Tumiel-Berhalter Laurene, Zayas Luis E
Family Medicine Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, NY 14215, USA.
J Natl Med Assoc. 2006 Jun;98(6):875-80.
National asthma guidelines are often not translated into practice. Barriers to translation impactboth provider and patient adherence.
This qualitative study describes how perceptions and experiences of patients with asthma or their caregivers affect disease management in a Puerto Rican community in Buffalo, NY.
Two community-based asthma workshops following a focus group format were conducted with 22 Puerto Rican adults with asthma or who cared for asthmatic children. A bilingual-bicultural community moderator used a semistructured interview guide to foster discussion on asthma definitions, triggers, management, coping and concerns. Four analysts interpreted data transcripts following the grounded theory approach, identifying salient thematic categories. Multiple analysts and a postsearch for conflicting evidence support analytical trustworthiness.
Perceptions of illness revealed concerns about the deceiving character and burden of asthma. Recognition of indoor household triggers underscored concerns about the impact on quality of life, emergency department use, and the ineffectiveness or side effects of some prescribed therapies. Misconceptions about asthma and self-management strategies were identified.
Learning about lay perceptions and management approaches regarding asthma may afford healthcare professionals insight to better understand, educate and care for ethnic minority patients, and help to improve their asthma outcomes.
国家哮喘指南往往未能转化为实际行动。指南转化过程中的障碍影响了医护人员和患者的依从性。
这项定性研究描述了哮喘患者或其照顾者的认知和经历如何影响纽约州布法罗市一个波多黎各社区的疾病管理。
以焦点小组形式举办了两场基于社区的哮喘研讨会，共有22名患有哮喘的波多黎各成年人或照顾哮喘儿童的人参加。一位双语双文化的社区主持人使用半结构化访谈指南，促进对哮喘定义、诱发因素、管理、应对方法和担忧等方面的讨论。四位分析人员采用扎根理论方法对数据记录进行解读，确定突出的主题类别。多名分析人员以及对矛盾证据的事后检索支持了分析的可信度。
对疾病的认知揭示了对哮喘欺骗性特征和负担的担忧。对室内家庭诱发因素的认识突出了对其对生活质量、急诊使用情况以及某些规定疗法的无效性或副作用影响的担忧。还发现了对哮喘和自我管理策略的误解。
了解关于哮喘的外行认知和管理方法可能会让医护人员有深入了解，以便更好地理解、教育和照顾少数民族患者，并有助于改善他们的哮喘治疗效果。
