Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Arch Dis Child. 2020 Sep;105(9):819-824. doi: 10.1136/archdischild-2019-318127. Epub 2020 Jul 3.
We aimed to explore the views of Malaysian children with asthma and their parents to enhance understanding of early influences on development of self-management skills.
This is a qualitative study conducted among children with asthma and their parents. We used purposive sampling and conducted focus groups and interviews using a semi-structured topic guide in the participants' preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo and analysed using a grounded theory approach.
We identified children aged 7-12 years with parent-reported, physician-diagnosed asthma from seven suburban primary schools in Malaysia. Focus groups and interviews were conducted either at schools or a health centre.
Ninety-nine participants (46 caregivers, 53 children) contributed to 24 focus groups and 6 individual interviews. Children mirrored their parents' management of asthma but, in parallel, learnt and gained confidence to independently self-manage asthma from their own experiences and self-experimentation. Increasing independence was more apparent in children aged 10 years and above. Cultural norms and beliefs influenced children's independence to self-manage asthma either directly or indirectly through their social network. External influences, for example, support from school and healthcare, also played a role in the transition.
Children learnt the skills to self-manage asthma as early as 7 years old with growing independence from the age of 10 years. Healthcare professionals should use child-centred approach and involve schools to facilitate asthma self-management and support a smooth transition to independent self-management.
Malaysian National Medical Research Register (NMRR-15-1242-26898).
本研究旨在探讨马来西亚哮喘患儿及其家长的观点，以深入了解对自我管理技能发展的早期影响。
这是一项在哮喘患儿及其家长中开展的定性研究。我们采用了目的性抽样，以参与者偏爱的语言，使用半结构化主题指南开展了焦点小组和访谈。所有访谈均进行录音，逐字转录，录入 NVivo 并采用扎根理论方法进行分析。
我们从马来西亚 7 所郊区小学中，确定了 7-12 岁、父母报告有、医生诊断为哮喘的患儿。焦点小组和访谈在学校或健康中心进行。
99 名参与者（46 名照料者，53 名患儿）参加了 24 个焦点小组和 6 个单独访谈。患儿对哮喘的管理与父母如出一辙，但同时，他们也通过自身经历和自我探索学习并获得了独立自我管理哮喘的信心。10 岁及以上的儿童独立性增强更为明显。文化规范和信念通过其社交网络直接或间接地影响了儿童独立自我管理哮喘的能力。外部影响，例如来自学校和医疗保健的支持，也在过渡中发挥了作用。
儿童早在 7 岁时就开始学习自我管理哮喘的技能，10 岁后独立性逐渐增强。医疗保健专业人员应采用以患儿为中心的方法，并让学校参与其中，以促进哮喘的自我管理，并支持向独立自我管理的顺利过渡。
马来西亚国家医学研究注册中心（NMRR-15-1242-26898）。
