Dietary management experiences and support needs of primary caregivers of children with asthma and food allergy: a qualitative descriptive study.

OBJECTIVE: Children living with both asthma and food allergy require daily management that connects respiratory symptoms, allergen avoidance, emergency preparedness, and adequate nutrition. This study aimed to explore dietary management experiences and support needs among primary caregivers of school-age children with physician-diagnosed asthma and food allergy in Deyang, China. METHODS: A qualitative descriptive design was used. Semi-structured Mandarin interviews were conducted with 24 primary caregivers, and the data were analyzed using reflexive thematic analysis. RESULTS: Four themes were developed: (1) managing "double danger" when food allergy reactions, asthma symptoms, respiratory infections, and culturally mediated food concerns overlapped; (2) building protective food routines at home, school, and social events; (3) balancing safety, nutrition, and normal childhood; and (4) needing integrated, practical, and credible support across asthma, food allergy, nutrition, school communication, and emergency planning. CONCLUSION: Caregivers' dietary work extends beyond allergen avoidance and involves ongoing risk interpretation, emotional labor, and coordination across settings. The findings support the need for clearer, family-centered counseling and school-facing tools, but do not establish the effectiveness of any specific intervention. Future intervention development should test integrated education, individualized dietary planning, and age-appropriate self-management support with caregivers, children, clinicians, dietitians, and schools.