Dr Gabrielle Rose: A middle-age cohort study with Queensland women who have asthma.
Purpose of the study: The thesis is titled “Acumen, Ambivalence and Ambiguity: Stories of women with asthma.” This study explored the convergences and discrepancies in the representations of asthma and contrasted these with the life experiences of women with asthma in Queensland, Australia.
The aim was to reveal a gap between the dominant representational schemas and actual lives of asthmatic women and between the clinical perception of chronic conditions and the sufferers’ own perceptions. As the argument progressed biomedical, public health, and popular understandings of asthma diverged, resulting in tension between asthma research, public health policy and practice among biological, epidemiological and clinical researchers, and between consumers/patients and clinicians.
This approach juxtaposed various perspectives of the condition within the one text. Some of these perspectives have not been presented together so far, as the dominant narrative on conventional medical practice tends to exclude the subordinate ones. Perhaps the most obvious and yet most neglected of these perspectives is the personal experiences of people with asthma. Unlike most asthma research, or medical research in general, a crucial aspect of this study detailed accounts of women’s personal experiences of living with asthma. The research considered, not simply the women’s prescribed treatments, or the type of information found on hospital or medical charts (though this information was examined) but also their own perception of their asthma and how it affected their life on physical, psychological, spiritual, social and economic levels.
This type of information is often excluded or simplified in conventional accounts of illness. Medical practitioners tended to see the patient through their disease, rather than the disease through the patient. The medical gaze looks through the patient as if she were transparent and finds a predefined illness within her; we might say the individual suffocates under the blanket of their ailment. The project involved a quantitative and qualitative analysis utilising the data from the 1995/98 Mid-age cohort of women from Queensland, who had asthma.
Brief overview of results
- Onset, history, diagnosis, treatment and quality of life – A high percentage of the women were diagnosed with asthma late in their life
- The use of preventers by the women was not consistent
- Relievers were relied upon more so than preventers
- 64% of the women stated they had mild asthma yet compared to the Asthma Management Handbook criteria their asthma was moderate to severe
- A high percentage of the women were managing dual diagnoses of asthma with anxiety, depression and stress
- Women tended to ‘normalise’ their condition to ‘hide’ it from people
- Women had difficulty taking preventer medication when they felt well
- 36% of the women used alternative and complementary practices to treat their asthma
- A high proportion of the women did not consider their asthma as a serious condition
- Women viewed the treatment schedules for asthma as complex and difficult to understand
- Many of the women’s quality of life was affected across their social, emotional, work life, personal and interpersonal domains and this sometimes resulted from a history of asthma in the family and the body of knowledge the women had about their asthma. This knowledge was at times different to that of medical and public health knowledge.
The Asthma Management Handbook, while on the one hand was helpful for physicians, it did not validate the personal multiple experiences the women had about their condition. This could be a problem in terms of health promotion where a knowledge deficit model is used instead of an asset-based approach. A model that takes into account the knowledge, attitudes and practices that women bring to the consultation table may assist in the more effective management of this growing problem.