Asthma: The Role of Culture, Beliefs and Social Support

Topic: Pulmonology
Words: 2058 Pages: 7

Asthma is a condition that affects millions of people around the world. According to the National Asthma and Education and Prevention Program Expert Panel Report 3, asthma is a long-term inflammatory condition of the airways that involves several cells and cellular components (Stern et al., 2020). For those who are affected by such disease, this inflammation results in recurring episodes of cough, dyspnea, and chest pains (Stern et al., 2020). Over 300 million individuals globally, including 25 million Americans, suffer from asthma, a diverse clinical illness (Stern et al., 2020). In the United States alone, the incidence of asthma rose from 7.3% in 2000 to 7.9% in 2017 (Stern et al., 2020). It is the most prevalent chronic disease among children, impacting 6.4 million minors in the United States and children globally.

However, asthma incidence rate, intensity, and mortality vary worldwide. Asthma prevalence patterns have changed over time; while they are on the rise globally in low- to middle-income nations, they seem to have reached a plateau in some industrialized countries (Stern et al., 2020). The likelihood of contracting asthma has been linked to a number of risk factors, including genetic and environmental factors, such as exposure to allergens, tobacco smoke, and air pollution (Stern et al., 2020). Hence, asthma represents a public health issue due to its increasing trend and slow development of new effective treatments and deserves more attention.


The lungs are the primary organ that is impacted by the asthmatic condition. The lungs are comprised of sections and regions, with the left side of the organ having eight or nine sections based on how the region is divided and the right side having ten sections (Sinyor and Perez, 2019). The connecting area and respiratory area are the two physiological regions that make up the breathing system (Sinyor and Perez, 2019). Asthma predominantly affects the bronchial tree, which is responsible for distributing oxygen to the alveolar ducts in the airways. In individuals diagnosed with asthma, inflammation alters the physiological process, reducing the width of the airway (Sinyor and Perez, 2019). Collectively, these systems alter the lungs’ compliance only a little bit, making breathing considerably more laborious. As a result, when breathing normally, oxygen reaches the body through the mouth or nose before entering the trachea. It then travels via the bronchi, into the lungs, and eventually escapes the system. On the other hand, the airways in patients with asthma are enlarged and irritated, impeding proper oxygen intake.

However, physicians must detect the subtle clinical differences that asthma might produce. Heavy breathing, shortness of breath, and coughing, which are frequently worse at night, are common symptoms of asthma (Sinyor and Perez, 2019). There are many factors that make asthma worse. Activity, cool air, and the contaminants mentioned above are examples of such reactions (Sinyor and Perez, 2019). Tachycardia, tachypnea, and a patient sitting in a squatting position are some other non-specific indications that may point to a serious occlusion (Sinyor and Perez, 2019). If asthma is not effectively handled and controlled, it can develop into a life-threatening illness.

Lastly, various phases of asthma are identified based on pulmonary function results and/or clinical signs. Asthma intensity is divided into four categories: intermittent, mild, moderate, and severe. The treatment and care of the condition are based on its particular stage. One is said to have intermittent asthma when signs last for fewer than two days per week and night awakenings last for fewer than twice per month (Sinyor and Perez, 2019). Mild type is defined as experiencing attacks more than twice a week (but not every day), as well as night awakenings three to four times each month (Sinyor and Perez, 2019). The individual has a moderate type of condition if they experience symptoms daily and more than once a week, but not every night (Sinyor and Perez, 2019). In cases of severe asthma, the patient experiences symptoms all day long and frequently wake up throughout the night over than seven times each week(Sinyor and Perez, 2019). These frameworks allow for the proper treatment to be given to the patient in order to lessen their symptoms.

There are current treatments for asthma that target particular systems of the inflammatory process, or they are being developed. As for the traditional treatment, inhaled corticosteroids (ICS) and 2-adrenergic agonists, which have bronchodilatory and anti-inflammatory effects, are recommended as best-practice treatments (Palova et al., 2020). The pairing of these two treatments further improves the curative result since 2-adrenergic agonists encourage glucocorticoid receptor nuclear migration, which increases reactivity to corticosteroids (CS), which in turn up-regulates 2-receptors (Palova et al., 2020). These types of care are the most accepted and current trends.

