Managing asthma at school: The perceptions of children and school staff

This thesis presents the findings of a mixed methods study exploring the perceptions of children and school staff managing asthma in seven Bristol primary schools. Asthma is the most common chronic disease of childhood, affecting 1 in 10 children and is consequently the most frequent chronic disease that school staff will encounter in school or a school related setting. Children spend a 1/5 of their childhood in school or school related locations and are thus managing their asthma without the direct aid of parents/carers during this time. The research aim was to explore how asthma was managed in these schools from both the view point of school staff (both teachers and school support staff) and pupils with asthma. The use of a mixed methods approach facilitated integration of qualitative and quantitative research methods and resulted in greater exploration of the phenomenon of managing asthma in school than one approach alone could have provided. Discrete qualitative research interviews conducted with children and school staff together with quantitative surveys of both child perceived Health Related Quality of Life (HRQoL) and school asthma policies are presented in this thesis. Findings within this research indicated that generally school staff were unaware of how to help in the management of pupil asthma. There were significant obstacles within schools, in part created by school staff that pupils with asthma had to overcome when trying to manage their asthma at school. Pupils perceived that they were experiencing a high level of asthma associated morbidity and a significant reduction in HRQoL. Children discussed a range of coping strategies that they used in their daily school management of their asthma which significantly limited their interactions with peers and school staff and potentially had lifelong consequences. These findings were not those suggested by the literature, which suggest that asthma is understood in school and clearly managed. This research illustrates that managing asthma in school is a complex interplay of situational factors, expectations and dependent upon the ability of school staff and children to recognize not just asthma warning signs, but to facilitate ‘good’ daily asthma management