Soo WF, Tan NC
Correspondence: Dr Soo Wern Fern, soo.wern.fern@singhealth.com.sg
ABSTRACT
INTRODUCTION Asthma is a common childhood disease, and paediatric patients with asthma rely on caregivers to administer domiciliary asthma care. This study aimed to explore the knowledge, understanding, perceptions and main concerns of caregivers and its influence on their home management of children with asthma.
METHODS Data from 14 caregivers of children with asthma was collected during three focus group discussions held in two polyclinics in Singapore. The collected data was analysed using standard content analysis and classified into themes.
RESULTS The caregivers’ main concerns included the perceived effects of infection, food and exercise on children with asthma. Several caregivers considered the disease to be infectious and had a lower threshold for physician consultation, as they believed that any delay in treating the infection would be detrimental to the child’s health. Some also perceived asthma to be episodic and self-limiting, and that their children could ‘outgrow’ it. Many caregivers believed that asthma could be modified by abstinence from, or intake of, certain foods. Others had the perception that sports, including swimming, would worsen asthma. These perceptions resulted in unnecessary restrictions of the children’s diet and activities. Most caregivers were unaware of influenza vaccination as a preventive measure to reduce triggers due to respiratory viral infections.
CONCLUSION We found that the caregivers’ perceptions of asthma aetiology, its triggers and preventive measures affected their help-seeking behaviour and care of children with asthma. Healthcare professionals managing paediatric patients with asthma should recognise such caregiver misperceptions, and take a proactive approach to rectify and bridge the gaps in caregivers’ knowledge and understanding of the disease.
Keywords: asthma, caregiver, knowledge, understanding
Singapore Med J 2014; 55(3): 132-136; http://dx.doi.org/10.11622/smedj.2014032
REFERENCES
1. DeWalt DA, Dilling MH, Rosenthal MS, Pignone MP. Low parental literacy is associated with worse asthma care measures in children. Ambul Pediatr 2007; 7:25-31. http://dx.doi.org/10.1016/j.ambp.2006.10.001 | ||||
2. Liu W. Traditional Chinese Medicine Information Page. Am Acad Acupuncture Oriental Medicine. In: Traditional Chinese Medicine/TCM and Asthma [online]. Available at: www.tcmpage.com/hpasthma.html. Accessed April 16, 2013. | ||||
3. Glazebrook C, McPherson AC, Macdonald IA, et al. Asthma as a barrier to children's physical activity: implications for body mass index and mental health. Pediatrics 2006; 118:2443-9. http://dx.doi.org/10.1542/peds.2006-1846 | ||||
4. Lang DM, Butz AM, Duggan AK, Serwint JR. Physical activity in urban school-aged children with asthma. Pediatrics 2004; 113:e341-6. http://dx.doi.org/10.1542/peds.113.4.e341 | ||||
5. Lai KY, Lam Karry K L, Lam SC, et al. Exploring parents' understandings and concerns on self-management of childhood asthma. Hong Kong Practitioner 2005; 27:172-8. | ||||
6. Ministry of Health, Singapore. Management of Asthma. In: Clinical Practice Guidelines [online]. Available at: http://www.moh.gov.sg/content/moh_web/home/Publications/guidelines/cpg/2.... Accessed June 24, 2013. | ||||
7. Lai CKW, Kim YY, Kuo SH, Spencer M, Williams AE, and on behalf of the Asthma Insights and Reality in Asia Pacific Steering Committee. Cost of Asthma in the Asia-Pacific region. Eur Respir Rev 2006; 15:10-6. http://dx.doi.org/10.1183/09059180.06.00009802 | ||||
8. Hazir T, Das C, Piracha F, Waheed B, Azam M. Carers' perception of childhood asthma and its management in a selected Pakistani community. Arch Dis Child 2002; 87:287-90. http://dx.doi.org/10.1136/adc.87.4.287 | ||||
9. Wong E, Wong TW, Chung M, Lau CC. Knowledge and beliefs of parents of asthmatic children presenting to an emergency department. Hong Kong J Emerg Med 2001; 6:202-6. | ||||
10. Smeeton NC, Rona RJ, Gregory J, White P, Morgan M. Parental attitudes towards the management of asthma in ethnic minorities. Arch Dis Child 2007; 92:1082-7. http://dx.doi.org/10.1136/adc.2006.112037 | ||||
11. Shaw A, Thompson EA, Sharp D. Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study. BMC Health Serv Res 2006; 6:76. http://dx.doi.org/10.1186/1472-6963-6-76 | ||||
12. Sicherer SH, Sampson HA. Food allergy. J Allergy Clin Immunol 2006; 117 (2 Suppl Mini-Primer):S470-5. | ||||
13. Wicher IB, Ribeiro MA, Marmo DB, et al. Effects of swimming on spirometric parameters and bronchial hyperresponsiveness in children and adolescents with moderate persistant atopic asthma. J Pediatr (Rio J) 2010; 86:384-90. http://dx.doi.org/10.1590/S0021-75572010000500006 | ||||
14. Bernard A, Carbonnelle S, Michel O, et al. Lung hyperpermeability and asthma prevalence in school children: unexpected associations with the attendance at indoor chlorinated swimming pools. Occup Environ Med 2003; 60:385-94. http://dx.doi.org/10.1136/oem.60.6.385 |