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Family Practice Vol. 21, No. 2, 166-172
Family Practice Vol. 21, No. 2 © Oxford University Press 2004, all rights reserved.

Article

Choosing to attend an asthma doctor: a qualitative study in adults attending emergency departments

J Douglass, D Goeman, R Aronia, F Thien, M Abramsonb, K Stewartc and SM Sawyerd

CRC for Asthma and the Department of Allergy Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Commercial Road, b Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, St Kilda Road, Melbourne, Victoria, Australia, 3004, a School of Public Health, La Trobe University, Bundoora, Victoria, Australia, 3083, c Victorian College of Pharmacy, Monash University, Royal Parade and d Centre for Adolescent Health, Royal Children's Hospital and The University of Melbourne, Gatehouse Road, Parkville, Victoria, Australia 3052

Correspondence to Dr Jo Douglass, Department of Allergy Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Commercial Road, Melbourne, Victoria, Australia, 3004; E-mail: j.douglass{at}alfred.org.au

Background. Asthma treatment guidelines currently recommend a ‘therapeutic partnership’ to achieve best care. It is frequently assumed that individuals presenting to emergency departments with asthma do not have a good doctor–patient relationship. We asked what is the nature of patients' relationships with their doctors in those presenting to hospital emergency departments for asthma care.

Methods. A qualitative study of all consenting individuals aged 18–70 years who presented to a hospital emergency department over 2 months was carried out. Sixty-two participants (19 male) engaged in in-depth interviews which were taped, transcribed and underwent thematic analysis. Questionnaire data were also collected and asthma severity determined.

Results. Nearly all patients (61/62) had a doctor whom they saw for their asthma. Patients made thoughtful choices on where they sought care according to their needs. Our findings identified that perceptions of doctors' competence, listening to patients and time constraints were important influences on doctor–patient relationships. Participants had strong expectations that their personal disease experience would be acknowledged by their doctors.

Conclusion. This group of patients had doctors who cared for their asthma. The acceptability of medical care was determined as much by patient choice as by the quality of the doctor–patient relationship.

Keywords. Adherence, asthma, bodily experience, chronic illness, discourse, doctor–patient relationships.


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