Balancing: A grounded theory of asthma and everyday living

Statement of the problem. Despite much effort to combat rising asthma mortality and morbidity on a national and global level, progress has been minimal. Established guidelines from the National Asthma Education and Prevention Program put forth for clinicians by the National Heart, Lung, and Blood Institute of the National Institute of Health, propose a paradigm dictating the recommended course of action in situations when asthma symptoms are worsening and in need of intervention. People with asthma appear to fail to comply with these guidelines at high rates despite education by clinicians. Using grounded theory, this study examined narratives told by the participants and revealed a process of decision-making in asthma in everyday living from the perspective of the person with asthma.; Methodology. Grounded theory is based on the philosophic perspective of symbolic interactionism. Symbolic interactionism assumes that human action depends upon meanings that people ascribe to their situations. This assumption drives grounded theory research by allowing the researcher to look closely at an individual's interpretation of self and their actions as processes (Charmanz, 1990; Glaser & Strauss, 1967). The results become, then, a window into how a person with asthma decides to manage their illness.; Results. Through grounded theory the process of decision-making in asthma of balancing was revealed. The process of balancing is a dynamic process with two stages: perpetual calculation and regimen redesign. All participants were actively involved in making decisions to balance living with asthma through perpetual calculation and regimen redesign. All participants recounted the decision to seek the help of a health-care professional when they had lost control of the balance. The process represents a holistic approach participants use in attempting to attain a balance between symptoms and symptom management.; Conclusion/Nursing implications. Identification of the process used by people with asthma in evaluating symptoms in decision-making in asthma in everyday living may be useful to heath-care professionals designing and implementing successful self-care interventions. Understanding this process may assist health-care workers to facilitate positive asthma health outcomes through supporting accurate assessment of the severity of symptoms and encouraging decision-making according to the person's goals and available options.