Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지
DOI QR코드

DOI QR Code

The Disease Management Experience of Patients with Asthma: Grounded Theory Approach

천식 환자의 질병관리 경험: 근거이론접근

  • Kim, Bohye (College of Nursing, Ewha Womans University) ;
  • Kim, Oksoo (College of Nursing, Ewha Womans University)
  • Received : 2020.06.02
  • Accepted : 2020.09.16
  • Published : 2020.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to develop a situation-specific theory to explain the disease management experience of patients with asthma. Methods: Twenty participants with asthma were selected using the theoretical sampling method. The data were acquired through in-depth interviews conducted from June to October 2018 and analyzed using the grounded theory approach of Strauss and Corbin. Results: In total, 69 concepts, 30 subcategories, and 13 categories were generated to explain the disease management experience of patients with asthma. The core category of the disease management experience of patients with asthma was 'management of the disease to prevent aggravation of symptoms over the lifetime'. The disease management process of asthma patients included three steps: the 'cognition phase', the 'adjustment phase', and the 'maintenance phase'. However, some patients remained in the 'stagnation phase' of disease management, which represents the result of the continual pursuit of risky health behavior. There were three types of disease management experiences among patients with asthma: 'self-managing', 'partially self-managing', and 'avoidant'. Conclusion: This study shows that patients with asthma must lead their disease management process to prevent exacerbation of their symptoms. It is imperative to develop nursing strategies and establish policies for effective disease management of patients with asthma based on their individual disease management processes and types.

