Perceptions of mothers having children with bronchial asthma regarding inhaler therapy: a qualitative study

Abstract

Background: Bronchial asthma imposes a significant health burden on the children. Multiple inflammatory mediators are recruited in bronchial asthma. Inhaled corticosteroid therapy is the mainstay of bronchial asthma treatment which is most effective to suppress the inflammatory changes in bronchial airways. The principal issue in proper control of bronchial asthma is adherence to treatment. The objective of the study is to find out the causes of non-adherence to treatment and perceptions of mothers having child with bronchial asthma through a qualitative in-depth interview method. Methods: The study was conducted in the Paediatric Department of Burdwan Medical College, Burdwan, West Bengal. The study was one of qualitative descriptive types involving in depth interviews (IDI) of 27 mothers having children with bronchial asthma. The interviews were translated into English transcripts which were then analyzed to find out suitable codes and categories. Results: From the transcripts we found out eight categories each of which is further divided into several codes. The categories are given here with codes in parenthesis. Initial repercussion (disagreement, habit forming, harmful, future problems), non-willingness to treatment (discontinuation, avoidance and oral medication), hazards during treatment (cost, availability, remote places, lack of time and family crisis), technical difficulties (demonstration, lack of knowledge, and cleaning the device), problem of the baby (irritability, vomiting, and excessive crying), attitude of mother/caregiver (misconception, non-motivation, and worriedness), other modalities of treatment (homeopathy, and ayurvedic medicines), and response to treatment (better feeling, decreased frequency, reduced recurrences, and total cure). Conclusions: Most of the studies dealing with the various factors of non-adherence of treatment of bronchial asthma is not a qualitative approach. In the present study we have applied qualitative in-depth interview approach and able to find out different causes of non-adherence to inhaler therapy of bronchial asthma. In the category "response to therapy", a few of the comments is quite encouraging and fully support the modern views of the management of bronchial asthma.