College of Nursing, University of Rhode Island, Kingston, RI, USA.
University of Rochester School of Nursing, Rochester, NY, USA.
Clin Exp Allergy. 2021 Jan;51(1):63-77. doi: 10.1111/cea.13751. Epub 2020 Oct 18.
Young adults (ages 18-44) have increased emergency department use for asthma and poor adherence to medications. The objective of this mixed-methods study was to understand experiences with and approaches to managing asthma, of which little is known in this age group.
Surveys (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire) and 1:1 semi-structured interviews were used to explore experiences with asthma, symptoms, self-management behaviours, and relationship to asthma control and quality of life. Qualitative data were analysed using content analysis techniques. Descriptive statistics and bivariate correlations were used to examine distributive characteristics and associations between variables.
Forty urban adults participated (mean age 32.7 ± 6.2, 1σ). Coughing was reported nearly 46% more often than wheezing, with 42.5% (17/40) coughing until the point of vomiting most days. Most participants delayed using medication for symptoms due to misperceptions about inhalers. Higher symptom frequency and worse asthma control were associated with greater use of non-pharmacologic symptom management strategies (r = 0.645, P < .001; r = 0.360, P = .022, respectively). Five themes were identified regarding young adults experiences with asthma: (1) having asthma means being limited and missing out on life; (2) health care for asthma is burdensome, and other things are more important; (3) there is not enough personal benefit in medical interactions to make preventive care worthwhile; (4) there are insufficient support and education about asthma for adults; and (5) people normalize chronic symptoms over time and find ways of coping that fit with their lifestyle.
Young adults may tolerate symptoms without using quick-relief medication or seeking preventive care. Increasing engagement with preventive services will require decreasing perceived burdens and increasing the personal benefits of care. Evaluating for non-pharmacologic approaches to managing symptoms and asthma-related coughing may identify uncontrolled asthma. Enhanced training for clinicians in patient-centric asthma care may be needed.
年轻人（18-44 岁）因哮喘而增加了急诊就诊次数，并且对药物的依从性较差。本混合方法研究的目的是了解年轻人在管理哮喘方面的经验和方法，这在该年龄段知之甚少。
使用问卷调查（哮喘控制问卷、哮喘生活质量问卷）和 1:1 半结构式访谈，探讨了哮喘经历、症状、自我管理行为，以及与哮喘控制和生活质量的关系。使用内容分析技术对定性数据进行分析。使用描述性统计和双变量相关性分析来检查变量的分布特征和相关性。
40 名城市成年人参与了研究（平均年龄 32.7±6.2，1σ）。与喘息相比，咳嗽的报告频率高出近 46%，其中 42.5%（17/40）每天都会因咳嗽而呕吐。由于对吸入器的误解，大多数参与者在出现症状时会延迟使用药物。更高的症状频率和更差的哮喘控制与更频繁地使用非药物症状管理策略相关（r=0.645，P<0.001；r=0.360，P=0.022）。关于年轻人的哮喘经历，确定了五个主题：（1）患有哮喘意味着受到限制，错过了生活；（2）哮喘的医疗保健负担沉重，其他事情更重要；（3）在医疗互动中获得的个人利益不足以使预防保健值得；（4）成人对哮喘的支持和教育不足；（5）随着时间的推移，人们会使慢性症状正常化，并找到适合自己生活方式的应对方法。
年轻人可能会容忍症状，而不使用急救药物或寻求预防保健。增加对预防服务的参与将需要降低感知负担，并增加护理的个人利益。评估管理症状和与哮喘相关的咳嗽的非药物方法可能会发现未控制的哮喘。可能需要为临床医生提供以患者为中心的哮喘护理方面的强化培训。
