on the expression of these genes in patients with CKD. OBJECTIVE: The study aimed to evaluate the effects of SFN on the expression of NRF2 and NF-κB in patients on hemodialysis (HD). DESIGN AND METHODS: A randomized, double-blind, crossover study was performed on 30 patients on regular HD. Fourteen patients were randomly allocated to the intervention group (1 sachet/day of 2.5 g containing 1% SFN extract with 0.5% myrosinase) and 16 patients to the placebo group (1 sachet/day of 2.5 g containing corn starch colored with chlorophyll) for 2 months. After a washout period of 2 months, the groups were switched. NRF2 and NF-κB mRNA expression was evaluated by real-time quantitative polymerase chain reaction, and tumor necrosis factor alpha and interleukin-6 levels were quantified by enzyme-linked immunosorbent assay. Malondialdehyde was evaluated as a marker of lipid peroxidation. RESULTS: Twenty-five patients (17 women, 55 [interquartile range = 19] years and 55 [interquartile range = 74] months on HD) completed the study. There was no significant difference concerning the expression of mRNA NRF2 (P = .915) and mRNA NF-κB (P = .806) after supplementation with SFN. There was no difference in pro-inflammatory and oxidative stress biomarkers. CONCLUSION: 150 µmol of SFN for 2 months had no antioxidant and anti-inflammatory effect in patients with CKD undergoing HD.

Quality of life and family management of paediatric chronic condition amidst the COVID-19 pandemic.

PURPOSE: This study aimed to describe the perception of parents of children/adolescents with chronic conditions of their quality of life and family functioning during the COVID-19 pandemic and explore how the COVID-19 pandemic affected family management of children/adolescents' chronic conditions. DESIGN AND METHODS: A total of 237 parents of children/adolescents with chronic conditions participated in this cross-sectional study. Data were collected through an online questionnaire using the Paediatric Quality of Life Inventory™ Family Impact Module and an open-ended question about the impact of the pandemic on the family management of the paediatric chronic condition. RESULTS: The Total Score of PedsQL™ FIM was slightly higher than the midpoint of the scale (M = 60.27; SD = 19.04), and the impact of the pandemic on the family's management of the chronic condition was perceived by 30% of parents as high or moderate. Statistically significant differences were found between parents who reported a high or moderate impact of the pandemic and those reporting little or no impact of the pandemic regarding parental quality of life and family functioning (t (233) = 8.13, p = .00, Cohen's d = 1.14). Two themes emerged from the analysis of the open-ended question: Impact on the child/adolescent and Impact on the family. CONCLUSIONS: Parents of children/adolescents with chronic conditions reported an average quality of life, and the COVID-19 pandemic significantly impacted the family management of chronic conditions. PRACTICE IMPLICATIONS: These results highlight the importance of developing interventions to support families in complex situations and contexts, targeting family functioning, family quality of life, and emotional management.

Psychometric Testing of the Experience of Integrating Chronic Illness into Family Life Questionnaire.

Family members' experience of integrating chronic illnesses or chronic conditions into family life is valuable information for health care professionals, such as nurses, to understand, improve, and adjust the care provided to families of chronically ill patients. Furthermore, the assessment of the experience of integrating chronic illness into family life can support family nursing interventions and reduce suffering. This study aimed to adapt and psychometrically test a new Likert-type questionnaire on the experience of integrating pediatric chronic illness into family life (EICI-FLQ) in two European samples. A sample of 164 primary caregivers of children/adolescents with chronic illnesses/conditions in Iceland and another sample of 237 primary caregivers with children/adolescents with chronic illnesses/conditions in Portugal completed the online questionnaire. Exploratory factor analysis of the Icelandic sample yielded support for a one-factor solution with acceptable internal reliability (Cronbach's α = .866). Confirmatory factor analysis of the one-factor structure in the Portuguese sample indicated good model fit and similar internal reliability (Cronbach's α = .838). This instrument has good psychometric characteristics and is a promising tool for measuring the experience of integrating pediatric chronic illness into family life in clinical and research settings.

Cross-Cultural Adaptation and Psychometric Testing of the Portuguese Version of the Iceland-Family Illness Beliefs Questionnaire.

