Elsevier

Social Science & Medicine

Volume 55, Issue 9, November 2002, Pages 1619-1633
Social Science & Medicine

Living with asthma: the experiences of young people at home and at school

https://doi.org/10.1016/S0277-9536(01)00295-7Get rights and content

Abstract

This study is concerned with how young people with moderate to severe asthma live with and explain the disorder and manage the resulting symptoms. Based on in-depth interviews with 55 young people aged 11–16 living in West London, it shows that asthma restricted their lives at school and recreationally but that they were actively involved with their condition and its management. The study reveals that while prescribed medicines in the form of inhalers were used as the primary means of coping with asthma episodes, the young people were concerned about being dependent on such medicines, in line with more general ambivalence in late modern cultures about the long term use of prescribed medicines. It also demonstrates how social relations in particular contexts help to determine the extent to which asthma episodes can be managed.

Section snippets

Background

This paper reports on a sociological study of young people with asthma, focusing on their experience of living with the disorder, how they accounted for it and the strategies they employed to manage the symptoms. It is set against a background of rising concern about the extent of asthma in children and young people in Britain and in other developed societies. An increase in the prevalence of asthma is widely reported among young people in Britain, to the extent that in their teenage years one

Sociology of childhood

During the past decade, a new theoretical framework for the study of childhood has emerged within sociology which has a number of key features. These are usefully outlined by Alison James and Alan Prout (1990). They include, in particular, the contentions that ‘childhood should be understood as a social construction’, that ‘children's social relationships and cultures are worthy of study in their own right’, and that ‘children are and should be seen as active in the construction and

Chronic illness and disability

Asthma may be appropriately considered as a chronic illness as no ‘cure’ is currently available, and there is no time limit on its duration. Thus the alternative and arguably valued ‘sick role’ (Parsons, 1975) in acute illness offers only short term respite for those suffering from chronic illness. Bury (1988, p. 90) has argued that the ‘experience and meaning of chronic illness is emergent in character’. Research on the everyday management of adult chronic illness has also emphasised a

Methodology

The location of the project was decided on the basis of a Department of Health (1995) report on the prevalence of asthma in London which showed the highest rate of severe asthma to be in West London. It was decided to sample from inner to outer West London to maximise the range of socio-economic classes and to include in the sample those living close to Heathrow airport, as this has been identified as a possible source of air pollution.

We collected our sample of young people through GP

Experiencing asthma

The young people who took part in the study were selected according to whether they were rated as having moderate to severe asthma in accordance with the ISAAC questionnaire (see above). From the reports which they gave the length of time they had experienced asthma prior to being interviewed varied from 5 months to 12 years, with a mean of 9.1 years.

When describing episodes of asthma the young people distinguished between symptoms and their immediate effects, and the consequent restrictions.

Explaining asthma

It was noted earlier that a concern in the clinical literature was with the causes of asthma and that a cross-over was often present in relation to underlying aetiology and precipitating triggers. The focus in relation to the cause of asthma has increasingly come to centre on the external environment, for example, on pollution, rather than on specific morbidity. It was therefore of interest to discover what the young people thought was the ‘cause’ of their asthma and whether this was in accord

Management of asthma

When we talked to our respondents about living with and managing asthma, they focused on two main settings—the home and the school, and especially the latter. This will become apparent as we consider the different strategies described by our sample.

Conclusions

There has been little previous sociological work on the meaning of asthma to adult sufferers and even less on children and young people's experiences. This study has reported on how young people with moderate to severe asthma make sense of the illness and how they cope with it.

All of the young people in the study experienced symptoms which they associated with asthma. Of greatest consequence were wheezing, additional breathing difficulties, tightness of the chest and coughing. These symptoms

Acknowledgements

We should like to thank the young people who agreed to participate in this study, along with the GPs who gave us permission to approach them. We should also like to thank the two anonymous referees of the journal, and Mildred Blaxter, for their helpful comments on a previous version of the paper. We also gratefully acknowledge the financial support of the Department of Health which funded the study under the NHS R&D Programme for People with Physical and Complex Disabilities (project reference

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