Bibliography: leaves 363-416. / v, 416 leaves ; / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / A longitudinal observational study of hospital asthma patients, recruited from two different settings, has been conducted. The results show that failing to look at the patient in the context of their whole life and considering the socio-economic, psychological and attitudes and beliefs of patients, the current reductions in reductions in asthma morbidity and mortality may not continue. / Thesis (M.D.)--University of Adelaide, Dept. of Medicine, 1999

The study sought to identify reasons for non-compliance among a particular medical aid scheme's members and their dependants registered for the asthma disease risk management (DRM) programme. A quantitative descriptive study was undertaken, using postal questionnaires. The research results indicated that most asthma patients were not compliant with the DRM programme because they lacked knowledge about the programme. Asthma patients' compliance with the DRM programme can be enhanced by health providers' and case managers' positive attitudes, better promotion of the programme, and by involving the patients in managing their illnesses. Asthma patients require education about healthy lifestyles, empowering them to successfully manage their condition, preventing asthma attacks and/or hospital admissions. When asthma is well-managed the patients' quality of life and general wellbeing will improve and the medical aid scheme's costs will be contained. / HEALTH STUDIES / MA (HEALTH STUDIES)

[Truncated abstract] In Australia, asthma is a common chronic illness, which often requires complex treatment regimens. This study used an anthropological perspective to explore the experience of people living with asthma, with the specific aim of contributing to the health care programs offered to people living with asthma. The study was conducted in an Australian city (Perth, Western Australia). The foci of the study were Australian lay people, from the general community, living with asthma, and a small number of non- English speaking Vietnamese-Australian migrants. Some spouses of the Australians and biomedical practitioners were also included. Questionnaires, and particularly indepth interviews, were used to explore the explanatory models of asthma for doctors and lay people with the condition. The explanatory models of the doctors focused primarily on assessing and treating the physiological dimension of asthma, and educating patients. The explanatory models for lay people with asthma reflected their everyday reality: in addition to its impact on their physical health, asthma affected their daily life, social roles and participation, and their personal identity. Placing the experience of asthma in this wider perspective showed that the Australians used practical reasoning to make a trade-off between using medication, such that they felt safe from `attacks? and could `do all they wanted to do?, and minimising their `dependence? on potentially harmful medications. Responding to acute episodes involved a risk assessment in which people weighing the health risk of waiting against the social risk of seeking help unnecessarily. For the Vietnamese- Australians, caring for asthma was strongly shaped by their social position as non- English speaking migrants. They lacked access to information about asthma and to specialist care. They had sufficient medication, but were ill-informed about how to use their medicines effectively and safely: in general, the Vietnamese people were overmedicated but under-serviced in the care of their asthma. Beyond explanatory models, the Australian participants (lay people and doctors) shared a cultural model of asthma as a chronic illness. This Australian cultural model shaped the experience and care of asthma. It included concepts such as framing the past as an adjustment process, and the present as `living normally? with asthma. Taking care of asthma was expressed as `taking control? of asthma, so a person could minimise the illness and still be healthy. The Vietnamese-Australians did not share this cultural model of asthma as a chronic illness, as reflected in their expression of the hardship asthma created in limiting their ability to work hard for their family, and how they expected a cure for their condition from biomedicine. The Australians also shared a cultural model of health that was derived, in part, from the health promotion messages that are targeted at lay people. These promotional messages were the basis of a morality in health: people shared an implicit understanding that a person deserved health, and assistance when ill, when he/she displayed the required self-discipline in performing health behaviours.

The study sought to identify reasons for non-compliance among a particular medical aid scheme's members and their dependants registered for the asthma disease risk management (DRM) programme. A quantitative descriptive study was undertaken, using postal questionnaires. The research results indicated that most asthma patients were not compliant with the DRM programme because they lacked knowledge about the programme. Asthma patients' compliance with the DRM programme can be enhanced by health providers' and case managers' positive attitudes, better promotion of the programme, and by involving the patients in managing their illnesses. Asthma patients require education about healthy lifestyles, empowering them to successfully manage their condition, preventing asthma attacks and/or hospital admissions. When asthma is well-managed the patients' quality of life and general wellbeing will improve and the medical aid scheme's costs will be contained. / HEALTH STUDIES / MA (HEALTH STUDIES)