Case Study on Asthma: Pathology and Symptoms

Background

Asthma is a respiratory and genetic condition characterized by the inflammation and narrowing of airways in the lungs. The inflammation forces airways to swell, contributing to difficulties in breathing (Rubner et al., 2017). During asthma attacks, individuals experience periods of intense coughing, shortness of breath, chest tightness, and wheezing. Individuals with asthma may experience mild to severe symptoms, and a varying frequency of attacks. An individual’s physical activity may be related to the timing of asthma symptoms. Some people experience asthma attacks when exercising, a condition called exercise-induced asthma. Cold, smoke, animal dander, and pollen are other triggers for asthma attacks. The Centers for Disease Control and Prevention (CDC) reports show that about 27 million Americans have asthma (Rubner et al., 2017).

A range of factors accounts for the etiology of asthma. Genetics plays a critical part in the development of asthma (Rubner et al., 2017). A family with a history of asthma indicates that there is a genetic predisposition, an increased risk that other family members may develop it as well. Allergies also account for the development of this condition (Rubner et al., 2017). Some individuals are more allergic than others, particularly when their parents have also experienced allergic reactions. Asthma may also develop from respiratory diseases, especially during early childhood (Rubner et al., 2017). Particular respiratory infections, such as pneumonia, can damage lung tissues and cause inflammation during early childhood. Such damage can inflict life-long breathing struggles. The environment also influences the susceptibility of this disease. Exposure to viral infections and contact with irritants or allergens in early childhood enhances the chances of developing asthma. A poorly developed immune system also heightens the chance of acquiring asthma (Rubner et al., 2017).

Asthma affects people of all ages. Currently, one in 13 people has asthma, and it is the leading chronic condition in children (Asthma Facts and Figures, 2020). The onset typically occurs during childhood and is more prevalent in boys than girls. Although asthma is more common in children it can also develop in adulthood, affecting more women than men. Adult asthma is generally related to exposure of harmful inhalants and other allergens. Asthma profoundly impacts racial minorities, such as African Americans. In the US, the disease kills many more African Americans than any other ethnicity or race (Asthma Facts and Figures, 2020).

Pathology and Symptoms

A complex interaction of genetics and environmental factors predisposes individuals to asthma influencing the onset and severity of the disease (Dharmage et al., 2019). Environmental factors can trigger the development and increase the severity of asthma attacks (Dharmage et al., 2019). These factors include environmental chemicals, air pollutants, and allergens. Tobacco smoking during pregnancy and after birth increases the risk of asthma in children (Quirt et al., 2018). Reduced air quality due to air pollutants also contributes to the development of asthma and the severity of the condition (Dharmage et al., 2019). For instance, most of the asthma cases in the US are reported in areas with low air quality, especially in low-income households. Organic compounds, such as formaldehyde, also show a positive correlation to the development of this condition. Furthermore, a close connection exists between exposure to indoor allergens and the development of asthma. Such allergens include mold, animal dander, and dust mites (Dharmage et al., 2019).

Research implicates many genes in the development of asthma and a person’s predisposition to it. Currently, some of the genes associated with this condition include ADAM33, IL4R, SPINK5, CTLA-4, AND IL10 (Xu, 2014). Notably, environmental factors like allergens can increase the genetic predisposition to asthma (Quirt et al., 2018).

Certain medical conditions also predispose individuals to asthma. Atopic conditions increase the chance of developing asthma (Quirt et al., 2018). Atopic diseases are those conditions that trigger an exaggerated immune response to harmless environmental compounds (Dharmage et al., 2019). Asthma is also prevalent in individuals experiencing hay fever or eczema. Recent studies also link obesity to the development of asthma. The reason is that obesity reduces respiratory functions because of fat buildup (Dharmage et al., 2019). An increase in the adipose tissue also increases the chances of inflammatory states.

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People with asthma exhibit symptoms of wheezing, coughing, and shortness of breath with chest pain or tightness and also possibly trouble sleeping (Quirt et al., 2018). A wheezing or whistling sound during exhalation also indicates the presence of this condition in children (Quirt et al., 2018). Respiratory viruses like flu or cold worsen the wheezing and coughing attacks. Factors that indicate exacerbated asthma include frequent symptoms, which disrupt daily activities (Dharmage et al., 2019). Increased breathing difficulties also show a worsening condition.

Research Study

Hypothesis

Challenges related to self-care behaviors among school-going children with asthma emerge as the problem in this research. The research question from the study objectives, states, “what is the effectiveness of Staying Healthy-Asthma Responsible and Prepared (SHARP) on fostering the use of effective asthma self-care behaviors?” (Kintner et al., 2015). SHARP is a program designed to counsel and educate students in this study. A hypothesis developed by the researchers reveals that SHARP is effective in promoting effective self-care behaviors among students with asthma.

