Bridging the Gap Between Doctors' and Patients' Expectations of Asthma Management

Sawyer, Susan Μ; Fardy, H John

doi:10.1081/jas-120017983

Cited by 49 publications

(43 citation statements)

References 13 publications

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“…5 However, it has specific benefits for children with asthma, including reduced hospital admissions, reduced school absenteeism, fewer consultations with GPs, reduced medication, 6 and improved ability to cope with asthma. 7 Despite these benefits, rates of physical activity among young people with asthma are lower than their nonasthmatic peers, [8][9][10][11][12] and are continuing to decline as rates fall more generally among young people in most industrialised nations. 13,14 Three interconnected factors affect participation in physical activity by children with asthma: the illness beliefs of young people; 15,16 parental and family beliefs; 9,17 and the knowledge of teachers and organisational arrangements in schools.…”

Section: Introductionmentioning

confidence: 99%

Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs

Williams¹,

Hoskins

Pow

et al. 2010

Br J Gen Pract

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Background: Research shows that children are insufficiently active in most affluent societies. Although children with asthma may particularly benefit from physical activity, they are less active than their peers. Aim: To explore the reasons for low physical activity levels among children with asthma and to identify strategies to improve activity. Design of study: A qualitative study using in-depth interviews and focus groups. Setting: Six GP practices, a Paediatric Respiratory Unit, and four schools in Tayside, Scotland. Method: Purposive sampling identified 30 children with asthma, their parents (n = 38) and school staff (n = 28), who were interviewed or took part in focus groups. Data were examined using constant comparative analysis. Results: The lower level of activity among children with asthma was supported by a climate of fear among parents and teachers about what was safe and possible for the child. Restrictions were imposed because of perceived dangers of exercising in the presence of 'triggers'. Physical activity was regarded as a threat to be managed rather than something beneficial. Teachers found it difficult to distinguish between children who were physically incapable of exercise due to asthma and those who were unmotivated. GPs were unknowingly drawn into the controversy by children and parents who cite medical advice to sanction exemption from exercise. Conclusion: GPs and asthma nurses need to provide clear management plans explaining what is appropriate and safe in terms of exercise on a child-by-child basis, to counter the considerable misunderstanding and disagreement among children, parents, and teachers

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Section: Introductionmentioning

confidence: 99%

Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs

Williams¹,

Hoskins

Pow

et al. 2010

Br J Gen Pract

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“…GINA guidelines state that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be maintained.'' However, despite the availability of guidelines, a substantial proportion of adults as well as children with asthma is not optimally controlled [6][7][8][9][10].…”

mentioning

confidence: 99%

Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

et al. 2011

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Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children.145 children with asthma filled in a web-based daily diary card for 4 weeks on symptoms, use of rescue medication and limitations of activities, followed by either the C-ACT or ACT. For predicting uncontrolled asthma, score cut-off points of 19 were used for C-ACT and ACT.According to GINA guidelines, asthma was uncontrolled in 71 (51%) children and completely controlled in 19 (14%) children. The area under the curve in the receiver operating characteristic curves for C-ACT and ACT versus GINA guidelines were 0.89 and 0.92, respectively. Cut-off points of 19 for C-ACT and ACT resulted in a sensitivity of 33% and 66% in predicting uncontrolled asthma, respectively.C-ACT and ACT correlate well with GINA criteria in predicting uncontrolled asthma, but commonly used cut-off points for C-ACT and ACT seem to underestimate the proportion of children with uncontrolled asthma as defined by GINA.

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“…35 In the Living with Asthma Study performed in Australia, one in five children with asthma did not ride a bike, play at school or play with animals, and one in three did not participate in organised sports. 36 The study also reported that parents of children with asthma were more anxious than parents of children who did not have asthma. In a UK study of children with asthma aged between 5 and 17 years, children reported that asthma restricted their participation in everyday activities and caused frequent school absences and night disturbances.…”

Section: Impact Of Asthma On Health-related Quality Of Life In Childrenmentioning

confidence: 82%

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta 2 agonists for the treatment of chronic asthma in children under the age of 12 years

2009

Clinical Governance: An International Journal

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Bridging the Gap Between Doctors' and Patients' Expectations of Asthma Management

Cited by 49 publications

References 13 publications

Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs

Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs

Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta 2 agonists for the treatment of chronic asthma in children under the age of 12 years

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