Adolescents’ practical knowledge of asthma self-management and experiences in the context of acute asthma: a qualitative content analysis

Abstract

Objective

To characterize adolescents’ practical knowledge of asthma self-management and experiences during acute asthma episodes, and compare practical knowledge between minority and non-minority groups.

Methods

We conducted a secondary analysis using a qualitative descriptive design of textual data collected from 126 adolescents that participated in a randomized controlled trial of an asthma self-management program. Directed content analysis was conducted using four constructs of asthma self-management including symptom prevention, symptom monitoring, acute symptom management, and symptom communication.

Results

Most of the adolescents knew how to prevent exercised-induced bronchoconstriction, but had limited understanding about how to assess and monitor the severity of acute symptoms, appropriately use bronchodilators, seek timely medical help, and communicate acute symptoms to caregivers or healthcare providers during a slow-onset and rapid-onset asthma attack. More minority participants monitored asthma using peak expiratory flow than non-minority participants, who often relied on symptom-based monitoring. Minority adolescents more frequently mentioned bronchodilator use to manage asthma attacks, while non-minority adolescents often reported use of complementary and alternative approaches. Minority youth mentioned accessing healthcare services for acute episodes more often than their non-minority counterparts. Minority participants mentioned communicating acute symptoms to their providers, or family members less frequently than non-minority youth.

Conclusions

Adolescents have insufficient practical knowledge about ways to prevent and manage acute asthma. Periodic assessment of learning needs related to asthma attacks should be considered a routine part of clinical visits for adolescents to provide targeted information support to address their identified needs.

Keywords:

• Adolescents
• asthma attacks
• self-management knowledge
• qualitative

Acknowledgements

We would like to acknowledge the help and support from Drs. Kachina Allen, Constance Baldwin, and Jeanne-Marie Stacciarini. We would also like to thank the participants of the Teen Asthma Project who provided the invaluable data for this study.

Declaration of interest

The authors declare that there are no conflicts of interest.

Additional information

Funding

The study was made possible by Dr. Hyekyun Rhee and data collection was supported by grant number R21 NR009837-02 from the National Institute of Health’s National Institute of Nursing Research. ClinicalTrials.gov Identifier NCT01161225.