The experience of dyspnea in school-age children with asthma

Physical Activity Enforces Well-being or Shame in Children and Adolescents With Asthma: A Meta-ethnography

Asthma symptoms and experiences of dyspnea challenge participation in physical activity (PA). Therefore, in-depth understanding of experiences with PA is essential. In this meta-ethnography, we synthesized published qualitative studies of experiences of children and adolescents with asthma that influenced, or limited, participation in PA. We followed Noblit and Hare's 7 phases of meta-ethnography. We searched relevant databases by December 18, 2023 for published peer-reviewed studies (Medline (OVID), Embase (OVID), PsycINFO (OVID), CINAHL (EBSCHOhost), SPORTDiscus (EBSCHOhost), SocINDEX (EBSCHOhost), and Social Science Citation Index (WoS)) and theses (ProQuest Nursing & Allied Health Source, ProQuest Healthcare Administration Database, and ProQuest Public Health Database). We conducted study selection and assessment of methodological quality and data extraction using Joanna Briggs Institute's methodology. Sixteen reciprocally related qualitative studies, representing experiences of 238 children and adolescents aged 4 to 18 years were included. We translated primary study concepts and findings into 3 themes covering relationships with others, emotions, and behaviors related to PA participation: (1) feeling related to and connected with friends and family in PA; (2) acquiring and managing new PA and asthma skills; and (3) enjoying PA and experiencing well-being. We also defined 3 themes covering aspects related to PA limitations: (4) feeling misunderstood and penalized in relation to PA; (5) experiencing nervousness, embarrassment, shame, and sadness during PA; and (6) withdrawing from PA due to asthma, environment, and/or socially imposed attitudes. The themes were synthesized into the following lines of argument: children and adolescents with asthma experience that PA enforces empathic/non-empathic relationships, vulnerability, and awareness; PA enhances resilient participation and well-being, or reinforces resignment to isolation and shame. From the outset of either relatedness or being penalized, youngsters with asthma either manage well and experience well-being, or experience shame and withdrawal.Registration: PROSPERO No. 164797.

Children's and adolescents' descriptors of asthma symptoms: An integrative review

Background

Accurate assessment of asthma symptoms is central to appropriate treatment and management; however effective communication about symptoms-how it is perceived and reported-remain challenging in pediatric clinical and research settings.

Objective

To synthesize the existing pediatric literature on children's and adolescents' word descriptors of asthma symptoms.

Methods

In this integrative review, we systematically searched Cumulative Index of Nursing and Allied Health Literature and PubMed databases to identify original research studies from 1980 to 2021 on children and adolescents' word descriptors of asthma symptoms.

Results

The search yielded 2,232 articles, of which 21 studies met the eligibility criteria. Scientific literature focused on children and adolescents' descriptions of asthma symptoms are limited. In addition to standard asthma symptom terminology (e.g. cough, wheeze, chest tightness, shortness of breath), pediatric populations used nonstandard word choices to describe the asthma symptom experience. Children and adolescents used a variety of affective (e.g. 'helpless', 'afraid of dying') and sensory words (e.g. 'pressure in chest', 'tightness, lungs feel shut') to describe the phenomena. Literature examining race differences in word descriptors in pediatrics is limited; thus it is unclear if word descriptors vary by race or ethnicity. Evidence of relationships between descriptors and gender and age are also lacking.

Conclusions

Our review elucidates gaps in the literature regarding the full extent of the language common to racially and ethnically diverse samples of children and adolescents. Further research is warranted to help clinicians and researchers query children and adolescents' experience of asthma symptoms.

The role of cardiopulmonary exercise testing in evaluating children with exercise induced dyspnoea

Exercise induced dyspnoea (EID) is a common manifestation in children and adolescents. Although EID is commonly attributed to exercise induced bronchoconstriction, several conditions other than asthma can cause EID in otherwise healthy children and adolescents. Cardiopulmonary exercise testing (CPET) offers a non-invasive comprehensive assessment of the cardiovascular, ventilatory and metabolic responses to exercise and is a powerful diagnostic and prognostic tool. CPET is a reproducible, non-invasive form of testing that allows for comparison against age- and gender-specific norms. CPET can assess the child's exercise capacity, determine the limiting factors associated with this, and be used to prescribe individualised interventions. EID can occur due to asthma, exercise induced laryngeal obstruction, breathing pattern disorders, chest wall restriction and cardiovascular pathology among other causes. Differentiating between these varied causes is important if effective therapy is to be initiated and quality of life improved in subjects with EID.