Illness beliefs have a role in the adaptation, coping, well-being, healing, and recovery in families of children/adolescents with chronic illness. The assessment of family illness beliefs can support family nursing interventions that address the suffering of family members when illness arises. The purpose of this study was to translate, cross-culturally adapt, and psychometrically test the Portuguese version of the Iceland-Family Illness Beliefs Questionnaire. A sample of 237 parents of children/adolescents who experienced chronic health conditions completed the online questionnaire. The original factor model was tested through confirmatory factorial analysis. The results showed satisfactory model fit indices (χ2/gl = 3.004; comparative fit index [CFI] = 0.90; root mean square error of approximation [RMSEA] = 0.092) and internal consistency (Cronbach's α = 0.74). The instrument showed good psychometric characteristics of validity and reliability, suggesting it may be useful in the assessment of illness beliefs in families experiencing a pediatric chronic illness.

The magical smell and taste: Can coffee be good to patients with cardiometabolic disease?

Coffee is a beverage consumed globally. Although few studies have indicated adverse effects, it is typically a beneficial health-promoting agent in a range of diseases, including depression, diabetes, cardiovascular disease, and obesity. Coffee is rich in caffeine, antioxidants, and phenolic compounds, which can modulate the composition of the gut microbiota and mitigate both inflammation and oxidative stress, common features of the burden of lifestyle diseases. This review will discuss the possible benefits of coffee on complications present in patients with diabetes, cardiovascular disease and chronic kidney disease, outwith the social and emotional benefits attributed to caffeine consumption.

Sudden death in paediatrics as a traumatic experience for critical care nurses.

BACKGROUND: Research shows that nurses working in critical care units and in particular, paediatric units, are at risk of developing symptoms of secondary traumatic stress (STS). However, little attention has been given to this phenomenon when associated with situations of sudden death in paediatrics. AIM: This study aimed to examine the impact of sudden death in paediatrics on nurses working in paediatrics critical care units and to explore nurses' experiences of this event. METHODS: This study used a mixed-methods design. The Impact of Event Scale - Revised was used for investigating the presence of STS symptoms. In addition, an interview was conducted with six nurses. RESULTS: Fifty-seven percent of nurses responded to the surveys and six nurses were interviewed. The results showed that the sudden death of children and adolescents is an event that elicits symptoms of STS in nurses. The quantitative assessment, revealed that 19·4% presented total scores indicating high impact. The participants interviewed described experiences of subjective distress, such as intrusive thoughts, avoidance and hyperarousal. Other factors were also reported as influencing the experience of the sudden death of a child/adolescent, namely, the child's age, the cause of death and the family's reaction to the loss. According to the participants, the emotional impact was also determined by parenthood, previous training and professional experience. CONCLUSIONS: Sudden death in paediatric critical care units is one of the most difficult situations in nursing practice and elicits STS symptoms, which may severely impact the physical and psychological health of nurses and ultimately affect the quality of the provided care. RELEVANCE FOR CLINICAL PRACTICE: This study emphasizes the need for promoting better conditions for professional practice, namely, with regard to emotional support, as well as training programmes for skills development in the area of management of traumatic situations and of communication with clients.

How chronic disease affects children's views on being ill and healthy: a comparative study.

BACKGROUND: Understanding children's views of illness and health is vital to a child-centred approach in patient education and care. Paediatric healthcare providers should incorporate children's views of health and illness to enable children and their families to participate in self-management plans and achieve better health outcomes. However, there is limited scientific knowledge regarding the views of children with specific diseases. METHOD: This comparative study investigated whether and in what ways the experience of having different chronic diseases influenced children's views of being ill and healthy. The participants were 82 children aged 8-13 years diagnosed with a chronic disease (31 had asthma, 27 had diabetes and 24 had cancer). A group of 81 healthy children participated as a comparison group. The 'draw-and-write' technique was used to collect the children's views, and the data were analysed using a previously validated coding system (inter-rater agreement of 93%) and subsequently quantified for the examination of any differences in relation to illness. RESULTS: Statistically significant differences were found in all dimensions of the children's conceptions of health and illness according to whether they had a chronic condition (effect sizes calculated with Cohen's d ranged from 0.35 to 1.22). Globally, the chronically ill children expressed a narrower definition of being healthy and ill than their healthy peers. Moreover, the comparison among the children with asthma, diabetes and cancer showed differences that seemed to reflect their specific experiences with their type of chronic disease and the associated treatments (effect sizes calculated with Eta-squared ranged from 0.07 to 0.25). CONCLUSIONS: This study's findings can be used to guide education and clinical services tailored to ill children suffering from different chronic conditions.

