1. Patterns of concordance and non-concordance with clinician recommendations and parents' explanatory models in children with asthma.
- Author
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Bokhour BG, Cohn ES, Cortés DE, Yinusa-Nyahkoon LS, Hook JM, Smith LA, Rand CS, and Lieu TA
- Subjects
- Boston, Causality, Child, Child, Preschool, Health Knowledge, Attitudes, Practice, Humans, Intention, Medication Errors methods, Medication Errors psychology, Medication Errors statistics & numerical data, Nursing Methodology Research, Parents education, Patient Compliance statistics & numerical data, Qualitative Research, Self Administration methods, Self Administration psychology, Severity of Illness Index, Surveys and Questionnaires, Asthma drug therapy, Asthma etiology, Models, Psychological, Parents psychology, Patient Compliance psychology
- Abstract
Objective: Many children with asthma do not take medications as prescribed. We studied parents of children with asthma to define patterns of non-concordance between families' use of asthma controller medications and clinicians' recommendations, examine parents' explanatory models (EMs) of asthma, and describe relationships between patterns of non-concordance and EM., Methods: Qualitative study using semi-structured interviews with parents of children with persistent asthma. Grounded theory analysis identified recurrent themes and relationships between reported medication use, EMs, and other factors., Results: Twelve of the 37 parents reported non-concordance with providers' recommendations. Three types of non-concordance were identified: unintentional--parents believed they were following recommendations; unplanned--parents reported intending to give controller medications but could not; and intentional--parents stated giving medication was the wrong course of action. Analysis revealed two EMs of asthma: chronic--parents believed their child always has asthma; and intermittent--parents believed asthma was a problem their child sometimes developed., Conclusions: Concordance or non-concordance with recommended use of medications were related to EM's and family context and took on three different patterns associated with medication underuse., Practice Implications: Efforts to reduce medication underuse in children with asthma may be optimized by identifying different types of non-concordance and tailoring interventions accordingly.
- Published
- 2008
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