The lived experience of anxiety and the many facets of pain: A qualitative, arts-based approach

Background: Findings reported in this article emerged from the study titled "Youth's Voices: Their Lives and Experiences of Living with an Anxiety Disorder." Though the initial focus of this study was not on the pain experiences of youth living with an anxiety disorder, it became apparent from the very first interviews that pain and suffering was key in the youth lived experience, permeating their everyday lives and impeding their participation and functioning in the world. Aims: The aim of this article is to highlight the ways in which pain is a central experience for young people living with an anxiety disorder. Methods: The study was approached from the qualitative research design of hermeneutic phenomenology. Fifty-eight young people who were living with anxiety disorders and their parents participated in the study. Youth took part in multiple qualitative open-ended interviews and the participatory arts-based method of photovoice. Themes were developed using van Manen's method of data analysis. Results: The overall theme emerged as "anxiety is very much about pain." The four subthemes are (1) embodied experience of anxiety: physical pain; (2) a prominent symptom of anxiety: mental-emotional pain; (3) difficult interpersonal relationships: social pain; and (4) articulating their pain. Conclusions: Use of qualitative, arts-based methodologies provided the opportunity and space for youth with anxiety to articulate their multifaceted experience with pain in their own words. This work reinforces the need for use of qualitative approaches to understanding pain experiences in young people.

The Lived Experiences of Children and Adolescents with Non-Communicable Disease: A Systematic Review of Qualitative Studies

PROBLEM

Children and adolescents with non-communicable disease face more difficulties in achieving developmental milestones than their healthy peers, which affect their life and overall wellbeing. A non-disease-specific approach is important in identifying common challenges faced by children and adolescents across multiple non-communicable diseases.

ELIGIBILITY CRITERIA

Qualitative studies reporting first-hand accounts of children and adolescents aged 4 to19 years with non-communicable disease.

SAMPLE

A library search was conducted in five electronic databases (CINAHL, Embase, PsycINFO, PubMed, Scopus, and ProQuest Dissertations and Theses) for original qualitative English language papers. Fifty-five articles met the inclusion criteria and were subjected to a two-step meta-synthesis.

RESULTS

Initial reports of negative emotional experiences and disease perceptions were mixed with gradual acceptances of their diseases and positive coping strategies. Children and adolescents with non-communicable disease all desired a normal life, but physical limitations often led to social exclusions and self-imposed restrictions. Although most were highly appreciative of the support received from family, friends, and healthcare providers, they still struggled with disease management, the need for autonomy, and the fear of illness disclosure.

CONCLUSIONS

The impacts of non-communicable disease on children and adolescent's lives suggest a need for joint efforts between parents, clinicians, and educators to ensure children and adolescents' positive development of the self, acceptance and positive coping.

IMPLICATIONS

This review is able to inform the development of future educational and psychosocial intervention programs in the school and healthcare setting, and also encourages a revision of education policies to be more flexible and accommodating.

Dyspnea in Children: What is driving it and how to approach it

Dyspnea in children has important physical and psychosocial impact. It is useful to define the quality of the dyspnea and quantify its magnitude in a child-friendly manner. Through careful history taking and physical examination, a targeted investigation can lead to identification of the cause and potential treatment. This article provides a framework for the clinical approach to dyspnea in children, including important information to gather during the history, physical assessment, how to quantify dyspnea, and choice and use of laboratory measurements.

Children's experiences of a participation approach to asthma education

AIM AND OBJECTIVES

To explore the participation and responses of children to an asthma education programme that was developed with the aid of children with asthma. In a larger perspective, the aim was to understand how educational approaches can be designed to help children learn to live and cope with asthma.

BACKGROUND

A literature search showed that programmes where children participate in the development of educational materials or programmes are lacking.

DESIGN

An exploratory descriptive design was chosen to get an in-depth understanding of the communication and collaboration between children and healthcare personnel.

METHODS

Data were collected through observations, tape recordings of the conversations and notes of the interactions between the children and the healthcare personnel and analysed by content analysis.

RESULTS

The significance of the asthma education programme emerged in four themes: (i) children are learning from each other: in a positive learning climate, the children were able to express emotional themes that they may not have communicated before; (ii) children are learning through an interaction with the educational material: the children discussed stories and pictures in a fellow interplay: when one child expressed something, another child would recognise it and continue the story; (iii) children are learning from their interaction with healthcare personnel and vice versa: adjusting the vocabulary according to the children's experiences, they were met on their level of understanding; and (iv) children can express and discuss their understanding of asthma.

CONCLUSIONS

The unique aspect about this programme is that it emanates from children's perspectives. The children were actively involved and learnt from each other's shared knowledge and experiences, which is a good source of meaningful learning and empowering processes.

RELEVANCE TO CLINICAL PRACTICE

Future educational approaches should use children's perspectives in a manner in which their questions, thoughts and daily challenges are emphasised.

Children's experiences of living with asthma: fear of exacerbations and being ostracized

The aim of the study was to explore children's experiences of asthma to tailor a learning program based on their perspectives. Fifteen children (7-10 years) were interviewed, and they narrated the meaning behind their drawings; a phenomenological hermeneutical approach was used in the analysis. The findings are described in two themes with five subthemes: fear of exacerbation (bodily sensations, frightening experiences, and loss of control) and fear of being ostracized (experiences of being excluded and dilemma of keeping the asthma secret or being open about it). Drawings are a good tool for initiating a dialogue with children.