Acute childhood asthma significance from health care workers’ and caregivers’ perspective in a low resource setting: a qualitative study.

Abstract

Background: Little is known about how asthmatic children’s caregivers (CG) and health care workers (HCW) experience asthma attacks in a low resource setting. This could influence their attitude and actions towards asthma management. Aim: To better understand the significance of acute childhood asthma attacks from the caregivers’ and health care workers’ perspective in a low resource setting. Methods: We recruited CG of asthmatic children to focus group discussions (FGD) and HCW who attend paediatric asthma attacks, to in-depth semi-structured interviews (ISI), in Esmeraldas city, Ecuador. FGD and ISI were digitally recorded, transcribed, open-coded in QDA Miner, categorised using an interpretative phenomenological approach and analysed thematically. Results: 20 CG participated in 5 FGD and 3 paediatricians, 6 general doctors and 3 respiratory therapists provided 12 interviews, reporting diverse experiences. HCW feel responsible for the child’s outcome during the asthma attack and focus on the medical management. Inexperienced HCW may endure this event with fear and uncertainty, while more experienced workers are confident on their skills and knowledge. For the CG, asthma attacks are troublesome and urgent events that they live with fear, desperation and resignation in some cases. They affect the family’s economy, organisation and activities. Both CG and HCW feel responsible for the child and are aware of the possible complications and risk of death of the event. Conclusion: Asthma attacks in children are perceived and experienced differently by CG, inexperienced and experienced HCW. Personal perception is crucial to the experience of acute asthma.