Abstract:In this article, we analyze qualitative data from a purposeful sample of limited English proficiency (LEP) asthma health caregivers. We used ethnically concordant, semistructured, in-depth Spanish-language interviews and a follow-up focus group to explore issues related to communication during pediatric asthma encounters in medical settings. Inductive coding of Spanish transcripts by a bilingual research team was performed until thematic saturation was reached. Several key findings emerged. LEP caregivers enco… Show more
“…Even his little sisters know what to do in the event of an asthma attack…In my house the entire family practices with the child, so that if I'm not there when something happens, everyone knows what to do . (Mother, p. 22)…”
Section: Resultsmentioning
confidence: 98%
“…WAPs can help alleviate parental worry and boost their confidence in looking after their children. Parents across the studies described how having a WAP gave them reassurance and confidence as managers of their child's illness:[I find the plan very useful]. Just to refresh, or you know to know that for sure that we're doing the right thing when you're giving him medication especially when things get worse, or come back to being better (Parent, p. 145)…”
Section: Resultsmentioning
confidence: 99%
“…Parents also described how having a plan was particularly reassuring and useful when their children were under the care of someone else and liked to give it to schools and extended family . Some used the WAP as a tool to motivate the entire family to learn what to do when the primary care giver was not available:… We always practiced. Even his little sisters know what to do in the event of an asthma attack…In my house the entire family practices with the child, so that if I'm not there when something happens, everyone knows what to do .…”
BackgroundLong‐term conditions (LTCs) in children require a high level of self‐management. Written action plans (WAPs) have been advocated to guide decision‐making and support self‐management but there is uncertainty about how WAPs “work” and what aspects are important for successful implementation.ObjectiveTo review and synthesize existing qualitative evidence about the design and use of WAPs across childhood LTCs.MethodWe undertook a systematic search of the literature (Medline, EMBASE, CiNAHL, PsycInfo, Web of science) from inception to May 2015; critically appraised included studies; and synthesized the findings, drawing on normalisation process theory.Results3473 titles were screened and 53 papers read in full. Nine studies (four key, two minor and three of poor quality) contributed to our analysis, predominantly work on asthma from the USA and in specialist settings. WAPs may help to alleviate user worry and boost confidence. Confidence to act was closely linked to feelings of responsibility and authority. The value and use of WAPs are determined by multiple factors, and varies between different user groups. Logistical challenges include sharing a WAP between different stakeholders and keeping it up to date. Colour coding and pictures may enhance the appeal and usability of WAPS.Conclusion
WAPs are complex interventions but our understanding of their use and value in children with LTCs is limited. WAPs need to meet the needs of users who have different requirements/levels of understanding and confidence according to their different roles. Future research into WAPs needs to be both disease and context‐specific.
“…Even his little sisters know what to do in the event of an asthma attack…In my house the entire family practices with the child, so that if I'm not there when something happens, everyone knows what to do . (Mother, p. 22)…”
Section: Resultsmentioning
confidence: 98%
“…WAPs can help alleviate parental worry and boost their confidence in looking after their children. Parents across the studies described how having a WAP gave them reassurance and confidence as managers of their child's illness:[I find the plan very useful]. Just to refresh, or you know to know that for sure that we're doing the right thing when you're giving him medication especially when things get worse, or come back to being better (Parent, p. 145)…”
Section: Resultsmentioning
confidence: 99%
“…Parents also described how having a plan was particularly reassuring and useful when their children were under the care of someone else and liked to give it to schools and extended family . Some used the WAP as a tool to motivate the entire family to learn what to do when the primary care giver was not available:… We always practiced. Even his little sisters know what to do in the event of an asthma attack…In my house the entire family practices with the child, so that if I'm not there when something happens, everyone knows what to do .…”
BackgroundLong‐term conditions (LTCs) in children require a high level of self‐management. Written action plans (WAPs) have been advocated to guide decision‐making and support self‐management but there is uncertainty about how WAPs “work” and what aspects are important for successful implementation.ObjectiveTo review and synthesize existing qualitative evidence about the design and use of WAPs across childhood LTCs.MethodWe undertook a systematic search of the literature (Medline, EMBASE, CiNAHL, PsycInfo, Web of science) from inception to May 2015; critically appraised included studies; and synthesized the findings, drawing on normalisation process theory.Results3473 titles were screened and 53 papers read in full. Nine studies (four key, two minor and three of poor quality) contributed to our analysis, predominantly work on asthma from the USA and in specialist settings. WAPs may help to alleviate user worry and boost confidence. Confidence to act was closely linked to feelings of responsibility and authority. The value and use of WAPs are determined by multiple factors, and varies between different user groups. Logistical challenges include sharing a WAP between different stakeholders and keeping it up to date. Colour coding and pictures may enhance the appeal and usability of WAPS.Conclusion
WAPs are complex interventions but our understanding of their use and value in children with LTCs is limited. WAPs need to meet the needs of users who have different requirements/levels of understanding and confidence according to their different roles. Future research into WAPs needs to be both disease and context‐specific.
