A conceptual framework for asthma self-management in Ecuadorian children and adolescents: A qualitative study

Asthma symptoms can be controlled through proper self-management, medication adherence, and avoidance of triggers, thus avoiding high costs for multiple hospitalizations, emergency or outpatient visits. This article seeks to develop a conceptual framework of the factors that influence asthma self-management in a pediatric population living in the Andean urban area of Cuenca-Ecuador. A phenomenological study was carried out (February-April 2021) in 10 children and adolescents from 7 to 17 years old with asthma attending public and private hospitals. In-depth interviews were applied using open questions created after reviewing the literature. Factors influencing asthma self-management include individual (attitudes, self-education, seeking medical attention, managing crisis triggers) and environmental (health system, school/family support). The interviews were audio-recorded, transcribed, and analyzed by two independent researchers. Our results show that the pediatric population identifies individual and environmental influences that affect asthma self-management, with age and socioeconomic status moderating the influential factors. The participants described the beliefs, attitudes, practices, perceptions, and specific experiences in the family, school, and health system contexts as relevant to comply with asthma self-management. In addition, problems or barriers that hinder the self-management of the disease, mainly related to adherence to treatment, were identified. In conclusion, our analysis highlights the need to empower the pediatric population in asthma self-management. When delivering patient-centered education for effective asthma management, future interventions must consider children´s age and socioeconomic status influences in individual and environmental factors.