Tag Archives: barriers to care

Understanding of Asthma Management: Conclusions

Finally, a distinctive barrier was the parental perception on differences in quality of care, due to the use of Medicaid insurance. In some cases, parents believed that certain limitations (ie, the prescription of generic vs brand name medications, poor access to administrative assistance, limits on refills) were due to the fact that they had Medicaid insurance, as opposed to limitations imposed on both Medicaid-insured and non-Medicaid-insured patients. Asthma self-management education should be targeted to improve control among high-risk popula-tions. Medicaid-insured families face unique barriers related to income and insurance limitations as well as other issues faced by non-Medicaid-insured children with asthma.
Continue reading

Understanding of Asthma Management: Research

Understanding of Asthma Management: ResearchIf this is an unstated concern of parents, it may be important for physicians to specifically state that their decisions for care are not based on the type of patient insurance. One technique to improve this would be to focus on communication, reassuring patients about any concerns or fears. read
Many specific asthma and management challenges faced by Medicaid caregivers are not fundamentally different than those of other parents; however, they often have less social support to aid them in dealing with their child’s medical needs and face greater financial barriers compared to other parents. Our participants reported similar issues related to school, family quality of life, and financial issues as reported by Mansour et al in a study of urban, low-income families; however, they appeared to have greater asthma knowledge and voiced understanding that children with persistent disease required chronic anti-inflammatory therapy.
Continue reading

Understanding of Asthma Management: Study

In order for families to be compliant with antiinflammatory care, they need to understand proper use of such medications, have their questions regarding potential undesirable side effects addressed, and believe (outcome expectancy) that administering this chronic medication to their child will decrease asthma symptoms and improve health. When providers communicate this information well, patients use fewer acute care services and miss less school. More info
Like all children, these Medicaid-insured patients spend at least 6 to 8 h/d at school. The children are dependent on the school system to provide supervision and care for their asthma, which is a reasonable point of concern for parents. Many states including Michigan have policies that allow students to carry their own medication and self-medicate as necessary. A lack of awareness by teachers and school personnel of asthma was frustrating for the focus group caregivers. To tailor asthma care for children, physicians need to be knowledgeable of school-related care issues and assist families with school advocacy and asthma education.
Continue reading

Understanding of Asthma Management: Study

The management of asthma requires coordination and awareness of multiple tasks. This may impact the caregiver’s self-efficacy at both behavior specific and situational (environment)-specific levels. In other words, a parent with lower self-efficacy may not be able to act or trust their capability for dealing with and caring for their child’s asthma in the Medicaid or medical systems. Our findings suggest that the caregivers require and desire ongoing education with an emphasis to support development of parental confidence regarding asthma self-management skills; feedback and communication may be able to address this.
Continue reading

Understanding of Asthma Management: Adolescence

Understanding of Asthma Management: AdolescenceParents viewed their medical provider as their main source for asthma education. Some caregivers believed they needed asthma education beyond that provided by their physician, while others believed the physician and staff were in greater need of the asthma education. Several caregivers were very satisfied with the level of support and coordination of asthma care in the physician’s office. Successful medical provider approaches were multidisciplinary, including a physician staff team approach to the delivery of asthma care and education. so
As “she got older she came to me, she said ‘Mom, I’m tired of taking all this medicine. It’s nasty, I’m just tired’. And we went through a phase where she was half taking her medications.” An unanticipated issue that surfaced from parents was the need for support and age-appropriate asthma education for teenaged children. Caregivers reported a change in their ability to properly manage their child’s asthma during this transition from adolescent to teen. In younger children, parents were better able to oversee activities, adhere to medication schedules, and avoid exposure to environmental triggers. We found that with teenage children the impact of peer pressure and the need for belonging was not only evident but directly impacted the child’s adherence to their asthma management. The feelings of invincibility and embarrassment experienced by teenagers toward their asthma care routines were difficult for parent’s to penetrate even when the child fully comprehended the severity of their disease.
Continue reading

