Perceptions of asthma in South Asians and their views on educational materials and self-management plans: a qualitative study
Introduction
Studies [1], [2], [3], [4], [5] have demonstrated that Asians with asthma have a higher hospitalisation rate than whites without any evidence of increased asthma severity or high re-admission rates [2]. Possible reasons for this are poor asthma education, language barriers or poor compliance with medication. Since successful management of asthma requires attention not just to observable behaviour but also to the underlying attitudes and beliefs which drive that behaviour, a small scale qualitative study was undertaken to explore the experience of asthma in people of Pakistani and Indian background living in East London.
The major aims of this study were:
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To explore knowledge, attitudes, perceptions, health beliefs and health needs of those originally from India and Pakistan.
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To explore attitudes and acceptability of self management plans.
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Study population
The London Boroughs of Redbridge and Waltham Forest have a population of approximately 0.45 million. Information from the 1991 office of population censuses and surveys showed that ethnic minority groups, whether born in the UK or not, make up 28% of the population and they are mainly of Indian subcontinent origin or Black African Caribbeans.
Recruitment
After gaining approval from the local research ethics committee, an interpreting service was used to translate the English version of the invitation
The nature of asthma
All the participants were familiar that asthma was a condition associated with cough, wheeze and difficulty breathing. Some of the participants said “my chest makes a noise” rather than use the word wheeze. Tiredness, chest pain, chest tightness and hyperventilation were also mentioned as symptoms associated with asthma with one participant saying he produced large amounts of phlegm.
With regards to what was happening in the body, most participants said the tubes in the lungs blocked up but
Discussion
Despite not being satisfied with the asthma care provided by their GPs, all the participants had very good general knowledge of the triggers associated with asthma and were aware of the symptoms and episodic nature of asthma. This is not surprising because there has been increased levels of publicity around asthma in recent years particularly through the media. Since 1990 nurse led asthma clinics have been established in UK primary care and it appears from this study that adequate information
Conclusions
Despite limitations and the small scale nature of this qualitative study, the following important conclusions can be drawn:
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All participants with asthma were aware that it is a condition associated with cough, wheeze, difficulty breathing and the majority were aware of trigger factors for asthma.
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The majority of the patients with asthma were aware of the difference between ‘reliever’ and ‘preventer’ inhalers, although some stopped using the inhaled steroids because they felt they were
Acknowledgements
We are very grateful to Sue Collett and Denise Bentley for their considerable help with this project and for acting as reporters in the focus groups. The cost of the study was borne by the Department of Health and we acknowledge with thanks the assistance of Ms. Veena Bahl.
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