Walker Timothy J, Reznik Marina
Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx, New York , USA.
J Asthma. 2014 Oct;51(8):808-13. doi: 10.3109/02770903.2014.920875. Epub 2014 May 14.
Regular physical activity (PA) is an important component of pediatric asthma management. No studies have examined how in-school asthma management influences PA from children's perspectives. The aim of this study was to explore children's perceptions of the impact of in-school asthma management on PA.
Qualitative interviews with 23 inner-city minority children with asthma (aged 8-10 yrs; 12 girls, 11 boys) were conducted in 10 Bronx, New York elementary schools. Sampling continued until saturation was reached. Interviews were recorded, transcribed and independently coded for common themes.
Interviews produced five themes representing students' perceptions about (1) asthma symptoms during in-school PA; (2) methods to control asthma episodes during school PA; (3) methods to prevent asthma episodes during school; (4) limited accessibility of asthma medications; and (5) negative feelings about asthma and medication use. The majority of students experienced asthma symptoms while performing PA during school. Primary methods of managing asthma symptoms were sitting out during activity, drinking water, and visiting the nurse. Students lacked awareness or adherence to action plans to prevent or control asthma. Students reported limited access to medication during school and feelings of embarrassment and/or concerns of teasing when medicating in front of others.
Our results indicate inappropriate in-school management of asthma symptoms, poor asthma control, lack of accessible medication, and stigma around publicly using asthma medication. Thus, students often missed or were withheld from PA. Interventions to improve in-school asthma care must consider ways to address these issues.
规律的体育活动(PA)是儿童哮喘管理的重要组成部分。尚无研究从儿童的角度探讨校内哮喘管理如何影响体育活动。本研究的目的是探讨儿童对校内哮喘管理对体育活动影响的看法。
在纽约布朗克斯区的10所小学,对23名患有哮喘的市中心少数族裔儿童(8 - 10岁;12名女孩,11名男孩)进行了定性访谈。抽样持续进行直至达到饱和。访谈进行录音、转录,并独立编码以找出共同主题。
访谈产生了五个主题,代表学生对以下方面的看法:(1)校内体育活动期间的哮喘症状;(2)在学校体育活动期间控制哮喘发作的方法;(3)在学校预防哮喘发作的方法;(4)哮喘药物的可及性有限;以及(5)对哮喘和用药的负面感受。大多数学生在学校进行体育活动时出现哮喘症状。管理哮喘症状的主要方法是在活动期间休息、喝水和去看护士。学生缺乏预防或控制哮喘的行动计划的意识或依从性。学生报告说在学校期间获得药物的机会有限,并且在他人面前用药时会感到尴尬和/或担心被取笑。
我们的结果表明校内哮喘症状管理不当、哮喘控制不佳、缺乏可及的药物以及公开使用哮喘药物存在污名化现象。因此,学生经常错过或被禁止参加体育活动。改善校内哮喘护理的干预措施必须考虑解决这些问题的方法。