Understanding of Asthma Management: Role of Medical Provider

Caregivers expressed a concern that care provided differed when physicians or medical staff noted their Medicaid insurance coverage. Some had to show extra paperwork at the physician’s office, while others believed they received lesser treatment or were stigmatized. Overall, parents believed that coverage provided by Medicaid was adequate and that the needed care was available for their child. Medicaid was credited by some parents as allowing them to establish a medical home for their child’s asthma care. http://cfp-for-you.com/
Caregivers of children with asthma were concerned with the level of access to medical providers during an asthma episode. Availability of 24-h call lines during an emergency were seen as strategies to receive support prior to visiting an emergency department. Parents were concerned the level of office triage for asthma was either missing or of a lower priority, specifically during an asthma episode. Again, perceptions of discrimination and indifference were mentioned as issues for parents of children receiving care insured by Medicaid: “Or you are not going to get the full care that you would if you had regular insurance.”
Continue reading

Understanding of Asthma Management: Medicaid Health-Care System

Understanding of Asthma Management: Medicaid Health-Care SystemCaregivers addressed the impact of their child’s asthma on their employment. Parents expressed the need for care throughout the day, knowing that they were unable to monitor their child 24 h/d. Appropriate management strategies for monitoring of their child’s asthma, including peak flow readings, were utilized by some parents in adjusting medications as needed in the mornings and evenings to avoid problems during the work day.
Experiences with the Medicaid system and personnel varied, while some caregivers mentioned no complaints, others believed they were discriminated against or frustrated by paperwork and changing coverage. Physician or specialist referrals were cited by parents as a barrier to acquiring proper asthma care. An additional barrier to ensuring good asthma care for children was the limitations set on refills by insurance. Caregivers believed it would be easier to manage their child’s asthma if they were able to receive multiple inhalers: one for school and another for home. Likewise, they need to be allowed to refill medications that were lost prior to the Medicaid 30-day refill cycle. read
Continue reading

Understanding of Asthma Management: School/Daycare Support and Work

Although parents have learned methods to diminish the effects of environmental triggers, they continued to experience situations that were beyond their control. These included exposures at friends’ or relatives homes.
“We couldn’t even go to restaurants because they have part of it [where] you smoke [and] one part you can’t. So no matter what, if you’re in there… smoke is in the environment and the child gets sick. And [if] you complain about it, well it’s not a smoke-free environment.” Smoke-free restaurants and public locations continue to be a challenge for parents of children with asthma. Many believed community education of environmental triggers of asthma would assist in eliminating exposure and improving the family and child’s quality of life.
Continue reading

Understanding of Asthma Management: Caregiver/Patient Knowledge

Understanding of Asthma Management: Caregiver/Patient KnowledgeOthers remained stressed or overwhelmed by their child’s asthma: “I get nervous, I’m still not used to it, so I run to the doctor a lot. I don’t know if I’m giving too much medicine, the right medicine. You know, sometimes they treat me like I ought to know but I don’t know!” further
Unfortunately, some parents did not have asthma management plans, which provided them less support to deal with their child’s illness and their fears. Some parents expressed low self-efficacy in execution of management strategies needed to treat their child’s symptoms. The caregiver’s emotions appeared to play an important role in the delivery of asthma care but could be positively affected by a supportive relationship with the medical provider.
Continue reading

Understanding of Asthma Management: Results

Four focus groups were held between December 2001 and January of 2002, including 35 women and 1 man. Primary care providers were self-identified as the biological mother (89%) and were most commonly in the age range of 25 to 35 years (50%). The majority of participants were African Americans (64%), and 31% were married. Participants reported an annual income range of < $10,000, with only five participants with an income > $30,000/yr. The median level of education for the participants was 13 years. The children of the focus group members had a median age of 10 years. Forty-seven percent experienced frequent daytime asthma symptoms occurring daily or several times a week. Children missed a median of 8 days of school during the first half of the current academic year. Only four caregivers reported an asthma specialist managed their child’s asthma. All children were prescribed some asthma-related medication. Ninety-seven percent received an inhaled (3-agonist. Fifty percent reported taking a leukotriene inhibitor, and 47% reported inhaling corticosteroids. Almost one third reported taking oral steroids within the last year.
Continue reading

Pages: 1 2 Next