Stoneley Alannah, Anderson Judith, Sutton Clare
School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, AUS.
Cureus. 2023 Dec 11;15(12):e50350. doi: 10.7759/cureus.50350. eCollection 2023 Dec.
Asthma is a leading cause of respiratory illness in Australia and has a significant prevalence in rural areas. Literature suggests living in rural areas can act as a barrier to receiving emergency healthcare for asthma exacerbations resulting in the need for further resources and advocacy in educating rural asthmatics about managing their condition and knowing when to access further help. This study aims to explore decision-making in accessing emergency healthcare for people with moderate to severe asthma exacerbations in rural New South Wales (NSW).
A qualitative interpretative design involving semi-structured interviews with 12 participants was conducted between May and July 2021. Interviews were recorded and transcribed verbatim. Participants were asthmatics who had accessed emergency healthcare for a moderate to severe asthma exacerbation in NSW over the last five years. Data was thematically analysed and grouped into four overarching themes. Due to the depth and range of data this paper will be reporting on two of those themes.
Past experiences as education and the impact of self-management strategies were both shown to be prominent influences that affected decisions on choosing to access emergency healthcare during a moderate to severe asthma exacerbation. Participants shared how their decision-making was shaped by health literacy gained from their past experiences of asthma exacerbations and dealing with emergency healthcare. In addition, self-management strategies were utilised to minimise the need to access emergency healthcare. This was achieved through telehealth appointments, lifestyle changes and non-pharmacological strategies.
This study shows that an increase in health promotion activities throughout rural areas can help to reassure people about uncertainties that may be associated with their past experiences and improve health literacy. Additionally, providing tools to allow confident self-management of asthma effectively using evidence-based techniques to prevent it progressing to a moderate or severe exacerbation would also be of benefit.
哮喘是澳大利亚呼吸系统疾病的主要病因,在农村地区也有很高的发病率。文献表明,生活在农村地区可能成为哮喘急性发作时获得紧急医疗护理的障碍,这就需要投入更多资源,并开展宣传活动,以教育农村哮喘患者如何管理病情以及何时寻求进一步的帮助。本研究旨在探讨新南威尔士州农村地区中重度哮喘急性发作患者在寻求紧急医疗护理时的决策过程。
2021年5月至7月,采用定性解释性设计,对12名参与者进行了半结构化访谈。访谈进行了录音,并逐字转录。参与者为过去五年内在新南威尔士州因中重度哮喘急性发作而接受过紧急医疗护理的哮喘患者。对数据进行了主题分析,并归纳为四个总体主题。鉴于数据的深度和广度,本文将报告其中两个主题。
过往经历作为一种教育方式以及自我管理策略的影响,在中重度哮喘急性发作期间,都被证明是影响患者决定是否寻求紧急医疗护理的重要因素。参与者分享了他们的决策是如何受到哮喘急性发作和应对紧急医疗护理的过往经历所获得的健康素养的影响。此外,还采用了自我管理策略,以尽量减少寻求紧急医疗护理的必要性。这是通过远程医疗预约、生活方式改变和非药物策略实现的。
本研究表明,在农村地区增加健康促进活动有助于消除人们对可能与他们过去经历相关的不确定性的担忧,并提高健康素养。此外,提供工具,让患者能够使用循证技术自信地对哮喘进行自我管理,有效预防其发展为中度或重度急性发作,也将有所帮助。