Monitoring Patient-Reported Outcomes in Self-management of Postsurgical Symptoms in Oncology: A Scoping Review.

BACKGROUND: Surgery is used widely for cancer treatment, and in most types, after discharge, patients usually report multiple symptoms, which, if not controlled, can put postoperative recovery at risk. Understanding which patient-reported outcomes (PROs) should be monitored could have a significant impact on reducing the symptom burden associated with cancer and its treatment by playing a pivotal role in developing symptom self-management plans and designing tailored approaches to optimize patients' symptom self-management behaviors. OBJECTIVE: To map the PROs used for patients' postsurgical symptom self-management after hospital discharge following cancer surgery. INTERVENTIONS/METHODS: Our scoping review process was guided by the steps for conducting scoping reviews recommended by the Joanna Briggs Institute. RESULTS: The search identified 97 potentially relevant studies, with 27 articles meeting the inclusion criteria. The most frequently assessed and monitored PROs were problems with surgical wounds, more general physical symptoms, psychological functioning outcomes, and quality of life. CONCLUSIONS: Our results showed an overall uniformity among the PROs selected to be monitored in surgical cancer patients after hospital discharge. Monitoring through electronic platforms is widely used and seems useful to self-manage symptoms and optimize the recovery of cancer patients after discharge following surgery. IMPLICATIONS FOR PRACTICE: This study provides knowledge about PROs that can be applied in oncologic patients after surgery to self-report their symptoms following discharge.

Understanding quality of life's challenges in sarcoma patients: A mixed-methods study.

PURPOSE: Sarcoma, a highly aggressive form of cancer, profoundly affects patients both physically and psychologically. This study aimed to assess sarcoma patients' health-related quality of life and explore their experiences of living with the disease and their specific care requirements. METHODS: This research employed a convergent parallel mixed-methods design. Fifty-two sarcoma patients completed the European Portuguese version of the EORTC QLQ-C30 questionnaire, and seven of them participated in semi-structured interviews. Descriptive measures, Cronbach alpha for internal consistency, t-teste-Anova and stepwise regression were employed in the quantitative analysis. Qualitative data was analysed thematically. RESULTS: The most affected Quality of life (QoL) dimensions were role functioning and global health, areas of functioning that were also described as impacted in patients' experiences. Symptoms like insomnia, pain, and fatigue were frequently reported. Symptoms such as fatigue, pain, and financial difficulty explain QoL variance. No significant differences in QoL were found according to the different forms of treatment. Analysis of the interviews revealed three overarching themes: (1) disruption of daily life, (2) adaptation to life with sarcoma, and (3) the demand for more personalized care, allowing to gain a deeper understanding of living with sarcoma. CONCLUSION: The results underscore the significance of delivering care that enhances the quality of life for sarcoma patients, addressing both their physical and psychosocial needs, and providing personalized support throughout all stages of the disease.

Production of Toxins by the Gut Microbiota: The Role of Dietary Protein.

PURPOSE OF REVIEW: This narrative review will discuss how the intake of specific protein sources (animal and vegetable) providing specific amino acids can modulate the gut microbiota composition and generate toxins. A better understanding of these interactions could lead to more appropriate dietary recommendations to improve gut health and mitigate the risk of complications promoted by the toxic metabolites formed by the gut microbiota. RECENT FINDINGS: Gut microbiota is vital in maintaining human health by influencing immune function and key metabolic pathways. Under unfavorable conditions, the gut microbiota can produce excess toxins, which contribute to inflammation and the breakdown of the integrity of the intestinal barrier. Genetic and environmental factors influence gut microbiota diversity, with diet playing a crucial role. Emerging evidence indicates that the gut microbiota significantly metabolizes amino acids from dietary proteins, producing various metabolites with beneficial and harmful effects. Amino acids such as choline, betaine, l-carnitine, tyrosine, phenylalanine, and tryptophan can increase the production of uremic toxins when metabolized by intestinal bacteria. The type of food source that provides these amino acids affects the production of toxins. Plant-based diets and dietary fiber are associated with lower toxin formation than animal-based diets due to the high amino acid precursors in animal proteins.

