Table 3.

Representative quotes of the main themes – narrative of disruption.

2.1 Dealing with an asthma diagnosis (disruptive impact; feelings of stigma; to hide asthma)
[2.1a]	Isabel: “Asthma did change my life and the way I see life… At least when I’m attacked.”
[2.1b]	António: “When practicing swing, soccer, running, and other sports, it (asthma) does not allow us to be as resistant as other persons.”
[2.1c]	Rita: “I want to do things, but I’m not able to do so (…) and people sometimes do not understand. Sometimes I feel people are saying: ‘she is faking it.’ (…) It is very upsetting.”
[2.1d]	Idalina: “It’s hard! People stay disgusted, with a weird face (when seeing an asthma attack).”
[2.1e]	Isabel: “He (participant’s son, also asthmatic) does not take it (the pump) to school (…) (because) he does not like to say he has asthma, since very little.”
[2.1f]	Laura: “Causes? I think it was from tobacco (her husband smokes). And I don’t smoke! Do you believe? It is so frustrating.”
2.2 Self-management skills (reactive approach; alternative solutions; feelings of personal guilt)
[2.2a]	Rita: “I feel anxious and in panic [when having a crisis]. (…) Oh my God, if I use the pump and it does not work, I panic, and I just pray to pass.”
[2.2b]	Anabela: “Yes, I have searched for other options, such as, acupuncture. And it was good, I felt some benefits.”
[2.2c]	Helena: “I have the pump. My doctor told me to use it every day, but I only do it once in a while. Because I like to read patient information leaflet, and if everybody read that, people would not take medications. Because what it is written there, it really might happen.”
[2.2d]	Anabela: “I don’t know, maybe I’ve been lazy…The pediatrician of my son told me my medication (for asthma) was totally outdated and I should start a new treatment. I really have to convince myself and have a medical consultation about this.”
[2.2e]	Isabel: “People say that the beach is bad for the lungs, and when I’m attacked I don’t go to the beach. I’m afraid.”
[2.2f]	António: “The last couple of years, (…) I take medication more regularly (…) and I go to the emergency rooms quite often (…) It already happened go to the hospital twice a month.”
[2.2g]	Anabela: “Usually, when I’m attacked I take Ventilan in SOS, and it is effective. However, since last month I have been taking Ventilan 3 to 4 times a day, and it is not working, I still have the symptoms.”
2.3 Health literacy mediators (restricted network)
2.3.1 Health professionals (PCP; communication issues)
[2.3.1a]	António: “Sometimes I need to know something quite specific – for instance why my crisis are more regular – and I just ask to the doctor. But actually, nowadays, we don’t need to come here to know something, I go online or to the medical leaflets.”
[2.3.1b]	Rita: “I’m from the opinion that explaining things helps a lot. For instance, last month I went to do some exams at the hospital, and during the exam I asked a lot of things to the nurse. She was very nice, and answered me. But her colleague told me: ‘you don’t need to know! It’s the doctor that must know everything!’. But that’s wrong. We are the patients, we should know.”
[2.3.1c]	Ema: “I think the hardest part is the language, I think it is. Because doctors speak for each other’s, not for the patient. Once I was hospitalized, and a group of doctors just came to my room, they spoke for each other’s, and I didn’t understand a thing.”
2.3.2 Media (Internet; not reliable)
[2.3.2a]	Anabela: “Once I was having cramps, so I went online to search something about what was causing me that, and read that people with asthma tend to have more cramps than usual. But I don’t know if it is true, I only find that in one website. No where else.”
2.3.3 Family and friends (lack of support)
[2.3.3a]	Helena: “My husband usually tells me: ‘Calm down’! (…) When he tells me that, I got much worse. Oh my God, I can’t hear that. (…) I know that my husband just wants to help me, but I can’t avoid this.”
[2.3.3b]	Idalina: “Nobody helps or anything. I am the one who have to help the others.”