How young children learn independent asthma self-management: a qualitative study in Malaysia

• Main Authors: Ramdzan, Siti Nurkamilla, Ee, Ming Khoo, Su, May Liew, Cunningham, Steve, Kendall, Marilyn, Sukri, Nursyuhada, Salim, Hani, Suhaimi, Julia, Lee, Ping Yein, Cheong, Ai Theng, Hussein, Norita, Hanafi, Nik Sherina Haidi, Mohd Ahad, Azainorsuzila, Pinnock, Hilary
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2020
• Online Access: http://psasir.upm.edu.my/id/eprint/89214/1/ASTHMA.pdf; http://psasir.upm.edu.my/id/eprint/89214/; https://adc.bmj.com/content/105/9/819
• Institution: Universiti Putra Malaysia

Objective 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. Design 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. Settings 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. Results 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. Conclusion 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.