Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2002 Aug;87(2):131–134. doi: 10.1136/adc.87.2.131

Parents' accounts of wheeze and asthma related symptoms: a qualitative study

B Young 1, G Fitch 1, M Dixon-Woods 1, P Lambert 1, A Brooke 1
PMCID: PMC1719200  PMID: 12138062

Abstract

Aims: To examine parents' accounts of how they recognise and judge respiratory symptoms in children, and to investigate their interpretations of respiratory survey questions about wheeze, shortness of breath, and cough.

Methods: Qualitative study using semistructured interviews. Data were analysed using the constant comparative method. Nineteen parents of children aged under 6 years were recruited from a cohort of parents who had responded to an earlier respiratory symptom survey and from one general practice.

Results: Parents judged respiratory symptoms using a range of cues, including changes in the sound of breathing and changes in appearance and behaviour. Experiential resources and contextual factors played an important role in parents' judgements. Interpretations of questions about respiratory symptoms were varied, particularly in relation to the terms "attacks of wheeze" and "shortness of breath". Parents' descriptions of wheeze differed from descriptions of the sound of wheeze used in some survey questionnaires. Parents drew fine distinctions between different "types" of cough and identified a distinct "asthma" cough.

Conclusions: Attention needs to be given to the complexity of reporting respiratory symptoms in children and to the importance of contextual factors in parents' judgements. We suggest that questions which require parents to report on children's internal feelings or states be avoided. Consideration should be given to providing parents with explicit direction on what cues to attend to or ignore in reporting symptoms, and to clarifying some questions that are currently used in clinical practice and in surveys.

Full Text

The Full Text of this article is available as a PDF (47.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asher M. I., Keil U., Anderson H. R., Beasley R., Crane J., Martinez F., Mitchell E. A., Pearce N., Sibbald B., Stewart A. W. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483–491. doi: 10.1183/09031936.95.08030483. [DOI] [PubMed] [Google Scholar]
  2. Cane R. S., McKenzie S. A. Parents' interpretations of children's respiratory symptoms on video. Arch Dis Child. 2001 Jan;84(1):31–34. doi: 10.1136/adc.84.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cane R. S., Ranganathan S. C., McKenzie S. A. What do parents of wheezy children understand by "wheeze"? Arch Dis Child. 2000 Apr;82(4):327–332. doi: 10.1136/adc.82.4.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clifford R. D., Radford M., Howell J. B., Holgate S. T. Prevalence of respiratory symptoms among 7 and 11 year old schoolchildren and association with asthma. Arch Dis Child. 1989 Aug;64(8):1118–1125. doi: 10.1136/adc.64.8.1118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dixon-Woods M., Findlay M., Young B., Cox H., Heney D. Parents' accounts of obtaining a diagnosis of childhood cancer. Lancet. 2001 Mar 3;357(9257):670–674. doi: 10.1016/S0140-6736(00)04130-1. [DOI] [PubMed] [Google Scholar]
  6. Elphick H. E., Sherlock P., Foxall G., Simpson E. J., Shiell N. A., Primhak R. A., Everard M. L. Survey of respiratory sounds in infants. Arch Dis Child. 2001 Jan;84(1):35–39. doi: 10.1136/adc.84.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gardner K., Chapple A. Barriers to referral in patients with angina: qualitative study. BMJ. 1999 Aug 14;319(7207):418–421. doi: 10.1136/bmj.319.7207.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Joseph C. L., Foxman B., Leickly F. E., Peterson E., Ownby D. Sensitivity and specificity of asthma definitions and symptoms used in a survey of childhood asthma. J Asthma. 1999 Oct;36(7):565–573. doi: 10.3109/02770909909087293. [DOI] [PubMed] [Google Scholar]
  9. Kai J. Parents' difficulties and information needs in coping with acute illness in preschool children: a qualitative study. BMJ. 1996 Oct 19;313(7063):987–990. doi: 10.1136/bmj.313.7063.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kelly Y. J., Brabin B. J., Milligan P. J., Reid J. A., Heaf D., Pearson M. G. Clinical significance of cough and wheeze in the diagnosis of asthma. Arch Dis Child. 1996 Dec;75(6):489–493. doi: 10.1136/adc.75.6.489. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kuehni C. E., Davis A., Brooke A. M., Silverman M. Are all wheezing disorders in very young (preschool) children increasing in prevalence? Lancet. 2001 Jun 9;357(9271):1821–1825. doi: 10.1016/S0140-6736(00)04958-8. [DOI] [PubMed] [Google Scholar]
  12. Magnus P., Jaakkola J. J. Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveys. BMJ. 1997 Jun 21;314(7097):1795–1799. doi: 10.1136/bmj.314.7097.1795. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ng Man Kwong G., Proctor A., Billings C., Duggan R., Das C., Whyte M. K., Powell C. V., Primhak R. Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms. Thorax. 2001 Apr;56(4):312–314. doi: 10.1136/thorax.56.4.312. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES