What are the perceived influences on asthma self-management at the workplace? A qualitative study

Heinrichs, Katherina; Vu-Eickmann, Patricia; Hummel, S; Gholami, Jalal; Loerbroks, Adrian

doi:10.1136/bmjopen-2018-022126

Cited by 13 publications

(32 citation statements)

References 29 publications

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“…Prior to the study, a topic guide was developed by Adrian Loerbroks (AL) and Thomas Muth (TM) and two medical students (SS and CB) to facilitate focus group discussions (the topic guide can be found in Additional file 1). AL and TM have a vast knowledge of the current stress literature, are experienced in qualitative research [26, 27], and are teaching staff of the medical school. Furthermore, TM has close contact with medical students in his role as coordinator and contact person for elective courses at our institute.…”

Section: Methodsmentioning

confidence: 99%

Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study

et al. 2019

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Background: Prior evidence suggests that medical students' mental health is poor and deteriorates during the course of academic studies. This qualitative study therefore aims to improve our understanding of medical students' perceptions of i) stressors related to their academic studies, ii) resources that may facilitate coping with those stressors and iii) suggestions to potentially reduce stress. Methods: Eight focus groups were conducted with medical students enrolled at a medical school in Germany until thematic saturation was reached. A topic guide was used to facilitate the discussion. Subsequently, focus group discussions were transcribed and content-analyzed using MaxQDA. Results: Organizational factors especially related to inadequate information flow as well as exams (e.g. repeat exams, scheduling, perceived unfair grading), poor theoretical and practical teaching quality, time and performance pressure, social interactions and individual characteristics (e.g. self-expectations, fear of failure) emerged as major contributors to stress. Resources perceived to facilitate coping with those stressors pertained to some other organizational aspects (e.g. flexibility, availability of contact persons), career prospects, practical training, social support, personal characteristics (e.g. knowledge base, past experience) and leisure time. Suggestions for improvement related primarily to organizational measures rather than individual-level measures. Conclusions: Besides well-known stressors (e.g. exams and high performance pressure), some new aspects emerged from our study including stress related to organizational factors and repeat exams. Accordingly, students' wishes for organizational-level interventions, including better information systems and better interweaving of practical and theoretical education, could be first target areas for improvement.

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Section: Methodsmentioning

confidence: 99%

Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study

et al. 2019

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“…During analysis these categories were further broken down into sub-categories by inductive category formation. After MD completed the first coding round of 25% of the data, AL, an experienced qualitative researcher [29,30,32,33], reviewed the coding scheme. The coding scheme was then adapted and a second coding round was performed by MD.…”

Section: Discussionmentioning

confidence: 99%

Students’ perspectives on interventions to reduce stress in medical school: A qualitative study

et al. 2020

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The mental health of medical students remains to be a matter of concern. Numerous setting-based and individual-based interventions for student mental health have been proposed in the literature. However, the student perspective on those interventions has been largely neglected. This study aims to explore how medical students perceive different interventions and if they desire any additional changes with regard to their studies. Eight focus groups with 71 participants were conducted at a large German medical school. Focus groups were recorded, transcribed and content-analyzed using MAXQDA 18. We found that medical students prefer setting-based interventions. Most proposed interventions were on a setting-based level. For instance, students asked for more information on the university's psychosocial counseling services and for better information management regarding contact persons. Interventions proposed in the literature received mixed reactions: Several participants did not favour a pass/fail grading system. Students considered a peer-to-peer mentoring program for freshmen very helpful. Students had diverse attitudes towards Balint groups. They approved of several self-management courses, most of them being related to time or stress management. Interestingly, the most urgently wanted interventions appear to be rather easy to implement (e.g. a mentoring program). This study explored the medical student perspective on student mental health interventions. Additionally, our study illustrates the benefit and feasibility of involving students early on in the conception of interventions. Further research with a representative sample is needed to obtain broader information on the acceptance of the suggested interventions.

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“…Effective asthma self‐management behaviour (SMB)—e.g., symptom prevention or acute symptom management [1 ]—can improve the control of asthma and its prognosis [2 ]. The actual implementation of SMB is partially determined by contextual factors [1 ], e.g., by the working conditions employees with asthma are exposed to [3 ].…”

Section: Introductionmentioning

confidence: 99%

“…A qualitative interview study among employees with asthma suggested that two specific elements of well‐established work stress models play a crucial role in the effective implementation of asthma SMB at work [3 ]: job decision latitude (JDL; i.e., the control over one's tasks and when and how to complete them [4, 5 ]) and social support by colleagues and line‐managers [6–8 ]. The two factors subjectively related to different domains of asthma SMB: high JDL seemed to promote symptom prevention, symptom monitoring, and acute symptom management, whereas support was perceived to facilitate symptom prevention, acute symptom management and communication (e.g., self‐disclosure of one's condition) [3 ].…”

Section: Introductionmentioning

confidence: 99%

“…In this epidemiological study, we sought to build on the findings from our prior qualitative study and investigate the associations of JDL and social support with different types of asthma SMB [3 ]. Furthermore, we aimed to also test the relationships between the two psychosocial working conditions and asthma morbidity (i.e., asthma control and asthma‐specific quality of life) and to investigate possible mediation of these associations by asthma SMB.…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study

Heinrichs

Hummel

Gholami³

et al. 2019

Clin Transl Allergy

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Background Adverse psychosocial working conditions—in particular poor job decision latitude and poor social support at work—may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with (2) asthma morbidity. Methods A total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate = 29.3%). Job decision latitude and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four asthma self-management behaviours were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regression analyses to calculate odds ratios with 95% CIs. Results Low job decision latitude and low social support were significantly associated with poorer trigger avoidance (odds ratios ≥ 2.09) and poorer acute symptom management (odds ratios ≥ 2.29); low social support was further related to significantly less communication (odds ratio = 2.82). Low job decision latitude and low social support were also associated with significantly poorer asthma control (odds ratios ≥ 1.95) and poorer asthma-specific quality of life (odds ratios ≥ 2.05). The relationships with asthma morbidity were attenuated after adjustment for the four asthma self-management behaviours (odds ratios ranging from 1.1 to 1.9). Conclusions Adverse psychosocial working conditions are associated with poorer asthma self-management behaviour at work and with increased asthma morbidity. The latter association may be mediated by asthma self-management behaviour. Trial registration German Clinical Trials Register, registration number: DRK S00011309, date of registration: 22.12.2016. Electronic supplementary material The online version of this article (10.1186/s13601-019-0264-9) contains supplementary material, which is available to authorized users.

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What are the perceived influences on asthma self-management at the workplace? A qualitative study

Cited by 13 publications

References 29 publications

Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study

Stressors and resources related to academic studies and improvements suggested by medical students: a qualitative study

Students’ perspectives on interventions to reduce stress in medical school: A qualitative study

Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study

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