Guided asthma self-management or patient self-adjustment? Using patients' narratives to better understand adherence to asthma treatment.
Identifieur interne : 000480 ( Main/Corpus ); précédent : 000479; suivant : 000481Guided asthma self-management or patient self-adjustment? Using patients' narratives to better understand adherence to asthma treatment.
Auteurs : Biagina-Carla Farnesi ; Francine M. Ducharme ; Lucie Blais ; Johanne Collin ; Kim L. Lavoie ; Simon L. Bacon ; Martha L. Mckinney ; Sandra PeláezSource :
- Patient preference and adherence [ 1177-889X ] ; 2019.
Abstract
Purpose
The purpose of this study was to better understand patients' perspective of asthma self-management by focusing on the sociocultural and medical context shaping patients' illness representations and individual decisions.
Patients and methods
We conducted a secondary analysis of semi-structured interviews carried out as part of a multicentered collective qualitative case study. In total, 24 patients, aged 2-76 years with a confirmed diagnosis of asthma (or were parents of a child), who renewed the prescription for inhaled corticosteroids in the past year, participated in this study. The thematic analysis focused on asthma-related events and experiences reported by the patients. Consistent with narrative inquiry, similar patterns were grouped together, and three vignettes representing the different realities experienced by the patients were created.
Results
The comparison of experiences and events reported by the patients suggested that patients' perceptions and beliefs regarding asthma and treatment goals influenced their self-management-related behaviors. More specifically, the medical context in which the patients were followed (ie, frame in which the medical encounter takes place, medical recommendations provided) contributed to shape their understanding of the disease and the associated treatment goals. In turn, a patient's perception of the disease and the treatment goals influenced asthma self-management behaviors related to environmental control, lifestyle habits, and medication intake.
Conclusion
Current medical recommendations regarding asthma self-management highlight the importance of the physicians' guidance through the provision of a detailed written action plan and asthma education. These data suggest that while physicians contribute to shaping patients' beliefs and perceptions about the disease and treatment goals, patients tend to listen to their own experience and manage the disease accordingly. Thus, a medical encounter between the patient and the physician, aiming at enhancing a meaningful conversation about the disease, may lead the patient to approach the disease in a more effective manner, which goes beyond taking preventative paths to avoid symptoms.
DOI: 10.2147/PPA.S195585
PubMed: 31114172
PubMed Central: PMC6485321
Links to Exploration step
pubmed:31114172Le document en format XML
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<front><div type="abstract" xml:lang="en"><p><b>Purpose</b>
</p>
<p>The purpose of this study was to better understand patients' perspective of asthma self-management by focusing on the sociocultural and medical context shaping patients' illness representations and individual decisions.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Patients and methods</b>
</p>
<p>We conducted a secondary analysis of semi-structured interviews carried out as part of a multicentered collective qualitative case study. In total, 24 patients, aged 2-76 years with a confirmed diagnosis of asthma (or were parents of a child), who renewed the prescription for inhaled corticosteroids in the past year, participated in this study. The thematic analysis focused on asthma-related events and experiences reported by the patients. Consistent with narrative inquiry, similar patterns were grouped together, and three vignettes representing the different realities experienced by the patients were created.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Results</b>
</p>
<p>The comparison of experiences and events reported by the patients suggested that patients' perceptions and beliefs regarding asthma and treatment goals influenced their self-management-related behaviors. More specifically, the medical context in which the patients were followed (ie, frame in which the medical encounter takes place, medical recommendations provided) contributed to shape their understanding of the disease and the associated treatment goals. In turn, a patient's perception of the disease and the treatment goals influenced asthma self-management behaviors related to environmental control, lifestyle habits, and medication intake.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusion</b>
</p>
<p>Current medical recommendations regarding asthma self-management highlight the importance of the physicians' guidance through the provision of a detailed written action plan and asthma education. These data suggest that while physicians contribute to shaping patients' beliefs and perceptions about the disease and treatment goals, patients tend to listen to their own experience and manage the disease accordingly. Thus, a medical encounter between the patient and the physician, aiming at enhancing a meaningful conversation about the disease, may lead the patient to approach the disease in a more effective manner, which goes beyond taking preventative paths to avoid symptoms.</p>
</div>
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<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1177-889X</ISSN>
<JournalIssue CitedMedium="Print"><Volume>13</Volume>
<PubDate><Year>2019</Year>
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<Title>Patient preference and adherence</Title>