“…Difficulties in communication could be from many barriers [23], including doctor-patient relationship, discouragement of collaboration, resistance by patients, literacy [24], and language barrier [25]. However, communication skills between 2 parties can be improved using these five strategies: establish a relationship, listening, collaborate on the treatment plan, time management, and implement effective follow-up interventions, handling phone calls or text messaging (Table 2) [26].…”
Section: Strategies To Improve Adherencementioning
Promoting adherence to asthma treatment is an essential aspect of clinical practice. Approximately 60% of asthmatic patients are non-adherent to asthma regimen, resulting in adverse outcomes and higher costs of care. Non-adherence could be intentional (perceptions of asthma severity, self-manage therapy, fear of side-effects) or non-intentional (forgetful, cost, and misunderstandings). Adherence can be evaluated by patient's reporting, dose counter, electronic metered dose inhaler but using pharmacy records is a more cost-effective method. The most successful strategies to improve patients' adherence is to utilize the principle of patient-centered collaborative care and effective communication. Keys of communication skills consist of establishing a relationship, listening, collaborating on the treatment plan, time management, and implementing effective follow-up interventions. Interventions to improve adherence include providing reinforcement for patients' efforts to change, providing feedback on progress, tailoring education to patients' needs and circumstances and follow-up. Evaluation of health literacy is mandatory for prioritizing information from most to least critical, speaking slowly, avoiding medical jargon, and spending minimal extra time during each visit. Communication technology including texting or interactive voice response is another new strategy that can increase adherence.
“…The provision of care can last a long time and encompass the physical, psychological, social, spiritual and existential areas of a person (Servicio Nacional del Adulto Mayor, 2010). The demand that is required of a caregiver to satisfy all of the care-recipient’s needs puts the caregiver at risk of developing emotional stress, physical ailments, work abandonment and family conflict, among other issues (AARP, 2015a; Riera et al, 2015; Toms, Quinn, Anderson, & Clare, 2015). As a result, the weight of the caregiver’s responsibility takes shape, and has been defined as a dynamic process resulting from negative emotions and experiences that are characterized by negative effects at the physical, emotional and psychological level, (M.-C. Chen, Chen, & Chu, 2014; Del Río-Lozano, García-Calvente, Marcos-Marcos, Entrena-Durán, & Maroto-Navarro, 2013; Werner, Mendez-Luck, Kennedy, & Wallace, 2008; Yen, Huang, Ma, Lee, & Lee, 2009).…”
Purpose: Informal caregivers of bedridden elders need a respite. One form of obtaining a respite is through volunteers who are contacted by means of information and communication technology (ICT). Method: A qualitative study was carried out in a low-income district in Santiago, Chile, to learn about how caregivers of bedridden elders perceive the possibility of using ICT to access this respite. In-depth interviews were carried out and transcribed verbatim, then analysed using open coding. Results: The results reveal that caregivers are willing to receive a volunteer in their home and use ICT to communicate with them, although a discrepancy exists between the use of devices connected to the Internet and feature phones. Conclusion: This study concludes that informal caregivers of bedridden elders have a favourable disposition towards accessing a respite system by means of ICT based on a peer-to-peer economy.
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