Nursing Research Case Study: Asthma Management and Social Impacts

This case study examines the case of a 12-year-old boy named John with asthma, highlighting the impact of social circumstances on his treatment and care. It discusses the onset, illness trajectory, and pathophysiology of asthma, emphasizing the role of inflammation and the interplay between environmental exposures and genetics. The study further explores the psychosocial and lifespan considerations, noting the financial and emotional strain on families and the potential for social isolation and mental health issues in affected children. It advocates for multidisciplinary teams to support patients, promoting health literacy and community-based learning. Finally, the study addresses nursing care requirements for mild intermittent asthma, including the use of short-acting beta-agonists and anti-inflammatory therapies to prevent disease progression. This assignment is available on Desklib, a platform offering a wealth of study resources for students.

Running head: RESEARCH IN NURSING 1
Research in nursing
Students Name
Institution Affiliation

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Research in nursing
Task 1
Introduction
Nursing is a field which requires analysis to enhance evidence-based practices. The case
presented in this paper involves a 12 year old boy by the name John with a life-long condition
and the social circumstances involved in the context. The article will be able to show that social
events can influence the treatment and care of patients with life-long conditions. For instance, a
country like New Zealand is said to have numerous cases of Asthma because of deprived
socioeconomic conditions. These socioeconomic conditions and insufficient heating in the
homes act as a great contributor to asthma (Asher et al., 2017). The paper will look at a John who
is a young boy who has been affected by asthma a lifelong condition which is a major threat to
New Zealand children.
Literature has proven that over 5 billion is spent per annum in New Zealand to take care
of respiratory diseases with over 2000 people dying every year due to these diseases (Camargo et
al., 2011). The case of John's illness was presented to the general practitioner by his parents since
he could not represent himself well due to his age. Just like other people in the population, John
never received the required intervention and was in danger of getting another deadly attack. To
most people with asthma, the cost of living continues to increase when affected with asthma
because they have to endure different financial and personal expenses when receiving treatment.
For instance, physicians say that asthma is associated with psycho-social challenges such as
depression and anxiety. It means that John will be away from school most times which
automatically leads to poor performance in academics (Webb, 2011). The paper will address

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more concerns to do with asthma and provide relevant evidence from health professional works
to offer a better understanding of the issue.
Task 2
Typical onset, potential illness trajectory, and pathophysiology of Asthma
Researchers need to investigate on what initiates inflammatory processes and makes
people susceptible to infections. Some research which has been conducted indicates that asthma
initially starts in the early part of life. Asthma is expressed as a disease which has an interactive
process and complex, but it is influenced by the interplay between environmental exposures and
host factors (especially genetics) (Chang et al., 2010). These factors occur during the immune
system development hence acting as high trajectories.
In children like John, the asthma mostly affects the airways and the lungs because these
parts become inflamed easily when they are exposed to particular triggers like catching cold,
inhaling pollen or various respiratory infections. The symptoms which show every day can be
disturbing to children hence interfering with their school, sleep, sports and play. And when the
attacks lack proper management, they might develop to severe cases.
It has been discovered that airway inflammation acts as a significant aspect in the
pathophysiology and pathogenesis of asthma. The essence of inflammation to primary
characteristics of asthma underscores and expands this feature as a central objective of treatment
(Menclova and Webb, 2016). Treatment might have significant specificity and become more
effective if the understanding of different inflammation phenotypes become apparent. Physicians
have discovered that asthma together with its persistence begins in the early life. The information
can assist in determining how asthma patients can be treated, even though it is still unclear which

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factors determine intermittent versus persistent asthma. Present treatment cannot prevent asthma
severity, but it can help in reducing airflow restrictions, preventing exacerbations and controlling
symptoms. Asthma is a lifelong condition and therefore affects the general health of those
affected throughout their lives hence costing them a fortune. Developing a way of treating this
chronic illness can, therefore, help people to get better lifestyles like better participation in
classrooms.
Psychosocial and lifespan considerations
Asthma has different lifespan conditions and psychosocial impacts on the lifelong
conditions of people affected together with people related to them. The disease lead affects
families including creating a stressful environment because they have to take care of the sick
both economically and socially. For instance, John’s parents will have problems with rentals
payments, service, food and fuel costs, employment loss, change in the employment market, loss
of investments, and inability to provide for other dependents. The family of such a boy who is
suffering from asthma will have to incur a lot of costs which may even lead to displacement
(Doolan-Noble et al., 2015). Families are always concerned with the well-being of their children,
and they are the ones responsible for the maintenance of children’s well-being. In this case, the
time spent with the family will reduce and some turn out to become alcoholics and drug users,
and in the long run, they develop different mental disabilities.
According to professional literature, many children who get affected never get time to
play with others. They lack recreation and leisure time because they do not have the energy to
play and also have no money to spend on leisure activities because most of the money is spent on
treatment. An individual might even change the view of himself from those of the world. These

