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Objective: The difficulties adults have using inhaler devices is well documented but much less is known about how parents administer inhaler devices to young children and the difficulties experienced. The purpose of this article is to explore the underlying concepts and practical issues that parents encounter in administering inhaled asthma medications to their young children. Methods: This is a qualitative study using applied thematic analysis on parental written discourses from asynchronous online discussion forums on the topic of administration and use of asthma inhaler devices to young children. Results: "At a loss of what to do" summarizes the experiences parents described when administering inhaler devices to their young children. Parents describe the problems, the situations, the emotions, the decisions, and the confusion they face. They struggle with their child's resistance and the associated conflict, describing their own and their child's distress. Results highlight the coping strategies used in administration, how parents decide whether to use coercive measures or not, their help-seeking endeavors, together with the assurance they give to themselves and others after administration. Conclusion: The online discussions highlight parents' distress, lack of preparedness, and understanding of administering inhaler devices to young children. While the prevalence of the problem cannot be estimated from our data, it illustrates a need for some healthcare professionals to review their own knowledge and skills in administration of inhaled medication to younger patients, and their provision of patient and family centered care. [ABSTRACT FROM AUTHOR]

Objective. It is unclear which of the commonly used asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views on three asthma-specific QoL questionnaires. Methods. Ten adult individuals with asthma were asked to complete three asthma-specific QoL questionnaires (Standardized Juniper Asthma Quality of Life Questionnaire (AQLQ-J-s), Sydney Asthma Quality of Life Questionnaire (AQLQ-S), and Fragebogen zur Lebensqualität bei Asthma (FLA)). Interviews were conducted to elicit patients' views on the questionnaires. Interviews were transcribed verbatim and thematic content analysis was performed. Results. Participants spoke about response format and options, missing and redundant/similar content as well as content that was perceived to be irrelevant. A lack of specificity was named for some items, and issues concerning layout were raised. Despite the diversity of views expressed, participants mostly agreed on the ranking of the questionnaires and, overall, favored the AQLQ-S. Conclusions. Patient involvement highlights shortcomings and strengths of various asthma-specific questionnaires in terms of both format and content. The AQLQ-S was the most positively perceived questionnaire. Future research will need to explore other settings and potentially involve a larger and more diverse sample. [ABSTRACT FROM AUTHOR]

Grandparents are increasingly becoming the primary carers of children orphaned by the HIV epidemic in South Africa. Traditional family roles are being reversed as aging family members take responsibility for the physical and psychosocial needs of children. This study uses qualitative research to explore the experiences of grandparents fostering children orphaned by AIDS in Richards Bay, KwaZulu-Natal Province, South Africa. The idea was born after a local HIV support organisation (Richards Bay Family Care) observed a trend within their organisation of grandparents increasingly becoming foster parents for orphans. An exploratory study was conducted in the organisation's three target areas (two rural villages and urban Richards Bay); the ultimate aim was to explore options for improving financial and emotional support for this group. The qualitative research methods included: four focus group discussions with foster-carers and community leaders (including two pocket-chart voting exercises); 12 in-depth interviews with grandparent foster-carers; and ten key-informant interviews, mostly with staff who provide support services. Data analysis was by thematic framework. The needs of the grandparent foster-carers varied: the rural participants were essentially concerned with meeting children's basic needs (housing, food and education), while those in urban areas more often felt pressure to provide emotional and psychological support for orphans. In both groups, women were at the forefront of foster care. Important problems identified by the grandparents were child discipline and a feeling of disharmony in the intergenerational relationship. Government foster care grants were identified as a regular source of income for especially the rural foster-carers. The findings may help programme managers better understand the differences in the needs of urban and rural foster parents. The experiences of grandparents as carers of orphans affected by HIV or AIDS are unique considering their age, frailty and poverty status. More research is needed on the role played by men in fostering children orphaned by AIDS. [ABSTRACT FROM AUTHOR]