Childhood asthma: parents' perspective--a qualitative interview study

Abstract

Objective: We aimed to describe the parents' perspective of their child's asthmatic disease, and relate it to the dialogue with the doctors and the diagnostic delay.

Methods: Qualitative studies with semi-structured interviews were carried out with 20 parents of 30 asthmatic children aged from 2 to 15 years who had had asthma for at least 1 year and were all attending a Copenhagen outpatient asthma clinic.

Results: The asthma symptoms, for most of the children starting during their first year, were manifold and complex, including long-lasting coughing as a frequent symptom. Parents recognized specific asthma patterns in their child, often including behaviour change. Many parents had difficulty in understanding why doctors changed the dose of medicine. The diagnostic delay was significant. The study indicated problems in doctor-patient communication: differences in the conceptual vocabulary; the doctor's reluctance to consider the patient's story and rely instead on auscultation; as well as unexpected odd differential diagnoses. All contributed to the disturbed mutual understanding.

Conclusion: The new asthma definition from the First International Pediatric Consensus Report is a milestone because it focuses on the patient's story and emphasizes the chronic episodic course rather than asthma as attacks. The study highlights the importance of "listening to the parents" in order to make the diagnosis and to secure parents' participation in starting anti-inflammatory therapy, as well as regulating drug doses according to the symptoms, to secure the lowest possible but effective drug doses.