Describe the main limitations suffered by those wi
th chronicOne of the major public health problems facing Australia today is Asthma. It is disturbing that there has been an apparent increase in its prevalence and severity, and increased rates of hospital admissions. (E.J.Comino, 1996) For the diagnosed patient, the degree to which he or she suffers is related to severity of the condition, compliance with recommendations by medical experts, the immediate environment and the effectiveness of education programs.
Like other major health problems, asthma has varying degrees of symptoms. As such, the degree and frequency of the symptoms limits many aspects of the asthmatics life. To describe the main limitations suffered by those with chronic asthma, asthma must be defined.
Asthma is a condition whereby the sufferer has difficulty breathing due to widespread narrowing of the airways of the lungs. This narrowing can be caused by a local inflammation of the air-ways, muscle contraction or the production of excess mucus with in bronchi. (R.Roberts, 1996) Most common is bronchial asthma. Medical definitions of asthma suggest that environmental triggers can substantially contribute to the occurrence of an asthma attack. The review of asthma in Victoria (1988) by the Asthma Foundation of Victoria outlined infection, exercise, climatic conditions, exposure to airborne irritants and emotional upsets as the main trigger factors. However, doctors use a general classification to identify a patients pattern of asthmaclassifying people who experience some symptoms of asthma on most days as having a chronic asthma condition. The classification system also extends to the categories of children, occupational asthma and asthma in later life. Usually regular medication is required to keep the lungs functioning as normally as possible. Some chronic asthmatics have severe symptoms over a long period of time and may require long term or indefinite medication to be able to lead a normal life. (Lane, 1996)
The most obvious limitations suffered relate to the asthmatics physiological dysfunction. However, physiological dysfunction can in turn contribute to greater social and psychological limitations. This area is related more specifically to quality of life and morbidity and will be discussed further on. The main physiological limitation is related to the presence of the bronchial narrowing slowing the movement of air into and out of the lungs. Thus, there is difficulty both breathing in and out. Asthmatics commonly describe the feeling – tightness of the chest, congestion and wheezing. Although these symptoms can commonly occur in other chest diseases, in asthma it is a characteristic that can occur in an aggravated attack. This may be either brief episodes of chest tightness lasting a matter of minutes or a prolonged episode of wheezing lasting up to and hour, which can merge into a full blown attack of asthma. (D.J.Lane, 1996)
Other physiological limitations relate to the sufferers sensitivity to known triggers factors and the consequential effect on their daily functioning. The Global Strategy for Asthma Management and Prevention (1995) states that triggers are risk factors that cause asthma exacerbations by inducing inflammation or provoking bronchio-constriction. This report also describes the main triggers as allergens, air pollutants, respiratory infections, exercise and hyperventilation, weather changes, allergies to foods, additives and drugs, and emotional stress. For example it is well established that viral respiratory infections can exacerbate asthma, especially in children under the age of 10. (Busse, 1993) Because the triggers may vary from person to person and from time to time, it is important to take the sufferers natural history into account and identify each individuals triggers. Therefore, an individuals identified trigger can restrict the sufferers ability to function normally. For example an asthmatic child may try to avoid exercise for fear that it may trigger an asthmatic attack. This may in turn limit the sufferers physiological development over the long term and hence further contribute to the problem. (Global Strategy, 1995)
Some psychological and social problems can also be considered as a consequence of the interaction with physiological limitations. The Global Strategy for Asthma Management and Prevention (1995) states that asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients and may have an impact on their careers. Chronic asthma sufferers have to live