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      “This illness diminishes me. What it does is like theft”: A qualitative meta‐synthesis of people's experiences of living with asthma

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          Abstract

          Background

          What matters to people in their everyday experiences of living with asthma is influenced by a diverse range of personal, social, medical and environmental factors. Previous reviews of the asthma literature have largely focused on medical aspects of asthma or specific population groups with particular needs.

          Objective

          To identify, describe and synthesize from the available qualitative literature the views and experiences of adults living with asthma.

          Method

          We systematically searched for qualitative studies reporting on the personal experience of living with asthma. A meta‐synthesis approach was used to analyse and interpret the data. Key themes relating to personal perspectives on asthma were identified and grouped into overarching concepts.

          Results

          We identified 26 studies. There was a paucity of literature on the physical burden of asthma symptoms and the role of social support. Our synthesis generated a central concept of the “work” associated with living with asthma: work was of a personal nature, and at times an intensely emotional experience. Individuals tailored their behaviour in response to demands of the physical and social environment, including interactions with health‐care professionals.

          Conclusion

          This is the first systematic review of the qualitative literature reporting on people's own perspectives of living with asthma. Our findings draw attention to the nuances and sensitivities surrounding patient experiences of self‐management. Medical care is a central plank of managing chronic conditions, but our health‐care systems are now expected to deliver patient‐centred care. Considering the broader aspects of asthma management, beyond that of symptoms and treatment, will help to facilitate comprehensive care.

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          Most cited references65

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          Status of implementation of Framework Convention on Tobacco Control (FCTC) in Ghana: a qualitative study

          Background The Framework Convention on Tobacco Control (FCTC), a World Health Organization treaty, has now been ratified by over 165 countries. However there are concerns that implementing the Articles of the treaty may prove difficult, particularly in the developing world. In this study we have used qualitative methods to explore the extent to which the FCTC has been implemented in Ghana, a developing country that was 39th to ratify the FCTC, and identify barriers to effective FCTC implementation in low income countries. Methods Semi-structured interviews with 20 members of the national steering committee for tobacco control in Ghana, the official multi-disciplinary team with responsibility for tobacco control advocacy and policy formulation, were conducted. The Framework method for analysis and NVivo software were used to identify key issues relating to the awareness of the FCTC and the key challenges and achievements in Ghana to date. Results Interviewees had good knowledge of the content of the FCTC, and reported that although Ghana had no explicitly written policy on tobacco control, the Ministry of Health had issued several tobacco control directives before and since ratification. A national tobacco control bill has been drafted but has not been implemented. Challenges identified included the absence of a legal framework for implementing the FCTC, and a lack of adequate resources and prioritisation of tobacco control efforts, leading to slow implementation of the treaty. Conclusion Whilst Ghana has ratified the FCTC, there is an urgent need for action to pass a national tobacco control bill into law to enable it to implement the treaty, sustain tobacco control efforts and prevent Ghana's further involvement in the global tobacco epidemic.
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            The influence of social support on chronic illness self-management: a review and directions for research.

            A review of the empirical literature examining the relationship between social support and chronic illness self-management identified 29 articles, of which 22 were quantitative and 7 were qualitative. The majority of research in this area concerns diabetes self-management, with a few studies examining asthma, heart disease, and epilepsy management. Taken together, these studies provide evidence for a modest positive relationship between social support and chronic illness self-management, especially for diabetes. Dietary behavior appears to be particularly susceptible to social influences. In addition, social network members have potentially important negative influences on self-management There is a need to elucidate the underlying mechanisms by which support influences self-management and to examine whether this relationship varies by illness, type of support, and behavior. There is also a need to understand how the social environment may influence self-management in ways other than the provision of social support
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              Shared Treatment Decision Making Improves Adherence and Outcomes in Poorly Controlled Asthma

              American Journal of Respiratory and Critical Care Medicine, 181(6), 566-577
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                Author and article information

                Contributors
                lorraine.smith@sydney.edu.au
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                02 August 2017
                February 2018
                : 21
                : 1 ( doiID: 10.1111/hex.2018.21.issue-1 )
                : 23-40
                Affiliations
                [ 1 ] Centre for Values, Ethics & the Law in Medicine University of Sydney Sydney NSW Australia
                [ 2 ] Faculty of Pharmacy University of Sydney Sydney NSW Australia
                [ 3 ] Woolcock Institute of Medical Research University of Sydney Sydney NSW Australia
                [ 4 ] Nuffield Department of Primary Care Health Science University of Oxford Oxford UK
                Author notes
                [*] [* ] Correspondence

                Lorraine Smith, Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.

                Email: lorraine.smith@ 123456sydney.edu.au

                Author information
                http://orcid.org/0000-0002-9164-9205
                Article
                HEX12605
                10.1111/hex.12605
                5750696
                28768067
                647b5700-638c-41af-a3bb-754c97be7078
                © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 June 2017
                Page count
                Figures: 1, Tables: 5, Pages: 18, Words: 12557
                Funding
                Funded by: Centre for Research Excellence in Severe Asthma, Australia
                Funded by: NIHR Oxford Biomedical Research Centre
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                hex12605
                February 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.8 mode:remove_FC converted:15.01.2018

                Health & Social care
                adults,asthma,chronic illness,lived experience,qualitative synthesis
                Health & Social care
                adults, asthma, chronic illness, lived experience, qualitative synthesis

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