How do young adults experience asthma implications for education
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How do young adults experience asthma? Implications for education. by Didy Button Flinders University School of Nursing and Midwifery. Breath is Life. ….breathing comes naturally; it is so rudimentary that it requires no action of volition, no attention or thought.

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How do young adults experience asthma implications for education

How do young adults experience asthma?Implications for education

by Didy Button

Flinders University School of Nursing and Midwifery


Breath is life

Breath is Life

….breathing comes naturally;

it is so rudimentary that it requires no action of volition, no attention or thought.

But, for that very reason the wisdom of breathing is the most difficult, and the very last to be learned.

What is closest and most familiar is taken for granted: it is farthest from our thought.

Levin 1984 p.129


Asthma the recognized face

Asthma - the recognized face

  • Invisible

  • Intermittent

  • Predictable

  • Reversible

  • Easily treated with Bronchodilators

  • Forgotten until next time


Asthma the unrecognized face

Asthma - the unrecognized face

  • Severity underestimated

  • Under treated

  • Body compensates for  lung function

  • Inflammation is always present

  • Airway hyper-responsiveness 

  • Does not respond to Bronchodilators

  • Breathing is severely compromised

  • Expired air resuscitation fails

  • Death can result


Young adults missing group

Young adults missing group

  • National Asthma Council (NAC): Adolescents “problem group”

  • Few strategies to deal with adolescents or young adults

  • NAC no guidelines for young adults

  • Adherence guidelines no young adults


What the literature says

What the literature says

  • Literature centers on non-compliance

  • Gap in literature on experience of asthma

  • Particular omission young adults experiences


The study

The Study

  • Qualitative research methods seek to increase understanding.

  • Ethics approval from Flinders University.

  • No participants identified as being ATSI.

  • All spoke and understood English langauage.


The study1

The Study

  • 24 young adults 18 to 26 yrs.

  • 16 Female.

  • 8 Male.

  • Living in the Southern Adelaide metropolitan (21) and rural areas (3).


Recruitment

Recruitment

Young adults were recruited by purposeful sampling

(snowball sampling).

“Do you know anyone with asthma around your age who might like to talk with me about their experiences with their asthma?”


Participants

Participants


Participants profiles

Participants Profiles


Participants profile

Participants Profile

  • 23 out of 24 had paediatric asthma.

  • 1 had developed occupational asthma triggered by animal dander.


Young adults

18 to 26 year olds

Combined ‘X’ and ‘Y’ generations

Born after the baby boomers

Grown up with technology

Immediate results

Earn lots of money

Young adults


Young adults1

Job security.

Loyalty not paid off (redundancies)

Confident.

Delaying marriage.

Children later in life.

Young adults


Young adults2

Options Generation.

Staying at school longer.

Living with parents longer.

Saw fathers missing seeing children growing up.

Better quality of life.

Young adults


Analysis

Analysis

  • Thematic analysis of 24 interviews.

  • NUD*IST (Non-numerical Unstructured Data Indexing, Searching, and Theorizing)Qualitative research software helps people to manage, shape and make sense of unstructured information.

  • Theme identification.


Themes from the study

Themes from the study

  • Asthma as an embodied experience

    • Hard drawn breath

    • Not knowing what to do

    • Strength to overcome

    • Willing to risk it!

    • Just get on with it!


The nature of breathing and asthma

The nature of Breathing and Asthma

Conscious

Illness (dis ease) Dys appearance

Asthma is visible

Unconscious

Health(ease)

Appearance

Asthma is invisible

Asthma

Asthma

Asthma


Past first memories of asthma

Past - first memories of asthma

  • I remember I was pretty scared for a while…… (David (19) first asthma episode and hospital admission aged 7).

  • I woke up one night and couldn’t breathe and Mum rushed me to hospital…. (Barb (26) first asthma episode aged 12).


First memories of asthma

First memories of asthma

  • I was in hospital when I was two or three, with croup, really bad croup, and I’ve always had it. Anne (23).

  • Well I’ve had asthma since as long as I can remember. Darren (22).

  • I’ve had it forever! Kay (24).


The human setting

The human setting

I’m meant to be taking Pulmicort and Bricanyl turbuhaler: but I don’t take them. I just feel it’s under control but I am always getting into trouble with Mich for not taking them. ….. I really only get it mild, as I said - apart from colds, say. I mean I do all the normal activities. Barb (26)


The human setting1

The human setting

….It’s pretty hard…..I sort of know now that I can sort of prepare, or stay inside. I mean there’s not a lot I can do but I it’s there in the back of my mind so you know, between summer-winter , I can prepare a bit. I mean there’s nothing - Just sort of take it as it comes, usually. [Laugh] Barb (26)


The human setting2

The human setting

The dust the winter and the dog, I am back to needing to use my Ventolin everyday, I am waking up wheezy and then it gets better again during the day and when I am back home I get it back again. It is probably not very well controlled at the moment…… Cathy (23)


Human setting

Human setting

We always hoped it would go away but it never went away, so I just forget about it now. I can’t do anything about it so I might as well just get on with my life. David (19)


Human setting1

Human setting

It’s not like you really care about it. I don’t sit there and get angry……. It’s just another thing, like if you get a headache, you don’t start blaming your head. You get nowhere. You just take some medication and move on with it. David (19)


Asthma

Without warning, boom out. It’s no good at all

It’s there 24/7

Asthma

I thought I was going to die

It never fits in with what I am doing

It’s a pain

It sucks

Just get on with it

You are just aware of it all the time

A challenge

It just pops up from no where

I think you loose confidence

You’re ALWAYS thinking about managing it

Exploding in my chest

Disappointed


Implications for education

Implications for education

In this study young adults with asthma from childhood:

  • had little knowledge about asthma pathophysiology beyond bronchoconstriction and use of SABA.

  • any education was directed to their parents/care giver.


Implications for education1

Implications for education

  • These young adults did not recognise their asthma as a chronic health condition.

  • Rather they treated their asthma exacerbations like a cold virus.

  • They relied on SABA and after the symptoms do not improve they would see their GP.

  • Most did not continue ICS after they recovered.


Implications for education2

Implications for education

  • Revise:

    • basic A&P point out differences between asthma exacerbations and recovery from childhood asthma and now asthma as an adult.

    • pathophysiology linking to known triggers for the young adult.


Implications for education3

Implications for education

  • Explain the limits of SABA and the risks of over reliance.

  • Emphasise the importance of treating inflammation with ICS.

  • Explain strategies for minimising side effects of ICS.


Implications for education4

Implications for education

  • Encourage and reinforce their own knowledge of body listening, for early exacerbation identification.

  • Discuss how they currently manage exacerbations of their asthma.

    • Explain the added benefit of regular ICS

    • Limits of SABA in inflammation.


How do young adults experience asthma implications for education

Thank you for listening


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