Lindsay D Apps1, Stacey Chantrell2, Sally Majd3, Elizabeth Eglinton4, Sally J Singh3, Anna C Murphy5, Peter Bradding6, Ruth H Green6, Nicky Hudson7, Rachael A Evans8. 1. Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom. 2. Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. 3. Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester, United Kingdom. 4. Patient Representative, NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. 5. NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; School of Pharmacy, De Montfort University, Leicester, United Kingdom. 6. NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester, United Kingdom. 7. School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom. 8. Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester, United Kingdom. Electronic address: re66@le.ac.uk.
Abstract
BACKGROUND: The management of severe asthma poses many challenges related to treatment, adherence, and psychosocial morbidity. There is little direct data from the patient perspective to understand and negotiate the complexities of managing severe asthma. OBJECTIVE: To explore the patient perceptions of living with severe asthma and the experience of managing severe asthma, in order to better understand the support that might promote more effective self-management for severe asthma. METHODS: Participants were recruited from a specialist Difficult Asthma Service. Semistructured interviews were conducted by researchers independent of the patient's care. Interviews were transcribed verbatim and inductive thematic analysis was performed. RESULTS: Twenty-nine participants (13 male: mean [standard deviation] age, 49.5 [13.6] years: mean Asthma Control Questionnaire 2.2 [1.2]) participated in an interview. Analysis resulted in 4 major themes describing the experience and challenges to managing severe asthma: understanding of severe asthma, emotional impact of living with severe asthma (subtheme: fear of hospitalization), public perceptions of asthma, and concerns about medications. CONCLUSIONS: Health care professionals need to consider and discuss with patients their perceptions of severe asthma and the relevant treatments; particular attention should focus around education of disease control and actively exploring thoughts around hospitalization. Our data highlight the potential for psychological and social support to enhance self-management by directly addressing the wide-ranging individual challenges patients face. There is also a need for greater public awareness and education about severe asthma to minimize patient distress particularly in the work environment.
BACKGROUND: The management of severe asthma poses many challenges related to treatment, adherence, and psychosocial morbidity. There is little direct data from the patient perspective to understand and negotiate the complexities of managing severe asthma. OBJECTIVE: To explore the patient perceptions of living with severe asthma and the experience of managing severe asthma, in order to better understand the support that might promote more effective self-management for severe asthma. METHODS:Participants were recruited from a specialist Difficult Asthma Service. Semistructured interviews were conducted by researchers independent of the patient's care. Interviews were transcribed verbatim and inductive thematic analysis was performed. RESULTS: Twenty-nine participants (13 male: mean [standard deviation] age, 49.5 [13.6] years: mean Asthma Control Questionnaire 2.2 [1.2]) participated in an interview. Analysis resulted in 4 major themes describing the experience and challenges to managing severe asthma: understanding of severe asthma, emotional impact of living with severe asthma (subtheme: fear of hospitalization), public perceptions of asthma, and concerns about medications. CONCLUSIONS: Health care professionals need to consider and discuss with patients their perceptions of severe asthma and the relevant treatments; particular attention should focus around education of disease control and actively exploring thoughts around hospitalization. Our data highlight the potential for psychological and social support to enhance self-management by directly addressing the wide-ranging individual challenges patients face. There is also a need for greater public awareness and education about severe asthma to minimize patient distress particularly in the work environment.
Authors: Eleanor C Majellano; Vanessa L Clark; Rebecca F McLoughlin; Peter G Gibson; Vanessa M McDonald Journal: PLoS One Date: 2022-06-07 Impact factor: 3.752