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<ArticleTitle>Guided asthma self-management or patient self-adjustment? Using patients' narratives to better understand adherence to asthma treatment.</ArticleTitle>
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<Abstract><AbstractText Label="Purpose" NlmCategory="UNASSIGNED">The purpose of this study was to better understand patients' perspective of asthma self-management by focusing on the sociocultural and medical context shaping patients' illness representations and individual decisions.</AbstractText>
<AbstractText Label="Patients and methods" NlmCategory="UNASSIGNED">We conducted a secondary analysis of semi-structured interviews carried out as part of a multicentered collective qualitative case study. In total, 24 patients, aged 2-76 years with a confirmed diagnosis of asthma (or were parents of a child), who renewed the prescription for inhaled corticosteroids in the past year, participated in this study. The thematic analysis focused on asthma-related events and experiences reported by the patients. Consistent with narrative inquiry, similar patterns were grouped together, and three vignettes representing the different realities experienced by the patients were created.</AbstractText>
<AbstractText Label="Results" NlmCategory="UNASSIGNED">The comparison of experiences and events reported by the patients suggested that patients' perceptions and beliefs regarding asthma and treatment goals influenced their self-management-related behaviors. More specifically, the medical context in which the patients were followed (ie, frame in which the medical encounter takes place, medical recommendations provided) contributed to shape their understanding of the disease and the associated treatment goals. In turn, a patient's perception of the disease and the treatment goals influenced asthma self-management behaviors related to environmental control, lifestyle habits, and medication intake.</AbstractText>
<AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">Current medical recommendations regarding asthma self-management highlight the importance of the physicians' guidance through the provision of a detailed written action plan and asthma education. These data suggest that while physicians contribute to shaping patients' beliefs and perceptions about the disease and treatment goals, patients tend to listen to their own experience and manage the disease accordingly. Thus, a medical encounter between the patient and the physician, aiming at enhancing a meaningful conversation about the disease, may lead the patient to approach the disease in a more effective manner, which goes beyond taking preventative paths to avoid symptoms.</AbstractText>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Farnesi</LastName>
<ForeName>Biagina-Carla</ForeName>
<Initials>BC</Initials>
<AffiliationInfo><Affiliation>Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC Canada.</Affiliation>
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<Author ValidYN="Y"><LastName>Ducharme</LastName>
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<AffiliationInfo><Affiliation>Research Centre, CHU Sainte-Justine, University of Montreal, Montreal, QC Canada, sandra.pelaez@umontreal.ca.</Affiliation>
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<AffiliationInfo><Affiliation>Research Center, Sacré-Coeur de Montréal Hospital, CIUSSS du Nord-de-l'Ile-de-Montréal, Montreal, QC Canada.</Affiliation>
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<AffiliationInfo><Affiliation>CHU Ste-Justine, University of Montreal, Montreal, QC Canada.</Affiliation>
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<ForeName>Sandra</ForeName>
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<AffiliationInfo><Affiliation>Research Centre, CHU Sainte-Justine, University of Montreal, Montreal, QC Canada, sandra.pelaez@umontreal.ca.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada, sandra.pelaez@umontreal.ca.</Affiliation>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<ArticleDate DateType="Electronic"><Year>2019</Year>
<Month>04</Month>
<Day>23</Day>
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<MedlineJournalInfo><Country>New Zealand</Country>
<MedlineTA>Patient Prefer Adherence</MedlineTA>
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<ISSNLinking>1177-889X</ISSNLinking>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">adherence</Keyword>
<Keyword MajorTopicYN="N">asthma</Keyword>
<Keyword MajorTopicYN="N">narrative inquiry</Keyword>
<Keyword MajorTopicYN="N">patient-physician relationship</Keyword>
<Keyword MajorTopicYN="N">self-management</Keyword>
<Keyword MajorTopicYN="N">written action plan</Keyword>
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<CoiStatement>Disclosure Dr Francine M Ducharme reports grants from the Canadian Institute of Health Research, during the conduct of the study as well as from Astra Zeneca, Novartis, and Merck Canada, and also reports grants from GlaxoSmithKline, and personal fees from Sanofi, outside the submitted work. Dr Lucie Blais reports grants and personal fees from AstraZeneca and Genentech and grants from TEVA, outside the submitted work. Dr Kim L Lavoie reports personal fees from Boehringer Ingelheim, Astellas, Janssen, Novartis, Bayer, Abbvie, and Astra-Zeneca, outside the submitted work. Dr Simon L Bacon reports grants from Abbvie, personal fees from Astra-Zenica, Sygesa, Novartis, Jansen, and Bayer, outside the submitted work. Ms Biagina-Carla Farnesi, Dr Johanne Collin, Dr Martha L McKinney and Dr Sandra Peláez report no conflicts of interest in this work.</CoiStatement>
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