Perceptions and Practices of Adults With Asthma

Abstract

This article describes a qualitative study that investigated the experiences, attitudes, and opinions of adults with asthma regarding self-managing their disease. Focus groups were conducted with 22 adults living in metropolitan and regional New South Wales, Australia. Key findings were that the perceived stigma of asthma, the need for social support, and the need for "asthma-friendly general practitioners" concerned participants more than formal self-management procedures such as written Asthma Action Plans and medication regimes. Social cognitive theory was used to explain the fluid relationship between persons with asthma, their environment, and their behavior in relation to self-management strategies and in identifying patient-centered approaches. This qualitative research suggests that asthma is viewed as a specific, individualized condition best managed from the perspective of patients' disease experience and environmental context and not one that is appropriately represented by collective, generic self-management recommendations. The authors' findings suggest that self-management outcomes can be improved by recognizing the variance in self-efficacy levels between individuals and tailoring environmental and social support strategies around these. Abstract:This article describes a qualitative study that investigated the experiences, attitudes and opinions of adults with asthma regarding self managing their disease. Focus groups were conducted with 22 adults living in metropolitan and regional New South Wales, Australia.Key findings were that the perceived stigma of asthma, the need for social support and the need for "asthma-friendly general practitioners" concerned participants more than formal self-management procedures such as written Asthma Action Plans and medication regimes.Social cognitive theory was used to explain the fluid relationship between persons with asthma, their environment, and their behavior in relation to self-management strategies and in identifying patient-centered approaches. This qualitative research suggests that asthma is viewed as a specific, individualized condition best managed from the perspective of patients' disease experience and environmental context and not one that is appropriately represented by collective, generic self-management recommendations. The authors' findings suggest that self-management outcomes can be improved by recognizing the variance in self-efficacy levels between individuals and tailoring environmental and social support strategies around these.2

Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views

“…75 Data collection methods primarily comprised interviews ( n = 35) 23 – 26 , 29 , 30 , 35 – 38 , 41 , 44 – 53 , 55 – 58 , 60 – 62 , 64 – 66 , 68 , 72 , 74 , 75 and focus groups ( n = 21). 11 , 22 , 28 , 31 , 33 , 34 , 39 , 40 , 42 , 43 , 45 – 47 , 58 , 59 , 63 , 67 , 69 – 71 , 73 A few alternative methods were also used: diary or journal data ( n = 2), 21 , 27 online free text responses ( n = 1), 54 and the recording of clinical consultations ( n = 1). 32 The following groups of participants were studied: adults with asthma ( n = 25), 21 – 25 , 32 , 35 , 38 – 41 , 43 , 44 , 49 , 50 , 54 – 57 , 59 – 63 , 73 children, adolescents and/or carers ( n = 29), 11 , 26 – 31 , 33 ,…”

“… 11 , 22 , 28 , 31 , 33 , 34 , 39 , 40 , 42 , 43 , 45 – 47 , 58 , 59 , 63 , 67 , 69 – 71 , 73 A few alternative methods were also used: diary or journal data ( n = 2), 21 , 27 online free text responses ( n = 1), 54 and the recording of clinical consultations ( n = 1). 32 The following groups of participants were studied: adults with asthma ( n = 25), 21 – 25 , 32 , 35 , 38 – 41 , 43 , 44 , 49 , 50 , 54 – 57 , 59 – 63 , 73 children, adolescents and/or carers ( n = 29), 11 , 26 – 31 , 33 , 34 , 36 , 37 , 39 , 42 , 47 , 48 , 51 – 53 , 62 , 64 – 68 , 70 – 72 , 74 , 75 healthcare professionals ( n = 9), 11 , 31 , 32 , 39 , 46 , …”

“… • Patients who have a mutually trusting relationship with their HCP have confidence in their own understanding of asthma, avoid ED re-attendance 44 , and are more likely to adhere to SM advice 61 (P). • Patients want GPs to take an interest in them and try to understand their experience 38 , 54 , 59 (P). Some GPs need to learn about patients’ personal circumstances by listening to the patient, in order to develop a relationship and improve medication taking behaviour 21 , 62 (P/ R).…”

“… • Patient advocates can sometimes facilitate communication through interactions with patients 21 (P). • Some HCPs aim to be empathic, non-judgmental and open; putting themselves in the patient’s shoes 63 (HCP) Continuity and consistency of care • There is a perceived need for continuity of care to avoid patient and carer frustration and assessment difficulties for clinicians and to develop an effective patient-GP partnership 22 , 24 , 29 , 34 , 59 (P/Ca). • HCPs do not always give consistent advice regarding treatment decisions, and are not always consistent in tailoring medication to the patients’ or carer’s routines 24 , 74 (P/Ca).…”

AsthmaWise – a field of dreams? The results of an online education program targeting older adults with asthma

“…Such customisation would allow the program to provide dynamic, individualised care, which can adapt both to the users' disease experience and their environment thereby reinforcing findings both from the development of AsthmaWise and other studies (64,65).…”