Introduction and Objectives South Asian individuals living with asthma in the UK are more likely to experience excess morbidity and increased hospitalisation rates than any other ethnic group. Prevention is an integral part of self- management (Pinnock, 2015). Failure to adhere to prescribed regimens is common amongst this population. This study investigated people’s experiences with asthma, including medication adherence, the use of non-pharmacological treatment approaches, and the healthcare professional (HCP)-patient relationship in asthma healthcare.
Methods Using a qualitative approach, fourteen adults (12 female, 2 male, aged between 18–50) who identified as South Asian with a diagnosis of asthma (at least step 2 of the BTS guidelines) took part in semi-structured interviews. Interpretative phenomenological analysis (IPA) was used, informed by a symbolic interactionist (SI) perspective; a micro level theoretical framework which suggests that society is shaped and upheld by social interaction and explores how people make sense of their social world (Carter & Fuller, 2015).
Results Four themes were developed, focusing on how the asthmatic identity is negotiated, managing medications, seeking non-pharmacological treatments, and the HCP-patient relationship (see figure 1). Despite suffering acute exacerbations, participants questioned whether they identified as asthmatic, which impacted their decision to use preventative medication. Cultural identity was linked to traditional treatments and medication adherence. Characteristics of developing a therapeutic relationship with HCPs were described, including patient involvement and mutual respect. This involved having open discussions on the use non-pharmacological treatments which were linked to participants’ cultural identity, illustrating the HCP’s desire to be culturally responsive.
Conclusions HCP’s should consider an explorative approach to consultation, to develop a culturally aware, therapeutic relationship and consider negotiation in prescribing. This could enhance the patients’ ability to self-manage, and reduce resistance to advice and guidance from HCPs. Cultural identity is an important aspect of treatment and should be discussed to develop mutual care objectives between HCP and patient, to establish a therapeutic relationship.
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