Nevertheless, while there is a well-accepted and efficient treatment of asthma, the development of new drugs is in action. Asthma treatment based on anti-IgE is among the relatively modern examples. Omalizumab was the first medication recognized as an anti-IgE monoclonal antibody (Palova et al., 2020). Omalizumab is already recommended for IgE-mediated moderate-to-severe types of conditions that are not reacting well to standard therapies based on the GINA (Palova et al., 2020). Another example is macrolides, and in a relatively limited and focused sample of asthmatics, macrolide antibiotics seemed to be an efficient off-label approach. Yet, none of the aforementioned treatments for non-eosinophilic asthma have shown to be effective in major clinical investigations. This is likely because of the heterogeneous participant selection or inadequate knowledge of pathogenesis.

However, there are further asthma treatment alternatives that show better results, such as satins. Statins have pleiotropic actions that include anti-inflammatory and antioxidant qualities (Palova et al., 2020). Statins decreased AHR and airway remodeling in preclinical trials, although various retrospective and prospective trials lacked consistency (Palova et al., 2020). Therefore, when it comes to asthma treatment development, more profound knowledge of the phenotypes and endotypes of asthma, the discovery of more reliable biomarkers, the identification of molecular variations across people, and the subsequent classification of patients are required.

Cultural Sensitive Care

When it comes to culturally sensitive care, it is important to take into account the position of cultural and group diversity. Asthma control effectiveness depends on patient engagement in therapy, which necessitates knowledge of what, when, and how to administer medicine and assiduous compliance with management strategy. Patients with asthma from racial and ethnic minorities tend to be sicker and complete their medications less frequently (Shum et al., 2017). As a result, it is necessary to incorporate specific approaches to ensure that patients of different backgrounds not only receive proper care but are capable of maintaining treatment.

Among the examples of such cultural diversity are the Chinese and Punjabi patients. In terms of how they saw the causes, effects, and consequences of having asthma and self-management techniques, the Chinese and Punjabi groups had some commonalities and contrasted with one another. For example, Chinese and Punjabi patients frequently believe that asthma is a contagious illness like the common cold, perceiving asthma as a contagious illness (Shum et al., 2017). Many Punjabi patients also mentioned being embarrassed to use an inhaler in public since they were worried that people would think they had a contagious viral lung condition like tuberculosis (Shum et al., 2017). Consequently, the patients did not fully comply with the asthma treatment plan.

Yet, the groups who were examined had diverse attitudes toward smoking. Though smoking was widely and frequently done by Chinese patients, as they noted, smoking tended to be strongly supported by the Chinese culture and allowed them to interact socially with peers, friends, and coworkers (Shum et al., 2017). However, Punjabi patients noted that smoking was not a normal practice in their society, especially among women (Shum et al., 2017). Many also said they preferred not to smoke in front of the elderly since it went against their religious and cultural standards (Shum et al., 2017). The decisions of patients may be influenced to some extent by these ideas and a lack of knowledge.

Thus, the healthcare professional should minimize medical terminology and communicate clearly in order to explain the importance of proper care; preferably, they should have an adult close relative who speaks fluent English act as a translator when speaking with patients who are not proficient in the language. Additionally, healthcare professionals have to try to comprehend the cultural perspectives of their patients on the sickness (Shum et al., 2017). Such procedures will provide a more accurate portrayal and in-depth observations into improving the cultural competence of doctor-patient effective communication.

Nursing Theorist’s Model

Nurses are in a position to identify issues and stop their impact on patients’ everyday lives, interpersonal interactions, and quality of life. Self-care education is among the key strategies for promoting health that relies on involvement. Dorothea Orem, a nursing theorist, established a self-care theory and claimed it to be useful for all kinds of patients, which can also be applied to asthmatic patients. The impact of the Orem approach on self-care in asthmatic patients was examined in some studies analyzed by Hemati et al. (2017). According to Hemati et al. (2017), they provided instruction on how to manage medications properly as well as exercise routines, action plans, a cautious diet, and avoidance of triggers, all of which produced a noticeable change in the intervention group as compared to the pre-intervention group (Hemati et al., 2017). Additionally, it was discovered that after the Orem model treatment, the regulation of self-care behavior in asthmatic individuals was enhanced.

