Knowledge and perception of asthma and asthma treatment among school children of Chinese ethnicity with asthma in Malaysia

Transcription

1 Knowledge and perception of asthma and asthma treatment among school children of Chinese ethnicity with asthma in Malaysia Siti Nurkamilla Ramdzan, Ping Yein Lee, Ai Theng Cheong, Ee Ming Khoo, Nik Sherina Hanafi, Hani Syahida Salim, Nursyuhada Sukri, Su May Liew, Norita Hussein, Julia Suhaimi, Azainorsuzila Mohd Ahad, Hilary Pinnock

2 Introduction Prevalence of asthma symptoms among year old (ISAAC)

3 Prevalence of asthma among primary school children in Malaysia was 8.9%. (Ahad & Khoo, 2017) Prevalence varies between ethnicity Indian 10.1% Malays 9.2% Chinese 6.6%

4 Variation in asthma control Malays % Indians 33.7% Chinese 10.6% Objective: to explore the knowledge and perception of asthma and its treatment among children with Chinese ethnicity

5 Methods Participant identification Screening questionnaire distributed to 2 suburban primary school Recruitment Called up the parents of the children and arrange date for interview Interview Written consent from the parents and assent from the children Interviewed using semi-structured questionnaire Conducted in Mandarin, audio recorded Coding and analysis Transcripts were transcribed verbatim Translated to English, checked by interviewer Coded by 2 researchers and used thematic analysis

6 Results 10 children were interviewed 2 FGDs and 4 IDIs Socio-demography Age Gender 9-12 years old Boys-6 Girls-4 Asthma control test ACT > 20 (good control) ACT < 20 (poor control) 9 1

7 Themes Knowledge and perception of asthma and asthma treatment Knowledge of asthma was confined to asthma symptoms from self experience Misperceptions regarding asthma and its treatment Asthma selfmanagement skills were poor

8 Knowledge of asthma was confined to asthma symptoms from self experience All children had poor understanding of asthma. Most knew that they have asthma but do not the what it is. I do not know. My mother did tell me my asthma occurred once but she did not tell me much about it so that is why I do not know. 10-year-old boy, ACT 25

9 One child do not know the name of the condition Another child was not sure that he has asthma

10 Understanding of asthma is confined to the symptoms that they experienced [Asthma] is a condition that we cannot withstand air pollution and we feel breathing against pressure, similar to breathing difficulty. 12-year-old boy, ACT 25 Asthma is difficulty in breathing and then the rate of breathing is fast. 9-year-old girl, ACT 17 I think asthma is very difficult to breathe, the nose can t breathe, and the mouth too. 10-year-old girl, ACT 22

11 Asthma self-management skills were poor Most children were not on inhaler Doctor did not give me that kind of medication. 12-year-old boy, ACT 22 Yes, not using anymore. 11-year-old girl, ACT year-old boy, ACT 21..Yes, I didn t use it for 6 years already.

12 Various ways to self-manage their symptoms After drinking water, I rested and then watched TV for a while. I will be better after the TV show ended. (10-year-old boy, ACT 21) For me, I will rest a while. (12-year-old, boy, ACT 27)

13 Some will inform their parents that they have asthma symptoms Parents will decide either to give medication or to seek medical attention She gives me medicine to eat and then sleep. (12-year-old girl, ACT 27) I would call my mum. My mum would use a device to deliver a fine mist into my mouth. (9-year-old girl, ACT 25)

14 At school, children do not administer medication on their own I stopped doing schoolwork and had some rest. My teacher then phoned my mum. (9-year-old, girl, ACT 25) I will wait by myself. Sometimes I will tell my mother after school if there was breathing discomfort. (11-year-old girl, ACT 20) I didn t bring them to school before. (10-year-old girl, ACT 22)

15 Misperceptions regarding asthma Aetiology and its treatment Asthma is infectious., I know it will because it is too powerful and definitely, it will infect other people. (12-year-old boy, ACT 22) Asthma could be recognised by appearance Of course the teacher know I am suffering from asthma based on my fat appearance. (10-year-old boy, ACT 22) Caused by triggering factor e.g cold food or drinks It is because drink too much ice water and also eat the icecream. (9-year-old girl, ACT 17)

16 Misperceptions Treatment I will have to have an injection if it relapses. (9-year-old boy, ACT 24) Follow up I will go to the clinic only when I cough badly, but I don t go when there is no cough. (11-year-old girl, ACT 20)

17 Discussion Misperceptions regarding asthma and its treatment Knowledge of asthma and asthma treatment was poor Asthma selfmanagement skills were poor

18 Asthma care Structured/guided self-management Effective to reduce unscheduled care and improve asthma control Effective in diverse cultural background and broad clinical setting

19 Intervention to educate patient Telephone By nurse or automated Education by asthma educator One to one or group Web-based

20 Conclusion Poor knowledge of asthma and asthma treatment Improve the healthcare delivery and improve the awareness in the community level Improvement knowledge of asthma Better asthma control and less complications

21 Acknowledgement This study receives financial support from IPCRG University of Malaya

22 References 1. International Study of Asthma and Allergy in Children Ahad A. and Khoo E.M., Asthma control and care among Malaysian Primary School children: A cross-sectional Study. Asia Pacific Journal of Public Health; Australian Asthma Handbook Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, Available from: 5. Anwar H, et al. Asthma knowledge among asthmatic school children. Oman Medical Journal; Partridge M.R. In what way may race, ethnicity or culture influence asthma outcomes? Thorax; Soo F.W., and Tan N.C. The influence of caregivers knowledge and understanding of asthma aetiology on domiciliary management of children with asthma. Singapore Medical Journal; Pinnock et al. Systematic meta-review of supported self-management for asthma: a healthcare perspective. BMC Medicine; Joseph et al. Evaluation of a web based asthma management intervention program for urban teenagers: reaching the hard to reach. J Adolescent H; Pinnock et al. Implementing supported self-management for asthma: a systematic review and suggested hierarchy of evidence of implementation studies. BMC Medicine; 2015.

23 Thank you