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people have low levels of independence, have a negative self-cognitive appraisal, lack meaning
in their lives, and experience power inequalities (Fajt & Wenzel, 2015). Sometimes they will
also feel isolated and lack aspirations due to these uncontrollable conditions. The psychosocial
stressors in the society affect family and community relations hence affecting long-term
wellbeing and mental health of communities and individuals.
Families are the primary units which support children meaning that disruptions within the
family in terms of resources loss and long-term commitments will lead to distress and loss spirals
collectively. The family might, therefore, end up employing other resources to help in coping
with additional stress beside the stress caused by the disease. According to Granell, Henderson,
and Sterne (2016), children depend on parents and if they lack support they will have difficulties
in coping with the society.
Task 3
Role of multidisciplinary teams in supporting people with asthma
As discussed in this paper, asthma is a disease which causes a lot of suffering to induvial
together with their families. Building a team to support the affected child in the management of
his condition is therefore critical because it will make him feel valued hence creating a better
living environment. Patients’ attitudes, behaviors, and knowledge have an impact on their health
results in different ways. Lack of support leads to the development of negative experiences
making the patient develop inertia, lack of self-assurance and non-adherence. Sometimes you
cannot improve the health of a person by telling him what to do and what they should avoid.
Some health-care providers give conflicting information to their patients making it difficult for
them to engage with the existing healthcare providers and they also become more confused.

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Some people are forced to look for data and assistance from their social networks and the
internet. But healthcare providers can change this by assisting and supporting patients in a way
that they can become their managers.
Owora et al. (2018) state that the burden of asthma facing New Zealand requires general
public cognizance which involves teaching people on the seriousness of the issue and its causes.
Health care providers are the people who should have the necessary knowledge so that they can
treat patients based on up-to-date data. It is crucial for the healthcare system to promote and
recognize the essence of chronic diseases and health literacy management for everyone who is
involved in healthcare management. The system can support cross-cultural communication,
holistic Maori representations, and cultural competency. These people, therefore, need the
knowledge to engage with patients to ensure that they provide the required support.
Health organizations can work in partnership with members of the society to help in
developing and identification of high-quality resources which can support children who have
asthma. These health care providers will be required to incorporate these resources in the
educational strategies used in teaching the population (especially audio-visual and interactive
resources along with those resources designed primarily to help Maori children) (Zwar et al.,
2017). Community-based, flexible and innovative educational approaches require to be
implemented to meet the requirements of Maori Whanau in a better way. The partnership with
patients will be essential because it will help in developing the right monitoring tools and
supporting longitudinal asthma learning. Multidisciplinary teams will aid in the development of
health literacy, education sessions and community-based learning that will fit Whanau and Mauri
children appropriately.

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Nursing care requirements
Asthma has different stages including the first stage known as mild intermittent; the
second is mild persistent, the third stage is moderate persistent, and the last stage is severe
persistent asthma. In this, case the boy was diagnosed with a mild intermittent type of asthma
which has different symptoms. The symptoms exhibit themselves in the patient’s body in less
than twice a week, and patients do not have issues between flare-ups. Shahidi and FitzGerald
(2010) argues that most patients diagnosed with asthma have mild asthma meaning that it should
be maintained from this stage. Some patients are poorly treated, and this is what causes the
development of this disease to severe cases. John is one of the patient with mild asthma and
different things will be required to manage his condition as stated below.
Firstly, it is essential to control the disease to help in preventing future risks which may
occur in patients who have mild conditions (Shahidi, 2010). There are some control measures
which will help in averting asthma hence reducing its prevalence. Some patients will accept the
symptoms adhere poorly to preventive therapy. They do not know that these treatments do not
only control the current conditions, but they also assist in reducing the imminent asthma
exacerbations. In a country like Australia, a study conducted showed that most people who lost
their lives due to severe Asthma had mild asthma, but the condition advanced. At the present
stage of this patient, it is vital to carry out preventive measures to avoid the development of this
disease.
Task Four

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Issues identified by the patient
John experienced symptoms such as cough, chest tightness and breathing difficulties
about two times a week. As the nurse taking care of this patient, it is essential to recommend the
use of different control methods to prevent further development of the disease. Short-acting beta
two agonists (SABAs) can be given to the patient to provide relief through the reduction of
different symptoms such as chest tightening associated with airway narrowing. SABAs therapy
cannot help in controlling inflammatory processes, but it is the recommended therapy for mild
asthma. Bronchodilator can also be used to assist in relieving mild asthma while SABA
frequency can be used in the measurement of asthma regulation. Once the symptoms are
relieved, medication rescue is needed more than two times a week. Early considerations should
also be present to help in the development of anti-inflammatory therapy. For instance, there are
some treatments given to relieve pain when there is a dental cavity, but the cavity remains.
Similarly, the pain reliever regulates the disease and only masks inflammatory changes
associated with mild asthma.
ICS treatment is also essential for mild asthma because of the aptitude to regulate airway
inflammation. The therapy efficacy includes improvement of lung function, reduction of asthma
symptoms, improving the value of patient’s life, and decreasing severity and frequency of
exacerbations. Different studies with mild asthma improve their symptom score after the
treatment showing that it is an important part. But to the patients who receive ICS therapy
experience different side effects like occasional cough, dysphonia, and oropharyngeal
candidiasis. But it is not experienced when high ICS dosage is given in the case of systematic
effects like adrenal suppression, glaucoma, and easy bruising which may be present. Spacer

