Medicines and the maintenance of ordinariness in the household management of childhood asthma

Abstract

This paper applies and extends the 'adaption' perspective on chronic illness by arguing that, in the case of moderate childhood asthma, an important aspect of the process may be found in the ways in which children and parents construct a sense of their ordinariness. It is suggested that medicines may play a role in this process. Reporting an intensive and detailed qualitative study of the management strategies of nine English families, it is shown that household members did not generally regard asthma as a major problem. Regular medication, usually in the form of inhaled drugs, was their main response. Few other strategies were followed and little attention was paid to the non-medicinal preventive actions recommended in asthma management guidelines and educational material. Parents' and children's accounts suggest that they were involved not only in managing a disease but also in maintaining a sense of their own ordinariness. Paradoxically, medicines, especially inhalers, were the main resource for accomplishing this goal because they supported the ordinariness of the child and the family far more readily than other preventive measures.

Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research

“…(PP) 162/165 Asthma medicines seen as preferable to avoidance/(non-medical) preventive strategies 162/165 But because asthma medicines seen as so effective, hospital admission delayed even when serious 162 So possibly inhaler/reliever medicines over used, but preventer medicines underused (PP) 162/165 Purposeful adherence (or possibly non-purposeful adherence -not adherence) Acceptors…”

“…Rather, she suggested that reliance on medicine as a response to ill health can be regarded as culturally rooted. Prout et al 162 investigated the role of medicine in the lives of families with asthma and concluded that people much prefer it to the 'non-medical' preventive strategies that are advocated alongside the use of inhalers.…”

“…Factors influencing whether or not people take medicine as prescribed Acceptance of, or distancing from, asthma identity 161 Perceived effectiveness of [161][162][163]165 need for 163 medicine Whether or not medication supports ordinariness or stigmatises 161,162 Worries regarding steroids, 161 side effects of steroids, 161,163,165 dependency on steroids 161 Lay evaluation/experimentation regarding necessity of taking drugs 163 Nature of the medicine itself: difficulty or ease of use of inhalers, 163 convenient or inconvenient to use, 162,163,165 speed with which it works, 162 taste, 165 confusion between preventers and relievers (among children) 162 Negative experiences such as hospitalisation 163 …”

“…Older children described using brand names, younger using colours, shapes, general terms like pill, puffer 165 The older children got, the more autonomous they became in controlling own medicines 162,165 Children told caretakers when sick, but latter decided whether or not to seek medical help 165 …”

Thinking with Care Infrastructures: People, Devices and the Home in Home Blood Pressure Monitoring

“…For example Prout et al (1999) wrote about the ways in which inhalers were used in a family to maintain 'ordinariness' for children with asthma, while Willems (2000) explored their use as a technology of self care. In SHI, debate has recently returned to the meaning and use of medicine, putting space back in more explicitly.…”