Linda Nozart, MPH, BSRC, RRT, AE-C 

I remember being diagnosed with asthma at 8 years old. I caught bad colds often, coughed all night, and was not able to participate in gym class. I also frequently left school early due to being too sick to stay in class. My parents were scared that I was going to die in my sleep, so I slept in bed with them for a year. I don’t really remember what helped me gain asthma control back then. I just remember being on a lot of meds and my parents having to remove all the carpet in the house.

Asthma is a complex chronic disease. It takes a village to care for a child with asthma. Imagine when a parent first hears the word asthma as a diagnosis for their child in the clinical setting. They are handed a written Asthma Action Plan, an inhaler, a peak flow meter (depending on the age) and instructed to identify and avoid asthma triggers. Everything was explained (we hope) and then the parent is asked whether they have any questions. Most likely the parent feels so overwhelmed they don’t know what to ask. Then they go home with the child and all the new asthma self- management goodies likely asking, “now what?” or 2 weeks later their child is back in the ER with another asthma exacerbation.

How can we help this parent?

Here are 8 ways to  prepare someone for asthma self-management.

1. Motivational interviewing – Find out what the parents need, what their concerns are, practice active listening, and listen with empathy. Empathy is a great skill to have and takes time and practice to build up.
2. Tell them the truth as simply as possible – Asthma is not curable but it can be controlled.  People with asthma can have a normal life by working as a partner with their provider. The key is that they know it is a partnership. The provider and asthma team will do their job and the parent must do their duties as well to manage asthma.
3. Create with them a vision of asthma control – Describe what asthma control looks like in detail. Maybe the parent is at the point where they believe their child is always going to be sick and that they just have to deal with it. Paint a picture of bliss with no missed school or workdays and a child able to be active without limits. Building their self-confidence will lead to an increased quality of life for both the child and family.
4. Learn their health beliefs – Are they aware of the health concerns with uncontrolled asthma? Do they intend to make changes? Have they experienced discouragement in the past regarding asthma management? Are they ignoring the facts? You want to know the parent’s level of understanding and if they can achieve the goals of helping their child gain asthma control.
5. Keep coaching them – Repeat important points and steps but avoid becoming annoying. Encourage their efforts and compliment every small improvement. This will build their confidence in self-management.
6. Advocate for the parent – Help identify and remove barriers to asthma control. Remember this is a partnership. If you help remove barriers, it will lift some of the parent’s load off their shoulders and build trust.
7. Set accountability – Again reinforce this is a partnership: I support you and you do your best to follow through. Being consistent with this is important because it helps set boundaries, so the parent is not completely dependent on others. As the coach, remind the parent what is needed and expected from them to achieve asthma control. 
8. Encourage self-care – Assess if the parent has ways to practice self-care and has a support system. Offer tips that can simplify key areas in their lives like having daily routines and planning ahead.

Managing asthma on a day-by-day basis is often a struggle and overwhelming for families.  Self-management at home can be especially complex with having to identify triggers, reduce those triggers, and keep track of daily medications.

Do you have other ways that help prepare others for asthma self-management? Please share your tips.

Linda Nozart, MPH, BSRC, RRT, AE-C 

CEO Noz Health Ed,  LLC 

Health Behavior and Health Education: Theory, Research, and Practice. John Wiley & Sons; 2008 Aug 28