Urban American Indian family caregivers' perceptions of barriers to management of childhood asthma

Abstract

American Indian family caregivers of children with asthma face numerous barriers to effective management of the illness. The purpose of this qualitative, community-based study is to identify those barriers as perceived by family caregivers in a large Midwestern city. An ecological perspective and principles of family-centered care provided the theoretical orientation for the study. Interviews were conducted with 16 urban Ojibwe family caregivers of children with asthma. Five categories of barriers characterize the families' experiences: provider (individual and system), condition-related, family caregiver, socioeconomic, and environmental. Examination of these findings suggests directions for improving care to American Indian children with asthma and their families.

Family-Centered Pediatric Nursing Care: State of the Science

“…In both studies, families thought they were not respected or understood and believed they were treated less well because of their cultural background (Garwick, Jennings, & Theisen, 2002; Rose & Garwick, 2003). Differences in perceived provision of FCC were also found in a study of parents of hospitalized children (Young et al, 2006b).…”

“…There is evidence in these studies that there are differences in perceived provision of FCC based on culture (Galvin et al, 2000; Garwick et al, 2002; Rose & Garwick, 2003) and age of the child (Young et al, 2006b). These differences are supported in the non-nursing literature.…”

A Grounded Theory of the Process of Adherence to Oral Chemotherapy in Hispanic and Caucasian Children and Adolescents With Acute Lymphoblastic Leukemia

“…Numerous factors have been shown to adversely influence adherence, including increased complexity of the medication regimen (McDonald, Garg, & Haynes, 2002), longer duration of therapy (Haynes, McDonald, & Garg, 2002), unpleasant medication side effects (Partridge, Avorn, Wang, & Winer, 2002), and impaired cognitive functioning (Logan, Zelikovsky, Labay, & Spergel, 2003). Additional factors that influence adherence include health beliefs (Elliott, Morgan, Day, Mollerup, & Wang, 2001), family structure and dynamics (Fiese & Everhart, 2006; Gayer & Ganong, 2006; Leonard, Garwick, & Adwan, 2005), socioeconomic status (Blais, Beauchesne, & Levesque, 2006), cultural beliefs and practices (Rose & Garwick, 2003; Sidelinger et al, 2005), and communication with and trust in health care providers (Dimatteo, 2004).…”

Effect of an Asthma Question Prompt List and Video Intervention on Adolescents’ Medication Adherence 12 Months Later

“…Other common barriers to asthma treatment in disadvantaged families can include lack of access, especially for uninsured families and skepticism about the safety of regular use of controller medications, leading to preference for alternative medicine or nonmedicinal treatment options. 32,33,35 Providers should be aware of these family dynamics and health beliefs and be prepared to recommend strategies to overcome them, especially in disadvantaged families who may feel that they have other priorities that interfere with taking controller medications every day.…”