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devices, prodrugs, and mouth washing drugs can be given to patients to alleviate these side
effects (Beasley et al., 2016). But for any patient who has asthma, education is essential besides
the medical treatment to provide them with the necessary awareness and to educate them on the
potential risks associated with the illness. In such a way, it will be easy to control the disease in
the young boy with stage 1 asthma, and it will be difficult for the ailment to develop severe
cases.
Partnerships in New Zealand
As discussed earlier, connections in the healthcare sector are vital because they help in
supporting those with asthma. Nurses have a huge role in providing support and advice to people
who have asthma in New Zealand. They may partner with families, communities, and patients to
help in the delivery of better services to patients. Weinstein (2011) states that these partnerships,
multidisciplinary teams can be formed which provide different services to patients as a way of
supporting them in the management of diseases. New Zealand developed different
interdisciplinary groups to help in curbing the effects of the illness to societal wellbeing. These
groups help in the delivery of evidence-based guidance and practical, up-to-date treatment of
patients. Asthma affects many people in New Zealand with one in about seven children
undertaking medication. According to new findings, many children in the country have been
hospitalized due to asthma, and some even have a potentially life-threatening attack. Despite
these severe symptoms and the disease prevalence in the country, affected children, are dispersed
with few preventive treatments which result in worsening of the condition.
Some whanau and parents receive guidelines on how to take care of their children, but
they do not know the medications necessary. Some of them lack self-confidence in their abilities

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to help their children leading to lack of proper care, frustration and they feel that health care
provider fail to deliver what they need. Parents, therefore, need more education on the effects of
this condition and how it should be controlled to get better results (Welsh, Hasan, and Li, 2011).
People in the country should be taught about this disease and given support by the
multidisciplinary groups to advance on their knowledge besides increasing their confidence
when dealing with such cases.
It is necessary to develop a style that will ensure that health care equipments’ are
designed to help in better treatment. It is crucial to formulating inter-professional techniques
which require identification of roles that pharmacists, asthma educators, non-professional health-
care employees, volunteers, and community organization workers can have when supporting the
provision of integrated asthma maintenance (Becker & Abrams, 2017). A team approach is the
best thing that can help in the maintenance of asthma in New Zealand. It is therefore essential for
health organizations to adopt and develop procedures and policies that encourage enhanced
interdisciplinary harmonization. Multidisciplinary teams will, therefore, play a very crucial role
in the improvement of asthma management. They can help patients like the ones presented in this
case to get the necessary support while the disease is not fully developed. The circumstances of
severe asthma might even drop hence reducing the total finances spent on medication.
Recommendations
As discussed in this paper, asthma develops due to factors such as exercise, stress, cold
air smoking, the problem of lighting, and intake of various drugs among others. Health
professionals, in this case, can develop teaching strategies which require the engagement of
patients and their family members which are carried out according to their learning preferences

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and specific family needs. It is their responsibility to activate and empower patients so that they
can be able to take care of their health and also have the right tools to achieve this role. But to
accomplish this, the healthcare teams should provide the required training for management of
chronic diseases, cultural responsiveness, and health literacy-based learning techniques. Utilizing
high-quality resources is vital in this process including different media to help in supporting the
engagement of health care professionals and reinforcement of crucial information for all levels
and ages of understanding. This disease can also be prevented through the use of proper
medication such as ICS which will help in the prevention of further development in the body of
patients.
Conclusion
The healthcare centers should be appropriately equipped with the necessary tools to help
patients in getting the requisite satisfaction. Patients face different problems such as lack of
knowledge which can be prevented through the provision of education to the population. The
implementation of better strategies by nurses can help in reducing the cases of Asthma in New
Zealand hence creating a healthy living environment. Many people have to struggle every day
due to asthma and some even experience poor performance in schools due to lack of better
control of the disease. Children like John depend on parents and support is therefore required to
help them it taking better care for the affected.
References

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(2017). Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines:
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Becker, A. B., & Abrams, E. M. (2017). Asthma guidelines: the Global Initiative for Asthma in
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Beasley, R., Hancox, R. J., Harwood, M., Perrin, K., Poot, B., Pilcher, J., ... & Thayabaran, D.
(2016). Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick
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