Tod Angela Mary, Nelson Peter, Cronin de Chavez Anna, Homer Catherine, Powell-Hoyland Vanessa, Stocks Amanda
Faculty of Medical and Human Sciences, School of Nursing, Midwifery and Social Work/Central Manchester NHS Foundation Trust, University of Manchester, Manchester, England.
Faculty of Health and Wellbeing, Department of Social Work, Social Care and Community Studies, Sheffield Hallam University, Sheffield, England.
BMJ Open. 2016 Jan 6;6(1):e009636. doi: 10.1136/bmjopen-2015-009636.
This study aimed to understand the influences and decisions of households with children with asthma regarding keeping warm and well at home in winter.
Community settings in Rotherham and Doncaster, South Yorkshire, UK.
Individuals from 35 families and 25 health, education and social care staff underwent interview. 5 group interviews were held, 1 with parents (n=20) and 4 with staff (n=25).
This qualitative study incorporated in-depth, semistructured individual and group interviews, framework analysis and social marketing segmentation techniques.
The research identifies a range of psychological and contextual influences on parents that may inadvertently place a child with asthma at risk of cold, damp and worsening health in a home. Parents have to balance a range of factors to manage fluctuating temperatures, damp conditions and mould. Participants were constantly assessing their family's needs against the resources available to them. Influences, barriers and needs interacted in ways that meant they made 'trade-offs' that drove their behaviour regarding the temperature and humidity of the home, including partial self-disconnection from their energy supply. Evidence was also seen of parents lacking knowledge and understanding while working their way through conflicting and confusing information or advice from a range of professionals including health, social care and housing. Pressure on parents was increased when they had to provide help and support for extended family and friends.
The findings illustrate how and why a child with asthma may be at risk of a cold home. A 'trade-off model' has been developed as an output of the research to explain the competing demands on families. Messages emerge about the importance of tailored advice and information to families vulnerable to cold-related harm.
本研究旨在了解有哮喘患儿的家庭在冬季居家保暖及保持健康方面的影响因素和决策情况。
英国南约克郡罗瑟勒姆和唐卡斯特的社区环境。
来自35个家庭的个体以及25名卫生、教育和社会护理工作人员接受了访谈。共进行了5次小组访谈,其中1次是与家长(n = 20)进行的,4次是与工作人员(n = 25)进行的。
这项定性研究采用了深入的半结构化个人和小组访谈、框架分析以及社会营销细分技术。
该研究确定了一系列对家长产生心理和背景影响的因素,这些因素可能在不经意间使哮喘患儿面临家中寒冷、潮湿以及健康状况恶化的风险。家长必须权衡一系列因素来应对温度波动、潮湿环境和霉菌问题。参与者不断根据自身可利用的资源评估家庭需求。各种影响因素、障碍和需求相互作用,这意味着他们做出了“权衡取舍”,从而驱动了他们在家庭温度和湿度方面的行为,包括部分切断能源供应。研究还发现,家长在处理来自包括卫生、社会护理和住房等一系列专业人员相互矛盾且令人困惑的信息或建议时,缺乏相关知识和理解。当家长不得不为大家庭成员和朋友提供帮助和支持时,他们所承受的压力会增加。
研究结果阐明了哮喘患儿可能面临家中寒冷的方式及原因。作为研究成果,已开发出一种“权衡模型”来解释家庭所面临的相互竞争的需求。研究还得出了一些信息,强调了为易受寒冷相关伤害的家庭提供量身定制的建议和信息的重要性。