Transition to independent self-management among children with asthma

Background: Self-management of asthma improves asthma control and reduces exacerbations. Children are expected to independently self-manage asthma, as they get older. However, the transition from parental to independent self-management among children remains unclear. Aim: To explore the views of children with asthma and their carers regarding self-management of asthma. Methods: We identified children aged 7-12 years, diagnosed with asthma from seven suburban primary schools in Malaysia. We used purposive sampling and conducted focus groups supplemented by interviews using a semi-structured topic guide in participants’ preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo, and analysed using a grounded theory approach. Results: 99 participants (46 caregivers, 53 children: 34 Malays, 45 Indians, 20 Chinese) contributed to 22 focus groups and 7 interviews. Carers’ view and actions emerged as an important influencer. Children mirrored their carers’ actions and views but in parallel learnt from their own experiences, and gained more confidence to independently self-manage. External influences e.g. support from school and healthcare also played a role in the transition. Cultural norms and beliefs influenced children’s independence to self-manage asthma either directly or indirectly through their social network. Conclusion: Children gain skills to independently self-manage asthma based on their experiences and influences of surrounding people. Thus, interventions to improve self-management of childhood asthma should include childrens’ networks and incorporate elements based on good understanding of cultural beliefs in the community. Funding: NIHR RESPIRE