Understanding how patients establish strategies for living with asthma: a qualitative study in UK primary care as part of IMP
asthma
habits
health planning
personalised asthma action plans
primary health care
self-management
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
28
08
2019
accepted:
18
11
2019
pubmed:
25
3
2020
medline:
25
6
2021
entrez:
25
3
2020
Statut:
epublish
Résumé
In the context of a variable condition such as asthma, patient recognition of deteriorating control and knowing what prompt action to take is crucial. Yet, implementation of recommended self-management strategies remains poor. To explore how patients with asthma and parents/carers of children with asthma develop and establish recommended self-management strategies for living with asthma, and how clinicians can best support the process. A qualitative study in UK primary care. Patients with asthma and parents/carers of children with asthma from 10 general practices were purposively sampled (using age, sex, and duration of asthma) to participate in focus groups or interviews between May 2016 and August 2016. Participants' experiences of health care, management of asthma, and views on supported self-management were explored. Interviews and focus group sessions were audio-recorded and transcribed verbatim. Iterative thematic analysis was conducted, guided by the research questions and drawing on habit theory in discussion with a multidisciplinary research team. A total of 49 participants (45 patients; 4 parents/carers) took part in 32 interviews and five focus groups. Of these, 11 reported using an action plan. Patients learnt how to self-manage over time, building knowledge from personal experience and other sources, such as the internet. Some regular actions, for example, taking medication, became habitual. Dealing with new or unexpected scenarios required reflective abilities, which may be supported by a tailored action plan. Patients reported learning intuitively how to self-manage. Some regular actions became habitual; dealing with the unexpected required more reflective cognitive skills. In order to support implementation of optimal asthma self- management, clinicians should consider both these aspects of self-management and support, and educate patients proactively.
Sections du résumé
BACKGROUND
In the context of a variable condition such as asthma, patient recognition of deteriorating control and knowing what prompt action to take is crucial. Yet, implementation of recommended self-management strategies remains poor.
AIM
To explore how patients with asthma and parents/carers of children with asthma develop and establish recommended self-management strategies for living with asthma, and how clinicians can best support the process.
DESIGN AND SETTING
A qualitative study in UK primary care.
METHOD
Patients with asthma and parents/carers of children with asthma from 10 general practices were purposively sampled (using age, sex, and duration of asthma) to participate in focus groups or interviews between May 2016 and August 2016. Participants' experiences of health care, management of asthma, and views on supported self-management were explored. Interviews and focus group sessions were audio-recorded and transcribed verbatim. Iterative thematic analysis was conducted, guided by the research questions and drawing on habit theory in discussion with a multidisciplinary research team.
RESULTS
A total of 49 participants (45 patients; 4 parents/carers) took part in 32 interviews and five focus groups. Of these, 11 reported using an action plan. Patients learnt how to self-manage over time, building knowledge from personal experience and other sources, such as the internet. Some regular actions, for example, taking medication, became habitual. Dealing with new or unexpected scenarios required reflective abilities, which may be supported by a tailored action plan.
CONCLUSION
Patients reported learning intuitively how to self-manage. Some regular actions became habitual; dealing with the unexpected required more reflective cognitive skills. In order to support implementation of optimal asthma self- management, clinicians should consider both these aspects of self-management and support, and educate patients proactively.
Identifiants
pubmed: 32205333
pii: bjgp20X708869
doi: 10.3399/bjgp20X708869
pmc: PMC7101272
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e303-e311Subventions
Organisme : Department of Health
ID : RP-DG-1213-10008
Pays : United Kingdom
Organisme : Department of Health
ID : RP-PG-1016-20008
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
© British Journal of General Practice 2020.
Références
Br J Gen Pract. 2012 Dec;62(605):664-6
pubmed: 23211256
BMC Med. 2017 Mar 17;15(1):64
pubmed: 28302126
J Behav Med. 2016 Dec;39(6):935-946
pubmed: 27515801
J Clin Epidemiol. 2007 Jan;60(1):43-9
pubmed: 17161753
Prim Care Respir J. 2007 Dec;16(6):369-77
pubmed: 18026674
BMC Med. 2016 Aug 29;14(1):113
pubmed: 27568881
Br J Health Psychol. 2009 May;14(Pt 2):261-73
pubmed: 19102817
BMJ. 2008 Aug 07;337:a949
pubmed: 18687730
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Health Psychol Rev. 2015;9(3):277-95
pubmed: 25207647
J Asthma. 2018 Mar;55(3):310-317
pubmed: 28548896
BMC Med. 2015 Jun 01;13:127
pubmed: 26032941
Patient Educ Couns. 2011 Nov;85(2):e131-43
pubmed: 21396793
BMJ Open. 2018 Dec 14;8(12):e024262
pubmed: 30552277
NPJ Prim Care Respir Med. 2017 Jul 18;27(1):45
pubmed: 28720751
NPJ Prim Care Respir Med. 2018 Nov 6;28(1):42
pubmed: 30401831
J Health Serv Res Policy. 2016 Apr;21(2):73-82
pubmed: 26377727