What caregivers believe affected the quality of implementation of asthma‐related family management models (AFMM) during COVID‐19: A phenomenological qualitative study

Abstract

Purpose The recurrent COVID‐19 epidemic in China has disrupted many aspects of daily life for children with asthma and their caregivers, while negatively impacting their asthma family management models (AFMM). This phenomenological qualitative study identifies what affects the quality of implementation of AFMM in this population and outlines potential coping strategies for the caregivers. Methods We used purposive sampling to conduct semistructured interviews with primary caregivers of school‐age children with asthma from community healthcare centers (CHCs), which focused on understanding what factors influenced caregivers' implementation of AFMM during quarantine. The Colaizzi seven‐step method was used to independently code and categorize the transcript and to generate themes and identify associated key subthemes. Results Twenty‐four caregivers were interviewed, and they provided greater insight into barriers and motivators to implement AFMM. The three themes and nine relevant subthemes generated, (a) the “individual‐family” internal‐level factors: weak health literacy and beliefs, quietly changing family relationships, the dramatic increase in the care burden, gradual adjustment of negative psychology; (b) the “hospital‐community” external‐level factors: the endless power of peer support, strict community quarantine policy; and (c) the “health system‐public” social‐level factors: the enormous potential of internet‐based telemedicine, improved public awareness of prevention, government's prompt assistance. Conclusions This qualitative study reveals that the quality of AFMM implementation during pandemic is impacted by three different levels. Therefore, a targeted and comprehensive caring model that provides caregivers with the necessary coping strategies around these three levels is needed to achieve better asthma control outcomes.

Psychosocial and Service Delivery Impacts of the COVID-19 Pandemic on Children With Respiratory Conditions, Their Parents and Their Health Care Providers

“…However of studies focusing on children, negative psychosocial outcomes (eg, anxiety, depression) have been reported among children with asthma 4 and their parents. 5 , 6 In a qualitative study, parents reported fear about their child contracting COVID-19, challenges in the family such as managing family dynamics and child care concerns during the pandemic, and service delivery changes such as increased reliance on virtual care. 6 Parents drew on an array of supports including informal support (eg, friends and family) formal support (eg, parent support groups), and financial resources (eg, government programs offering financial benefits) to cope with these changes.…”

“… 6 Parents drew on an array of supports including informal support (eg, friends and family) formal support (eg, parent support groups), and financial resources (eg, government programs offering financial benefits) to cope with these changes. 6 …”

“… 7 , 8 However as the pandemic and related restrictions continued, negative psychosocial impacts were observed among pediatric respiratory care populations. Studies have reported that children with chronic respiratory conditions (eg, cystic fibrosis, asthma, tuberculosis, rhinitis allergica) experienced decreased physical activity, 7 , 9 less sleep, 7 more disagreements with family members, 6 , 9 and more screen time, that is, television, computer and telephone use. 7 , 9 COVID-19-related anxiety and psychiatric symptoms were reported to have predicted 27% of poor quality of life among children with asthma.…”

“… 9 In a recent study, parents of children with asthma emphasized the need for tailored guidance to maintain safety (eg, means to protect asthmatic children, guidance to manage symptoms and medication) particularly early in the pandemic. 6 …”