Caregiver Expectations of Clinicians during the Asthma Diagnostic Process in Young Children: Thematic Analysis of Focus Groups

Abstract

Objective. Asthma is difficult to diagnose in young children, and the subjective experience of caregivers varies. Clinicians’ ability to meet caregiver expectations during the diagnostic process improves the caregiver–clinician relationship, and effectiveness of disease management strategies. Methods. We performed thematic analysis of seven focus groups (FGs) with 38 caregivers of children 1–6 years old diagnosed with asthma in the preceding 12 months. Caregivers were classified as satisfied or dissatisfied with clinicians during the asthma diagnostic process. Differential themes in these two groups identified caregiver expectations that determined satisfaction with the diagnostic process. Results. Caregiver expectations during the asthma diagnostic process included (1) provision of a diagnostic strategy, (2) acknowledgment of caregiver advocacy, (3) addressing caregiver’s beliefs about treatment with asthma medications before a diagnosis was confirmed, and (4) discussing asthma specialist involvement in the diagnosis. Higher perceived severity of a child’s illness made caregiver expectations more difficult to meet. Conclusions. We conclude that clinicians considering an asthma diagnosis in young children must include a diagnostic strategy that is congruent with the caregiver’s beliefs about the underlying illness, use of medication, and asthma specialist involvement. Perceived illness severity must also be accounted for when designing a diagnostic strategy.