Qualitative phenomenological study informs the development of educational intervention for behaviour change to reduce morbidity and mortality in adults with chronic lung disease in rural India

Abstract

<b>Introduction:</b> A substantial burden of chronic respiratory diseases (CRDs) is being borne by the low and middle income countries. Community interventions that can change health behaviour related to CRD requires an understanding of people’s knowledge, perceptions, cultural beliefs, practices and factors influencing such behaviour. Our phenomenological qualitative study sought to explore people’s perceptions, experiences of living with the disease, opinions on barriers to treatment, cultural and subjective norms related to CRD to inform the design of a feasible educational intervention trial in the rural, low-health-literacy regions of Tamil Nadu, India. <b>Methods:</b> The qualitative data was collected between September to December 2018 through eight focus group discussions, five in-depth interviews and four key-informant interviews from patients and community members. Inductive coding was done for thematic analyses of the interviews and discussions. <b>Results:</b> Cultural practices like using biomass fuel for cooking, seeking treatment from traditional healers were common. Accessibility to inhalers was poor and use infrequent; respiratory exercises were practically unknown. Stigma for the disease and inhaler use created emotional challenges and mental health problems, besides influencing health behaviour. <b>Conclusion:</b> The health behaviour of CRD patients were rooted to their cultural practices and prevailing social norms, influenced by being unaware about the disease. Therefore behaviour change educational interventions are required at multiple levels to improve quality of life of patients with CRD.