Since the Orem self-care concept helped enhance all of the quality-of-life measures in asthmatic patients, nurses who spend a lot of time with these patients may be able to help patients learn how to take care of themselves, adjust to their condition, and follow prescribed treatment regimens. Consequently, the self-care nursing theory is the most suitable for asthmatic patients due to its focus on compliance with treatment regimens (Hemati et al., 2017). If such a theory is utilized in nursing care plans, it can lead to better implementation of care plans and maintenance of the quality of life.

Nursing Care Plan

Rhea is a 12-year-old female admitted to the hospital due to fainting, dizziness, and coughing. During the examination, Rhea stated that she has recently been experiencing coughing attacks twice a week and had chest pains, some of which resulted in night awakenings. Following this, nurses did both physical exams and clinical assessments. The respiratory rate, theophylline concentrations, risks factor, symptoms, and a chest x-ray were checked upon the evaluation. As a result, physical exam and clinical assessment, and signs indicated that Rhea had mild asthma. With the help of Dorothea Orem’s self-care nursing theory, nurses should be able to encourage her to comply with the treatment regimen by following a cautious diet and avoiding triggers.

Nurshing Diagnosis
(Nanda Approved)
Expected Outcome
(Measurable goal)
Nursing Interventions
(What do you plan to do?)
(Why are you doing this?)
Ineffective Breathing Pattern The patient will sustain an ideal inhalation and exhalation by calm respiration, lack of dyspnea, and a regular breathing rhythm.
  1. Evaluate the pace, intensity, and rate of breathing.
  2. Evaluate the relationship between inhalation and exhalation.
  3. Check for breathlessness while speaking.
  1. Variations in breathing pattern and volume may be a precursor of imminent respiratory failure.
  2. Responsive airways make it easier for oxygen to enter the lungs than to exit them.
  3. Lung tension can be detected by dyspnea during a routine discussion.
Anxiety The patient will agree that their degree of anxiousness has decreased.
  1. Look for indicators of emotional distress, such as emotions of terror or worry.
  2. Observe oxygen saturation.
  3. Check theophylline concentrations.
  1. Because anxiety induces quick, superficial respiration, asthma might get significantly worse due to such triggers.
  2. A rise in anxiety could be a precursor of hypoxia.
  3. Theophylline makes anxiety more severe and obvious.
Ineffective Airway Clearance The patient will retain respiratory function by demonstrating distinct breathing patterns, a standard intensity of breathing, and the capacity to cough up mucus efficiently.
  1. Examine the pattern, intensity, and rate of breathing.
  2. Evaluate the outcomes of the chest x-ray.
  3. Determine whether coughing is productive.
  1. Adjustments in breathing pattern and frequency may be a precursor of imminent respiratory failure.
  2. An x-ray of the lung area can reveal whether accumulates, inflated lungs, or barotrauma are present.
  3. Acute bronchospasm and tiredness of the respiratory muscles are a few reasons why a cough is unproductive.


Hemati, Z., Shakerian, B., Shirani, F., Mosaviasl, F. S., & Kiani, D. (2017). Effect of the Orem self-care model on quality of life in adolescents with asthma. Journal of Comprehensive Pediatrics, 8(2), 1-5.

Palova, R., Adamcakova, J., Mokra, D., & Mokry, J. (2020). Bronchial asthma: Current trends in treatment. Acta Medica Martiniana, 20(1), 1-17.

Shum, M., Poureslami, I., Liu, J., & FitzGerald, J. M. (2017). Perceived barriers to asthma therapy in ethno-cultural communities: The role of culture, beliefs and social support. Health, 9(7), 1-18.

Sinyor, B., & Perez, C. (2019). Pathophysiology of asthma. National Library of Medicine.

Stern, J., Pier, J., & Litonjua, A. A. (2020). Asthma epidemiology and risk factors. Seminars in Immunopathology, 42(1), 5-15.

Chronic Obstructive Pulmonary Disease Factors
Chronic Obstructive Pulmonary Disease Interventions