Amazonian Fruits for Treatment of Non-Communicable Diseases.

PURPOSE OF REVIEW: The Amazon region has a high biodiversity of flora, with an elevated variety of fruits, such as Camu-Camu (Myrciaria dúbia), Açaí (Euterpe oleracea Mart.), Tucumã (Astrocaryum aculeatum and Astrocaryum vulgare), Fruta-do-conde (Annona squamosa L.), Cupuaçu (Theobroma grandiflorum), Graviola (Annona muricata L.), Guarana (Paullinia cupana Kunth var. sorbilis), and Pitanga (Eugenia uniflora), among many others, that are rich in phytochemicals, minerals and vitamins with prominent antioxidant and anti-inflammatory potential. RECENT FINDINGS: Studies evaluating the chemical composition of these fruits have observed a high content of nutrients and bioactive compounds. Such components are associated with significant biological effects in treating various non-communicable diseases (NCDs) and related complications. Regular intake of these fruits from Amazonas emerges as a potential therapeutic approach to preventing and treating NCDs as a nutritional strategy to reduce the incidence or mitigate common complications in these patients, which are the leading global causes of death. As studies remain largely unexplored, this narrative review discusses the possible health-beneficial effects for patients with NCDs.

Older person's experience of PT4Ageing-A programme on self-management «support¼ in chronic illness.

OBJECTIVE: This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program. METHODS: The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis. RESULTS: Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention. CONCLUSION: The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.

Psychometric properties of the European Portuguese version of the Pediatric Quality of Life Inventory™ family impact module.

PURPOSE: This study aims to assess the psychometric properties of the European Portuguese version of the Pediatric Quality of Life Inventory™ Family Impact Module in parents of children/adolescents with chronic health conditions. DESIGN AND METHODS: The European Portuguese version of the Pediatric Quality of Life Inventory™ Family Impact Module was administered to 237 parents of children/adolescents with chronic disease and/or chronic disorder. Participants were recruited from the day hospital and/or outpatient services of four hospitals in Northern Portugal, the majority being mothers (87.3%) aged between 31 and 50 years (86.9%). The questionnaire was administered online through the REDCap platform. The hierarchical factor model of the Pediatric Quality of Life Inventory™ Family Impact Module proposed by Varni and colleagues was tested. RESULTS: Confirmatory Factor Analysis indicated good model fit, with the following indices (χ2 /gL = 2.19; comparative fit index [CFI] = 0.90;  root mean square error of approximation [RMSEA] = 0.07 immune cell [IC] 90% = 0.06-0.07). Internal consistency values were high (parent quality of life subtotal, α = .96; family functioning subtotal, α = .92; total score, α = .96). PRACTICE IMPLICATIONS: The European Portuguese version of the PedsQL™ FIM is a reliable and valid measurement tool for nurses to assess the impact of the child/adolescent chronic conditions on family's quality of life and to develop interventions to improve their well-being.

Royal jelly: a predictive, preventive and personalised strategy for novel treatment options in non-communicable diseases.

Royal jelly (RJ) is a bee product produced by young adult worker bees, composed of water, proteins, carbohydrates and lipids, rich in bioactive components with therapeutic properties, such as free fatty acids, mainly 10-hydroxy-trans-2-decenoic acid (10-H2DA) and 10-hydroxydecanoic acid (10-HDA), and major royal jelly proteins (MRJPs), as well as flavonoids, most flavones and flavonols, hormones, vitamins and minerals. In vitro, non-clinical and clinical studies have confirmed its vital role as an antioxidant and anti-inflammatory. This narrative review discusses the possible effects of royal jelly on preventing common complications of non-communicable diseases (NCDs), such as inflammation, oxidative stress and intestinal dysbiosis, from the viewpoint of predictive, preventive and personalised medicine (PPPM/3PM). It is concluded that RJ, predictively, can be used as a non-pharmacological therapy to prevent and mitigate complications related to NCDs, and the treatment must be personalised.

