Generational perspective on asthma self‐management in the Bangladeshi and Pakistani community in the United Kingdom: A qualitative study

Abstract

Background: Self-management strategies improve asthma outcomes, although interventions for South Asian populations have been less effective than in White populations. Both self-management and culture are dynamic, and factors such as acculturation and generation have not always been adequately reflected in existing cultural interventions. We aimed to explore the perspectives of Bangladeshi and Pakistani people in the United Kingdom, across multiple generations (first, second and third/fourth), on how they self-manage their asthma, with a view to suggesting recommendations for cultural interventions. Methods: We purposively recruited Bangladeshi and Pakistani participants, with an active diagnosis of asthma from healthcare settings. Semi-structured interviews in the participants' choice of language (English, Sylheti, Standard Bengali or Urdu) were conducted, and data were analysed thematically.Results: Twenty-seven participants (13 Bangladeshi and 14 Pakistani) were interviewed. There were generational differences in self-management, influenced by complex cultural processes experienced by South Asians as part of being an ethnic minority group. Individuals from the first generation used self-management strategies congruent to traditional beliefs such as 'sweating' and often chose to travel to South Asian countries. Generations born and raised in the United Kingdom learnt and experimented with self-management based on their fused identities and modified their approach depending on whether they were in familial or peer settings.Acculturative stress, which was typically higher in first generations who had migration-related stressors, influenced the priority given to asthma self-management throughout generations. The amount and type of available asthma information as

Experience in Accessing Healthcare in Ethnic Minority Patients with Chronic Respiratory Diseases: A Qualitative Meta-Synthesis

“…One recent study sought to understand the ways that Bangladeshi/Pakistani asthmatic patients in the UK dealt with asthma [33]. For example, one Bangladeshi patient said, 'Just don't see it [asthma self-management] as an issue really.…”

“…For example, one Bangladeshi patient said, 'Just don't see it [asthma self-management] as an issue really. Like if you got a headache you take paracetamol, you know' [33]. In contrast, the Pakistani patient stated: 'From the sweat, my cold comes, and my asthma happens, and I get breathless' [33].…”

“…Like if you got a headache you take paracetamol, you know' [33]. In contrast, the Pakistani patient stated: 'From the sweat, my cold comes, and my asthma happens, and I get breathless' [33]. These quotations illustrate how people from ethnic minorities may see medical interventions and behave towards them.…”

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“…Lectures, audiovisual presentations, and group discussions are all examples of forms of interactive learning that may be used in either individual or group sessions with a teacher. Other examples include role-playing, project- or assignment-based learning, participatory learning, and the case method for developing problem-solving skills [ 11 , 12 ].…”

Peer review of funding applications for health research in ethnic minority groups must improve

“…It is not sufficient to simply match a trial population to the served population, as the NIHR recommends, if the matching does not allow for the identification of harms in some population groups owing to small sample sizes 9. Caution should be exercised when assuming that problems are shared between—and within—ethnic, racial, or religious groups to avoid oversimplified cultural categorising and perpetuating inequalities 10…”