Understanding What Really Matters between Families and Providers Caring for Young Children Diagnosed with Asthma

Linda Hook, The University of Texas School of Public Health

Abstract

Advances in medical science have dramatically improved and refined the clinical guidelines for childhood asthma disease management. Despite these advances, there remain disparities in outcomes among certain population groups. A literature review pointed toward exploring the connections between caregivers’ personal health experiences and medical management of childhood asthma. A disease process like asthma is woven into one’s health beliefs, daily rituals, and values. Arthur Kleinman introduced the “Explanatory Model of Illness” as an ethnographic method to discern cultural differences within the context of scientific medical care. Ethnography extends understanding of personal health experiences within the context of natural settings. The purpose for this study was to conduct a qualitative study using ethnographic approaches to describe the cultural beliefs, values, and determinants held by families and healthcare providers caring for a young child (4 to 5 years old) diagnosed with persistent asthma. The study participants were commonly associated with San Antonio’s Obama Empowerment Zone. The families (n = 12) and the child’s healthcare provider (n = 12) were recruited between April 2016 through March 2017. Family and healthcare provider data were collected using an in-depth audiotaped semi-structured interview process. A thematic analysis method was used to analyze the data collected. Nvivo 11 software was used in coding of the data. Two overarching themes emerged within the dataset, uncertainty and distress. Both the families and healthcare providers expressed these two common themes, but each had varying contextual concepts for them. For example, families were worried about the next asthma event and how they would respond, whereas the providers expressed concern about the ability of the family to recognize the early signs of an asthma attack and respond accordingly. The families were worried about cigarette smoking but recognized that they did not have much control over cigarette exposure, whereas the providers knew of the cigarette smoking history but could not find the right intervention to assist the family. The findings suggest the continued development of outcome-based research to assess the experience of the illness and treatment within the “local world” of the patient because culture does matter in clinical care.

Subject Area

Health sciences|Public health|Individual & family studies|Health care management

Recommended Citation

Hook, Linda, "Understanding What Really Matters between Families and Providers Caring for Young Children Diagnosed with Asthma" (2017). Texas Medical Center Dissertations (via ProQuest). AAI10278007.
https://digitalcommons.library.tmc.edu/dissertations/AAI10278007

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