Method

The authors utilize a cluster-randomized research design. The research design employs two groups, the SHARP and the control intervention, to determine any improvement in self-care tendencies among students. Participants in the controlled group receive standard care to enhance a comparison with those in the SHARP intervention (Kintner et al., 2015). Notably, this research design facilitates data collection using self-report measures among the participants. The study design is useful in making a comparative analysis of the two interventions. Through this design, the researchers can make direct comparisons of the SHARP intervention to the control intervention to establish superiority. Significantly, the study design minimizes selection and allocation bias in the research. Significantly, the design is also statistically reliable.

The sample in this study comprised 4th and 5th-grade children whose ages ranged between 9 and 12 years. This population had to be diagnosed with asthma and had caregivers to take care of them. Kintner et al. (2015) adopted convenience sampling for the study. Using this technique, the researchers recruited students from different elementary schools from low socio-economic, medically marginalized, moderately sized, minority, and inner-city communities. Initially, the researchers screened 2770 students and caregivers for eligibility. After the screening, Kintner et al. (2015) remained with 216 students and caregivers while excluding the rest due to no asthma diagnosis. Following the preprogram assessment, the researchers remained with a sample of 205 students and caregivers. Kintner et al. (2015) allocated this sample to each of the two groups. The researchers allocated 117 dyads to the SHARP intervention. The remaining 88 dyads were assigned to the control program. The sample was appropriate for the study since the researchers recruited the relevant population for the study. The sampling method was also time and cost-saving for the researchers.

Outcomes

The outcome of the study supports the theory that SHARP can foster the psychological acceptance of asthma among students. The research builds upon previous problems related to difficulty in accepting asthma when transitioning from elementary to junior or middle school. In comparison to the participants in the control group, the SHARP intervention elevates risk prevention and episode management among students with asthma. The SHARP program outlined in this study can be immediately introduced in schools and communities through health education. Apart from asthma, this intervention is also relevant to the management of conditions like diabetes and epilepsy. As evident in this study, a SHARP intervention is critical to advancing nursing practice and fostering pediatric health. Based on the perceived benefits of this intervention, it helps enhance life quality and promotes health among school-aged children. Although asthma is non-communicable, it affects millions of children and teenagers around the world. Asthma impacts academic performance and social skills, which adversely impacts health. Since the researchers provide evidence to prove the efficacy of SHARP, schools and communities need to work with specialist nurses in implementing this intervention.

Further Studies

Future research should be carried out on this subject. Scholars should use this research to carry out cost-effectiveness studies on SHARP for implementation in schools and communities. A hypothesis for this study will indicate that the implementation of the SHARP program will require financial resources, parental support, and community engagement to benefit students with asthma. The outcome of this study will outline that financial costs and resources are necessary to incorporate the intervention in a school setting. Through cost analysis, schools can devise strategies to finance the intervention and improve the wellbeing of asthma students. The research can also explore the viability of implementing community programs for classmates of asthma students to promote acceptance. The program can promote an understanding of asthma and its related effects on individuals. Such knowledge can increase the acceptance of students with asthma among their peers. Therefore, this is essential to improving health among those with asthma.

References:

1. Asthma Facts and Figures |AAFA. (2018, February). Retrieved from https://www.aafa.org/asthma-facts/
2. Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of Asthma in Children and Adults. Frontiers in Pediatrics, 7. doi: 10.3389/fped.2019.00246
3. Kintner, E. K., Cook, G., Marti, C. N., Allen, A., Stoddard, D., Harmon, P., … Egeren, L. A. V. (2014). Effectiveness of a school- and community-based academic asthma health education program on the use of effective asthma self-care behaviors in older school-age students. Journal for Specialists in Pediatric Nursing, 20(1), 62–75. doi: 10.1111/jspn.12099
4. Quirt, J. J., Hildebrand, K. J., Mazza, J. J., Noya, F. J., & Kim, H. J. (2018). Asthma. Allergy, Asthma & Clinical Immunology, 14(S2). DOI: 10.1186/s13223-018-0279-0
5. Rubner, F. J., Jackson, D. J., Evans, M. D., Gangnon, R. E., Tisler, C. J., Pappas, T. E., … Lemanske, R. F. (2017). Early life rhinovirus wheezing, allergic sensitization, and asthma risk at adolescence. Journal of Allergy and Clinical Immunology, 139(2), 501–507. doi: 10.1016/j.jaci.2016.03.049
6. Xu, W. (2014, March 27). Expression Data Analysis to Identify Biomarkers Associated with Asthma in Children. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985200/