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Childhood asthma, Cultural competence, Explanatory models, Southeast Asian culture



  1. Reece, Susan M. DNSc, PNP-BC
  2. Silka, Linda PhD
  3. Langa, Bridget APRN-BC
  4. Renault-Caragianes, Paulette MPA, RN
  5. Penn, Sireena


Purpose: To examine how two groups (parents and healthcare providers) perceive asthma in Southeast (SE) Asian children in the United States, and to address issues of access to asthma care.


Study Design and Methods: Using Kleinman's Explanatory Models (EM) approach, semistructured interviews were used with 12 families and 26 providers. Families were interviewed in a clinic setting. Providers read a case example of a SE Asian child with asthma and were asked to anticipate the case family's EM of asthma. Data were analyzed using template analytic technique in which segments were clustered into etiology, causation, treatments, asthma impact, and access to asthma care.


Results: Families predominately followed current asthma practice guidelines, whereas providers believed that SE Asian families primarily followed cultural practices. Families described the severity and impact of asthma as more intense than the providers described the same items. While families identified barriers to care as difficulty getting appointments and unavailable providers, providers viewed family barriers to be predominately culturally based. Both groups noted the need for education and frequent healthcare visits as facilitators to care.


Clinical Implications: This study suggests that important differences may exist between the way providers and SE Asian families perceive childhood asthma. Nurses are encouraged to ask the families in their care how they explain their children's asthma, thus facilitating more culturally competent care and increased ability to meet the family's needs. Implications for policy change relative to improving access to care to immigrant groups are also suggested.