Keywords

References

  1. Global Initiative for Asthma. Global strategy for asthma management and prevention [Internet]. Fontana: Global Initiative for Asthma; c2018 [cited 2018 May 9]. Available from: https://ginasthma.org/.
  2. Lundback B, Backman H, Lotvall J, Ronmark E. Is asthma prevalence still increasing? Expert Review of Respiratory Medicine. 2016;10(1):39-51. https://doi.org/10.1586/17476348.2016.1114417
  3. Akinbami LJ, Fryar CD. Current asthma prevalence by weight status among adults: United States, 2001-2014. NCHS Data Brief. 2016;(239):1-8.
  4. Korea Centers for Disease Control and Prevention (KCDC). Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES VII-1) [Internet]. Sejong: Ministry of Health and Welfare; c2017 [cited 2018 May 4]. Available from: https://knhanes.cdc.go.kr/.
  5. Statistics Korea. Causes of death statistics [Internet]. Daejeon: Statistics Korea; c2017 [cited 2018 Dec 12]. Available from: https://kostat.go.kr/.
  6. Yoon J, Oh IH, Seo H, Kim EJ, Gong YH, Ock M, et al. Disability-adjusted life years for 313 diseases and injuries: The 2012 Korean burden of disease study. Journal of Korean Medical Science. 2016;31(Suppl 2):S146-S157. https://doi.org/10.3346/jkms.2016.31.S2.S146
  7. The Korean Academy of Asthma, Allergy and Clinical Immunology. Korean guideline for asthma [Internet]. Seoul: The Korean Academy of Asthma, Allergy and Clinical Immunology, Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD), National Strategic Coordination Center for Clinical Research (NSCR); c2015 [cited 2018 Dec 12]. Available from: http://www.allergy.or.kr/file/150527_01.pdf.
  8. Hiles SA, Harvey ES, McDonald VM, Peters M, Bardin P, Reynolds PN, et al. Working while unwell: Workplace impairment in people with severe asthma. Clinical and Experimental Allergy. 2018;48(6):650-662. https://doi.org/10.1111/cea.13153
  9. O'Byrne PM, Pedersen S, Schatz M, Thoren A, Ekholm E, Carlsson LG, et al. The poorly explored impact of uncontrolled asthma. Chest. 2013;143(2):511-523. https://doi.org/10.1378/chest.12-0412
  10. Ivanova JI, Bergman R, Birnbaum HG, Colice GL, Silverman RA, McLaurin K. Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma. The Journal of Allergy and Clinical Immunology. 2012;129(5):1229-1235. https://doi.org/10.1016/j.jaci.2012.01.039
  11. Zhang L, Zhang X, Zheng J, Wang L, Zhang HP, Wang L, et al. Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: A systematic review and meta-analysis. Journal of Thoracic Disease. 2016;8(6):1257-1268. https://doi.org/10.21037/jtd.2016.04.68
  12. Braido F. Failure in asthma control: Reasons and consequences. Scientifica. 2013;2013:549252. https://doi.org/10.1155/2013/549252
  13. Ritz T, Meuret AE, Trueba AF, Fritzsche A, von Leupoldt A. Psychosocial factors and behavioral medicine interventions in asthma. Journal of Consulting and Clinical Psychology. 2013;81(2):231-250. https://doi.org/10.1037/a0030187
  14. Chung MH, Park H. Symptom experiences, sleep quality and quality of life for patients with asthma. Journal of the Korea Academia-Industrial Cooperation Society. 2016;17(11):616-628. https://doi.org/10.5762/KAIS.2016.17.11.616
  15. Chung JH, Han CH. Health related quality of life in relation to asthma - data from a cross sectional study. Journal of Asthma. 2018;55(9):1011-1017. https://doi.org/10.1080/02770903.2017.1387266
  16. Gurkova E, Popelkova P, Otipka P. Relationship between asthma control, health-related quality of life and subjective well-being in Czech adults with asthma. Central European Journal of Nursing and Midwifery. 2015;6(3):274-282. https://doi.org/10.15452/CEJNM.2015.06.0016
  17. Moon HM, Kim Y, Kwak Y, Kim K. Association between smoking type and prevalence of atopic dermatitis and asthma in men and women. International Journal of Nursing Practice. 2018;24(6):e12680. https://doi.org/10.1111/ijn.12680
  18. Hyland ME, Whalley B, Jones RC, Masoli M. A qualitative study of the impact of severe asthma and its treatment showing that treatment burden is neglected in existing asthma assessment scales. Quality of Life Research. 2015;24(3):631-639. https://doi.org/10.1007/s11136-014-0801-x
  19. Mowrer JL, Tapp H, Ludden T, Kuhn L, Taylor Y, Courtlandt C, et al. Patients' and providers' perceptions of asthma and asthma care: A qualitative study. Journal of Asthma. 2015;52(9):949-956. https://doi.org/10.3109/02770903.2015.1010731
  20. Pai S, Boutin-Foster C, Mancuso CA, Loganathan R, Basir R, Kanna B. "Looking out for each other": A qualitative study on the role of social network interactions in asthma management among adult Latino patients presenting to an emergency department. Journal of Asthma. 2014;51(7):714-719. https://doi.org/10.3109/02770903.2014.903967
  21. Hughes M, Savage E, Andrews T. Accommodating interruptions: A grounded theory of young people with asthma. Journal of Clinical Nursing. 2018;27(1-2):212-222. https://doi.org/10.1111/jocn.13874
  22. O'Conor R, Martynenko M, Gagnon M, Hauser D, Young E, Lurio J, et al. A qualitative investigation of the impact of asthma and self-management strategies among older adults. Journal of Asthma. 2017;54(1):39-45. https://doi.org/10.1080/02770903.2016.1193602
  23. Andrews KL, Jones SC, Mullan J. Asthma self management in adults: A review of current literature. Collegian. 2014;21(1):33-41. https://doi.org/10.1016/j.colegn.2012.12.005
  24. Bidad N, Barnes N, Griffiths C, Horne R. Understanding patients' perceptions of asthma control: A qualitative study. European Respiratory Journal. 2018;51(6):1701346. https://doi.org/10.1183/13993003.01346-2017
  25. Corbin, JM, Strauss AL. Basics of qualitative research: Techniques and procedures for developing grounded theory. 4th ed. Los Angeles (CA): Sage Publications; 2015. p. 1-431.
  26. Strauss AL, Corbin JM. Basics of qualitative research: Techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks (CA): Sage Publications; 1998. p. 1-312.
  27. Morse JM. Qualitative health research: Creating a new discipline. Abingdon: Routledge; 2016. p. 23.
  28. Foster JM, McDonald VM, Guo M, Reddel HK. "I have lost in every facet of my life": The hidden burden of severe asthma. European Respiratory Journal. 2017;50(3):1700765. https://doi.org/10.1183/13993003.00765-2017
  29. Svedsater H, Roberts J, Patel C, Macey J, Hilton E, Bradshaw L. Life impact and treatment preferences of individuals with asthma and chronic obstructive pulmonary disease: Results from qualitative interviews and focus groups. Advances in Therapy. 2017;34(6):1466-1481. https://doi.org/10.1007/s12325-017-0557-0
  30. De Simoni A, Horne R, Fleming L, Bush A, Griffiths C. What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum. BMJ Open. 2017;7(6):e015245. https://doi.org/10.1136/bmjopen-2016-015245
  31. Jeong YY. Adherence: Implications for asthma treatment. Allergy, Asthma & Respiratory Disease. 2013;1(2):105-110. https://doi.org/10.4168/aard.2013.1.2.105
  32. Baddar S, Jayakrishnan B, Al-Rawas OA. Asthma control: Importance of compliance and inhaler technique assessments. Journal of Asthma. 2014;51(4):429-434. https://doi.org/10.3109/02770903.2013.871558
  33. Ryan P, Sawin KJ. The Individual and Family Self-Management Theory: Background and perspectives on context, process, and outcomes. Nursing Outlook. 2009;57(4):217-225.e6. https://doi.org/10.1016/j.outlook.2008.10.004
  34. Grey M, Knafl K, McCorkle R. A framework for the study of self- and family management of chronic conditions. Nursing Outlook. 2006;54(5):278-286. https://doi.org/10.1016/j.outlook.2006.06.004
  35. Bae JY. The study on the relationship between the burden of medical expenditures and health-related quality of life among the elderly with chronic diseases. Journal of Social Science. 2014;25(4):109-129. https://doi.org/10.16881/jss.2014.10.25.4.109
  36. Becker MH, Haefner DP, Kasl SV, Kirscht JP, Maiman LA, Rosenstock IM. Selected psychosocial models and correlates of individual health-related behaviors. Medical Care. 1977;15(5 Suppl):27-46. https://doi.org/10.1097/00005650-197705001-00005
  37. Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 5th ed. Upper Saddle River (NJ): Prentice Hall; 2006. p. 47-55.
  38. Coulter A, Entwistle VA, Eccles A, Ryan S, Shepperd S, Perera R. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database of Systematic Reviews. 2015;2015(3):CD010523. https://doi.org/10.1002/14651858.CD010523.pub2