Cardiovascular autonomic modulation during passive heating protocols: a systematic review.

Objective.To conduct a systematic review of the possible effects of passive heating protocols on cardiovascular autonomic control in healthy individuals.Approach.The studies were obtained from MEDLINE (PubMed), LILACS (BVS), EUROPE PMC (PMC), and SCOPUS databases, simultaneously. Studies were considered eligible if they employed passive heating protocols and investigated cardiovascular autonomic control by spontaneous methods, such as heart rate variability (HRV), systolic blood pressure variability (SBPV), and baroreflex sensitivity (BRS), in healthy adults. The revised Cochrane risk-of-bias tool (RoB-2) was used to assess the risk of bias in each study.Main results.Twenty-seven studies were included in the qualitative synthesis. Whole-body heating protocols caused a reduction in cardiac vagal modulation in 14 studies, and two studies reported both increased sympathetic modulation and vagal withdrawal. Contrariwise, local-heating protocols and sauna bathing seem to increase cardiac vagal modulation. A reduction of BRS was reported in most of the studies that used whole-body heating protocols. However, heating effects on BRS remain controversial due to methodological differences among baroreflex analysis and heating protocols.Significance.Whole-body heat stress may increase sympathetic and reduce vagal modulation to the heart in healthy adults. On the other hand, local-heating therapy and sauna bathing seem to increase cardiac vagal modulation, opposing sympathetic modulation. Nonetheless, further studies should investigate acute and chronic effects of thermal therapy on cardiovascular autonomic control.

Psychometric Properties of the Portuguese Version of the Iceland-Family Perceived Support Questionnaire in Parents of Children and Adolescents with Chronic Condition.

The support from nurses perceived by family members of children with chronic conditions has been shown to be a protective factor at different levels in a family's health. As such, nurses need to have instruments that assess this perception to increase the quality of the care provided to those families. This methodological study aimed to analyze the psychometric properties of the Portuguese translation of the Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) in parents of children/adolescents with chronic conditions. The ICE-FPSQ was administered to 237 parents recruited from the day hospital and outpatient services of four hospitals in Northern Portugal. Cronbach's alpha reliability coefficients for the Total Scale, Cognitive Support, and Emotional Support subscales were excellent (α = 0.96, α = 0.93, α = 0.96, respectively). Reasonable fit indexes were found by confirmatory factor analysis (χ2/df = 2.799; CFI = 0.960; PCFI = 0.791, and RMSEA = 0.087), indicating a good model fit to the original structure. The ICE-FPSQ is a valid and reliable instrument to measure perceived support.

Are home-based exercises effective to reduce blood pressure in hypertensive adults? A systematic review.

Sedentarism and chronic non-communicable diseases have been a worldwide health problem that is drastically exacerbated by the COVID-19 pandemic social impacts. Home-based exercises are widely encouraged during social isolation to counterbalance the physical inactive impacts. Although, in the context of hypertension, are home-based exercises effective in blood pressure controlling? Our objective is to conduct a systematic review of high-quality controlled trials comparing the possible effects of different types of home-based exercises in hypertensive patients. The literature search was carried out in three scientific databases: Medline, Europe PMC, and Lilacs. Articles were included following three criteria: analyzing the effect of home-based exercise programs on blood pressure in treated and untreated hypertensive patients; exercises must perform at home and on the frequency, intensity, time, and type (FITT) principle, and the articles were published in English. From the qualitative analysis of 27 original trials screened through 451 identified studies, the main results are the following: 1) both endurance, isometric strength, and respiratory home-based exercise programs were efficient to decrease blood pressure in hypertensive patients; 2) differences in methodological approaches regarding FITT components, distinct blood pressure values at baseline and specific underlying mechanisms must be considered as a potential bias of each home-based interventions. In conclusion, endurance, isometric strength, and breathing home-based programs seems to be effective to reduce blood pressure in hypertensive patients. However, further randomized controlled trials and mechanistic studies must be performing to guide evidence-based recommendations of home-based exercises as antihypertensive therapy.

