The lived experiences and embodiment of asthma and sports and exercise in the South Asian population: An interpretative phenomenological analysis

Individuals of South Asian origin with asthma in the UK are more likely to experience excess morbidity and increased hospitalisation rates compared to their White British counterparts. South Asian groups also have lower levels of active participation in sport and/or exercise and are less likely to maintain an exercise regime. There is limited research investigating the experiences of asthma and sport and/or exercise specific to the UK-resident South Asian population and therefore this thesis was designed to explore this. This study used a qualitative, interpretive, phenomenologically-inspired approach and employed a single method design. In-depth semi-structured interviews were conducted with 14 participants (12 female, 2 male) of Indian, Pakistani, Bangladeshi and Sri Lankan ethnic origin, who had experience of asthma and sport and/or exercise. Their accounts were analysed using interpretative phenomenological analysis (IPA), informed by a symbolic interactionist (SI) perspective. Central to the findings in this study was the presentation of the asthma self in an everyday and sporting context. Goffman’s (1959; 1963) conceptual analysis of self-presentation and stigma, together with Leder’s (1990) phenomenologically-inspired insights on the ‘absent’ body and ‘dys-appearing’ body, with Zeiler’s (2010) phenomenologically-inspired notion of the ‘eu-static’ body, were employed to understand these phenomena. Seven superordinate themes were formed from the participants’ data: negotiating the asthmatic identity; how they manage their medication; the impact of culture and how it affects treatment behaviour; integrating sport and/or exercise into their everyday lives; reasons for non-engagement in sport and/or exercise; stigma; and lastly the participants’ relationships with healthcare professionals. Recommendations for healthcare practice and policy include considering cultural stigma and ascertaining exactly which UK-resident South Asian communities require a better awareness of asthma. Patient sensitivity should be considered, as well as the stigmatising effects of asthma on sporting and/or exercising experiences. Sporting bodies need to acknowledge the role of South Asian cultural and gender differences when aiming to improve sport and/or exercise participation. Furthermore, healthcare professionals need to consider whether their patients perceive themselves to be ‘asthmatic’ and understand how this might affect medication taking behaviour, as well as being culturally responsive and discussing the use of non-pharmacological treatments in a non- judgemental manner. Finally, it is imperative that the patient and HCP aim to achieve a therapeutic relationship where they share similar notions about treatment objectives