Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs.
BACKGROUND
Research shows that children are insufficiently active in most affluent societies. Although children with asthma may particularly benefit from physical activity, they are less active than their peers.


OBJECTIVE
To explore the reasons for low physical activity levels among children with asthma and to identify strategies to improve activity.


METHODS
A qualitative study using in-depth interviews and focus groups.


METHODS
Six GP practices, a Paediatric Respiratory Unit, and four schools in Tayside, Scotland.


METHODS
Purposive sampling identified 30 children with asthma, their parents (n = 38) and school staff (n = 28), who were interviewed or took part in focus groups. Data were examined using constant comparative analysis.


RESULTS
The lower level of activity among children with asthma was supported by a climate of fear among parents and teachers about what was safe and possible for the child. Restrictions were imposed because of perceived dangers of exercising in the presence of 'triggers'. Physical activity was regarded as a threat to be managed rather than something beneficial. Teachers found it difficult to distinguish between children who were physically incapable of exercise due to asthma and those who were unmotivated. GPs were unknowingly drawn into the controversy by children and parents who cite medical advice to sanction exemption from exercise.


CONCLUSIONS
GPs and asthma nurses need to provide clear management plans explaining what is appropriate and safe in terms of exercise on a child-by-child basis, to counter the considerable misunderstanding and disagreement among children, parents, and teachers.
Williams
Brian
B
Social Dimensions of Health Institute (University of Dundee and University of St Andrews), Airlie Place, Dundee, DD1 4HJ, Scotland UK. b.y.williams@chs.dundee.ac.uk.
Hoskins
Gaylor
G
Pow
Jannette
J
Neville
Ron
R
Mukhopadhyay
Somnath
S
Coyle
Joanne
J
D000293:Adolescent; D001249:Asthma / Q000209:etiology*; D001294:Attitude to Health; D002648:Child; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation
J Adv Nurs. 2000 Oct;32(4):913-21
11095230
Arch Dis Child. 1990 Jun;65(6):622-5
2378521
Lancet. 2006 Jul 22;368(9532):299-304
16860699
Pediatr Pulmonol. 2005 Jul;40(1):57-63
15858799
Br J Gen Pract. 2003 Mar;53(488):185-90
14694693
Pediatrics. 2006 Dec;118(6):2443-9
17142530
Arch Dis Child. 2004 Jun;89(6):590
15155415
Ir J Med Sci. 1999 Jul-Sep;168(3):174-9
10540783
Br J Sports Med. 2000 Jun;34(3):162-7
10854014
Eur Respir J. 1998 Aug;12(2):315-35
9727780
Health Educ Res. 2002 Apr;17(2):181-94
12036234
Pediatrics. 2000 Sep;106(3):512-9
10969096
Pediatrics. 2004 Apr;113(4):e341-6
15060265
Br J Sports Med. 2005 Dec;39(12):892-7; discussion 897
16306494
J Sch Nurs. 2004 Jun;20(3):140-8
15147228
Pediatr Clin North Am. 2002 Aug;49(4):709-21, v-vi
12296528
Prev Med. 2002 Feb;34(2):266-78
11817924
Paediatr Respir Rev. 2002 Jun;3(2):154-60
12297065
Clin Rehabil. 2001 Aug;15(4):360-70
11518437
Sports Med. 2005;35(2):127-41
15707377
Respir Res. 2002;3 Suppl 1:S3-7
12119051
Pediatr Rehabil. 2005 Jan-Mar;8(1):53-8
15799136
Arch Pediatr Adolesc Med. 2003 Jun;157(6):540-4
12796233
J Asthma. 2003 Apr;40(2):131-8
12765314
Pneumologie. 2002 Aug;56(8):486-92
12174333
Br J Gen Pract. 1992 Dec;42(365):504-7
1297370
Chest. 2002 May;121(5):1661-9
12006458
J Allergy Clin Immunol. 2005 May;115(5):928-34
15867847
Pediatr Clin North Am. 2003 Jun;50(3):697-716
12877242
Arch Dis Child. 1997 Nov;77(5):420-2
9487965