Asthma is said to be a chronic disease that is affecting more and more australians today. Australia is the second highest country in terms of the prevalence of asthma. One in every four children, one out of seven young adults, and one in every ten adults are said to have asthma (NAC, 2005). Typically, it is characterized by wheezing and shortness of breath. The shortness of breath is caused by the narrowing of the airways within the lungs and obstruction to airflow. Inflammation of the air passages is said to be the underlying reason for this narrowing of the airways (Australian Centre for Asthma Monitoring, 2005). Symptoms of asthma are usually seen in very young children or the elderly. Also, those whith other diseases seem to show the symptoms of asthma. In the 1980’s, the National Asthma Management Plan of Australia was started. In 1999, asthma became a high priority of the government (Australian Centre for Asthma Monitoring, 2005).
According to the Australian Centre for Asthma Monitoring (2005) asthma is almost on the same priority as injuries, slightly lower than cardiovascular disorders and arthritis. This is mainly because the prevalence of the diseases are of the same level or slightly varying from one another.
In the Journal of Australian Centre for Asthma Monitoring (2005), the definition of Asthma that has been adopted for most international expert organizations is
Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role, in particular, mast cells, eosinophils, T lymphocytes, macrophages, nutrophi and epithelial cells. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. The inflammation also causes an increase in existing bronchial hyperresponsiveness to a variety of stimuli (p. 4)
There are two types of asthma. One is considered intermittent patients and the other, persistent asthma (Australian Centre for Asthma Monitoring, 2005). It could be said that the distinction between the two is based on the periodical nature of the exposure to triggers. Asthma can also be classified according to how severe the problem is to a patient. In relation to this, the severity could be measured by how well the patient responds to treatment. Subgroups of the illness are also cases for classification. Although most subgroup represent how asthma is triggered, like exercise-induced asthma or aspirin-sensitive asthma, it is still significant to know this since it may help in the treatment of the problem.
There are also different risk factors for asthma. One is the constitutional factors. This is the general reference to the predisposition of an individual to factors such as having family members with asthma, genetic mutations, sex and age group. On the other hand, environmental exposures refer to the risk of acquiring asthma and the necessary interventions needed to be taken (Australian Centre for Asthma Monitoring, 2005).
There are different tests to check if patients have asthma. One of the many is the skin prick test. This test is given to those who are suspected to have persistent asthma. Skin prick testing is said to be the gold standard for allergy testing. This is because it is more sensitive than blood tests (NAC, 2005). More than relying of the history of patients, skin prick test is more accurate for the identification of allergens of a patient. It is also very safe and can be tolerated even by small children because it causes little discomfort. Results are given just after 20 minutes.
People with asthma often seek health care and attention for non-urgent concerns such as routine review or prescription of asthma therapy. According to the National Asthma Council of Australia (2005), effective management helps in the maintenance of the quality of life. This is the key aim of the treatment. The main goal is to improve and make sure that the capacity to carry out everyday tasks is normal and not limited by asthma (NAC, 2005).
On the other hand, the role of the health professionals is to be aware of the impact of the treatment on short term and long term outcomes of the illness to the patient (NAC, 2005).
The impact of asthma on the quality life of people suffering from it report poorer general health than normal people. They suffer from anxiety and depression. Not being able to sleep properly is a common problem among adults and children with asthma. It can also be a hindrance in performing well in the workplace and in school. (Asthma.org, 2007).
Such is the reason why there is a great need to control asthma and its onset. The goal to stabilize and allow people to perform everyday tasks with ease is just the main answer to the concern of having difficulty in life.
The objective of self management is to empower patients with the knowledge and skills they need to treat their own illness. A first step towards this is to have patients share responsibility for their treatment with their caregivers.
There are self-management plans for people with asthma. The main objective of this is to empower patients and equip them with the right knowledge and skills to address and treat their illness (Thoonen and Van Weel, 2000). The first step that should be taken to carry this out is to have patients feel that they are sharing the responsibility of their treatment with their health professionals (Thoonen and Van Weel, 2000). . It aims to monitor their daily activities to pinpoint what stressors trigger their attacks. It is important for patients to steer clear of these stressors. Therefore, identification of the triggers is necessary for self-management. Also, they have to be familiar with how to properly use inhalers and other medical resources that they have to employ.
Asthma Action Plans (AAP) plays a big role in the management and treatment of asthma. It is a written manifestation of asthma symptoms and recognition of patient of how their bodies deteriorate due to asthma. Due to this written possession of each asthma patient, better medical attention, self-management treatments and interventions are given to patients. There is also sufficient evidence to say that treatment outcomes positively increase when patients have the AAP (Australian Centre for Asthma Monitoring, 2005).
Unfortunately, the majority of people with asthma still do not have a written asthma action plan. The 1990’s showed a tremendous increase in the possession of the AAP, however, it is enough to sustain it to present time. There has also been campaigns of the National Asthma Council that seem to improve awareness of the public regarding asthma, sadly, they have difficulty in reaching the outer regional and remote areas, including the socioeconomically disadvantaged regions (Australian Centre for Asthma Monitoring, 2005).
Management of asthma is also done through medication. This is where the role of health professionals is emphasized. Medication is used primarily to relieve symptoms during times when they occur, control the disease and treat exacerbations of the disease (Australian Centre for Asthma Monitoring, 2005).
In a study by Hawley (2001), she concluded that in asthma care, there is no one perspective that is better than the others. Different ways of knowing, beliefs and understandings should be taken into consideration. When one acknowledges that a patient may be different culturally and have distinct beliefs different from the health professional, then there would be a better, safer and more competent treatment to asthma (Hawley, 2001).
According to a study by Stoloff and Janson (1997), information, awareness and skills training can improve asthma control. Control is very important for patients because, as earlier mentioned, it helps the affected people perform everyday tasks like normal people. Education regarding asthma are proven to be very cost-effective and can lead to a decrease in morbidity among patients of all ages (Janson and Stoloff, 1997). Asthma education is carried out by health professionals such as nurses and doctors. This is very important. It has been noted that there is an increased patient knowledge, improved skills in using inhalers, improvement in clinical status and lesser emergency cases due to asthma (Janson and Stoloff, 1997).
Such are the reasons why the health professionals have a role in managing asthma. The patients turn to them for primary knowledge regarding their illness and to prevent worsening of such problems. This is a two-way relationship and it is important that each one’s tasks are performed appropriately for better outcomes.
Unfortunately, there are problems that could arise in the hand-in-hand patient-health professional treatment of asthma. According to one study, nurses’ comments on self-management were largely about the importance of patient education and for follow up and monitoring. They said that this could be achieved through attendance in asthma clinics where nurses could explain and elaborate on the condition and treatment. Self management treatment is also more advisable for people who have had the disease for a longer time, as compared to the newly diagnosed.
Problems arise when nurses see that patients are not to be trusted to take care of themselves properly. The study cited by Thoonen and Van Weel, mentioned that the nurses considered every patient different from the others. Ergo, different treatment is much more suited for them. (Thoonen and Van Weel, 2000). Finally, self-management plans are only effective if the patients themselves still continue to attend follow ups, check ups and coordinate with health professionals. Otherwise, they will just fall into bad habit if they are not closely monitored. (Thoonen and Van Weel, 2000).
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Hawley, R. (2001). Voices in time: The role of the nurse in asthma management-past, present and future. (Doctoral Dissertation. University of Sydney, 2001). Virginia Henderson National Nursing Library.
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Thoonen, B. and Van Weel, C. (2000). Self management in asthma care. British Medical Journal. 2000(321), pp.1482-1483