Patient-Reported Outcomes in Sarcoma: A scoping review.

PURPOSE: Sarcoma is a heterogeneous group of tumours, usually affecting young patients and related to both endogenous and exogenous risk factors. The importance of obtaining the patient's perspective of the illness experience is imperative. Patient-reported outcomes (PROs) are the outcomes that come directly from the patient. They include symptoms, functional health, well-being, quality of life, psychological issues, among other indicators reported by the patients. The objective of this scoping review was to map the PROs in sarcoma patients and how they are measured. METHODS: The review process was guided by the Joanna Briggs Institute (JBI) checklist for scoping reviews. RESULTS: The search identified 116 potentially relevant studies, with 27 articles meeting the inclusion criteria. The most common PRO evaluated in the selected studies were health-related quality of life (HRQoL), followed by functional outcome, aspects of mental health, and specific symptoms. Generic HRQoL questionnaires were widely used. Quantitative studies usually applied more than one type of Patient-Reported Outcome Measures (PROMs) to measure different PROs. CONCLUSIONS: PROs should be carefully analysed to better understand the sarcoma patient's needs. The PROMs used in the selected studies about sarcoma were not specific to sarcoma, therefore, to better reflect on the perceptions of sarcoma patients, a different new and specific measurement strategy should be considered.

Opuntia ficus-indica is an excellent eco-friendly biosorbent for the removal of chromium in leather industry effluents.

In Brazil, the leather industry is an important economic segment moving around U$ 3 billions of dollars a year. However, high amounts of water are requested to transform skin animals into leather, causing high wastewater amounts to be consequently produced. A major problem is attached to the presence of chromium in the wastewater from the tanning process. Chromium is a heavy metal potentially toxic both to the environment and to the human health. In order to control the levels of chrome dumped into the environment, Brazilian agencies require the treatment of effluents by the generating source. Thus, this study aimed to develop an alternative method to the removal of chromium in wastewater from the leather industry using the Opuntia ficus-indica biomass as eco-friendly biosorbent. Crude waste samples were collected in a tannery stabilization pond for chromium quantification and further treatments. The powdered Opuntia ficus-indica was obtained from species collected in Pernambuco, Brazil, and its physical parameters and pHPCZ were characterized. Adsorptions studies and acute toxicity were also carried out. The biomass remaining after the sorption was analyzed through scanning electron microscopy and Fourier-transform infrared spectroscopy. The chromium content was above the limit allowed by the Brazilian regulatory agency. In sorption studies, biomass was able to remove 74.8% and 84.88% of Cr (III) using 2.0 g and 4.0 g of biomass, respectively. The surface of biomass is very favorable to biosorption and the chemical bindings among oxygen atoms present in the chemical components of this biomass and the heavy metal was confirmed through infrared spectrum. This study proved that Opuntia ficus-indica is effectively biosorbent to chromium, promising and with low costs for the leather industry, able to reduce its ecotoxicity as proven by chemical and biological assays.

The psychological adjustment of children with asthma: study of associated variables.

As part of a larger research project aimed to understand the impact of asthma in the psychological adjustment of children, this study focuses in the identification of factors associated with this process. The sample of this study consisted of 89 children, aged 8 to 12 with physician diagnosed asthma. To assess children's adjustment, the Portuguese versions of the following instruments were used: School-age Temperament Inventory (McClowry, 1995) Schoolagers Coping Strategies Inventory (Ryan-Wenger, 1990); Pediatric Quality of Life Inventory - PedsQL (Varni, Seid & Kurtin, 2001); The Self-perception Profile for Children (Harter, 1985), Child Behavior Checklist (Achenbach, 1991); Social Skills Rating System (Gresham & Elliot, 1990). The results revealed that negative reactivity predicts the level of anxiety/depression, task persistence and perceived coping efficacy predicts social skills and that self-esteem is a significant predictor of the perceived quality of life. A significant proportion of shared variance was also found what seems to confirm the existence of multi-determination in the process of adjustment. The main conclusion is that two dimensions of temperament (negative reactivity and task persistence), as well as perceived coping efficacy and self-esteem, play a significant role in influencing the psychological adjustment of children with asthma.