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Being Unprepared: A grounded theory of the transition of
asthma Self-Care in College students.
Presentation
By
Steph
Velsor-friedrich, B., & Hogan, N. S. (2021). Being Unprepared: A Grounded Theory of the Transition of Asthma Self-Care in
College Students [Review of Being Unprepared: A Grounded Theory of the Transition of Asthma Self-Care in College
Students]. Journal of Pediatric Nursing, Nov2021(61: 305-311), 7(p). CINAHL Complete.
https://doi.org/10.1016/j.pedn.2021.08.019
The Authors
•
Barbara Velsor-Friedrich, PhD RN FAAN
– Professor Emerita, Marcella Niehoff School of
Nursing, Loyola University Chicago, IL, United States
of America
•
Nancy S. Hogan, PhD RN FAAN
– Professor Emerita, Marcella Niehoff School of
Nursing, Loyola University Chicago, CA, United States
of America
Asthma in Adolescence
The rebelliousness and need for independence that
comes with adolescence can be especially difficult
for teens with asthma and their families. Children
who have been responsibly managing their asthma
for years may start to have more problems with
symptoms. This could be caused by hormonal
changes, or by attitude and behavioral changes or by
just going off to college.This study addresses this
transition, self-care, self-management and more!
The Purpose
“The purpose of this study was to conceptualize the
basic social process of how college students transition
from home-based asthma management to
independent self-care management. An empirically
derived substantive theory to conceptualize the
process of transitioning to asthma self-management
for college-bound students will fill a gap in the
understanding of how this chronic disease is managed
by undergraduate students.”
( Journal of Pediatric Nursing 61 (2021)-page 306)
The concept
•
Self- Care And Self-management
– coping with long term health condition or chronic
disease i.e asthma
– managing the emotional and practical issues that
arise around the condition
– focusing on the treatment and being able to be
independent and responsible about it.
The Qualitative approach
•
A classical grounded theory ( CGT design)
•
Also called Glaserisn design- discovery of theory
from data- systemically obtained and analyzedproviding us with relevant predictions and
interpretations.
•
Audiotaped in-depth, open ended interviews,
transcribed verbatim and analyzed into a basic
social process.
The sample Size
•
17 college students, ages 18-22, in a Midwestern Urban University
•
13/17 were Females, 4/17 were males
•
16/17 were Caucasians, 1/17 was Hispanic
•
13/17 had early onset asthma, Most had exercise-induced, all used
emergency inhaler
•
3/17 in nursing, 2/17 in biology, 1/17 in each psychology, math,
engineering, physics, spanish, political science, marketing, education,
business, environmental and communication studies, film production
•
12/17 lived in the Midwest, 5/17 lived in other parts of the country
The Data Collection
•
Semi-structured interviews with college students with
asthma
•
Completed in person by the Co-PIs and audiotaped
•
45-60 min interview length
•
Participation was voluntary, no coercion
•
Audiotapes destroyed at the end of study
•
$30 gift card was given to each participant afterwards
The Interview Questions
1) Do you know how old you were when you were diagnosed with asthma?
(Probe on history).
2) By the time you graduated from high school, how much of your asthma management did you perform by yourself and with the help of others? (Probe on
family and health care assisted management).
3) During the past year, while in college, did you see a health care professional or
an urgent care facility for your asthma? If so, can you tell me about that/those
experiences?
4) How would you describe symptoms associated with a mild asthma episode?
(probe on a severe asthma episode)
5) Can you describe how you have managed your asthma since starting college?
6) What are some of the most challenging aspects of living away from home for
the first time and managing your asthma?
The Data Analysis
•
Each interview was transcribed verbatim
•
Data deidentified during transcription process
•
Authors review transcriptions for any missed identifiers
•
Data analyzed individually by the Co-PIs
•
Data simultaneously collected and analyzed using constant comparison methods.
•
Discrepancies were reconciled by consulting audiotapes and data for accuracy
•
When data showed sufficient saturation of key concepts, recruitment ceased.
•
CGT ors not use partitioning of concepts by demographic variables or numbers
The 5 Result Themes:
•
Relying on others
•
Lacking preparation for self-management in college
•
Dealing with the unexpected stressors associated with
starting college
•
Managing asthma episodes safely and effectively as
students
•
Becoming better prepared for their own safe asthma selfmanagement
1. Relying on others:
– becoming more independent on managing asthma in
high school
-relying on mother particularly for day-to-day asthma
management
-relying on coaches and teammates when playing
sports to provide backup
-swapping inhalers with other students is “not a good
idea”
2. Lacking preparation for asthma self-management
in college
– did not recall receiving information from parents or
HCPS about independently managing asthma in
college
-no asthma action plan for a serious episode or flareup
-all participants had PCPs but not frequently
contacted
3. Dealing with the unexpected
– dealing with college stressors including lack of
sleep negatively impacted their asthma
-new asthma triggers imposed additional stressors
-particular stressor with problematic dorm conditions
such as mold in shower, dust in air vents.
4. Managing Severe episodes
– symptoms of severe episodes could be frightening
-no thought out asthma plan for seeking help,
especially at night or evening
– not certain about hospital or urgent care locations in
the area
– unsure of the name of their medications to inform
HCPs in acute settings
5. Becoming Better Prepared
-recalled getting an information packet about healthcare
resources during orientation but could not recall the information
or where they placed the packet
-remembered about hearing of a wellness center on campus
but could not remember their locations
-participants concluded that becoming better prepared for their
own asthma self-management was necessary.
-recommended that transition information be given in incoming
orientation, to allow time for better preparation and selfmanagement during college years.
My feelings
Most college students were unprepared to deal with any kind of medical
emergencies while away from their families and parents.
After reading the participants experiences, I felt , as a medical professional,
that I can do better.
These students are not used to autonomy, self-care, self-awareness and a
sense of responsibility.
I hope that this study was an eye opener to all the participants and readers
as well when it comes to chronic conditions, transitioning to self- care and
management.
My Nursing Practice
My Ultimate goal is to have my own Practice that
ensures equality, awareness, and proper education.
This study would help my nursing practice by helping
me understand that adolescent patients , no matter
how stubborn or nonchalant, still need someone to
guide them ,someone to be there in emergent and
non-emergent situations.
The weakness
This study was done in a rural college, predominantly
white Caucasian females. Studies have shown that
there is a higher rate of asthma in inner city colleges
and schools. I hope that further studies focus on
teenagers or adolescents who reside in inner cities, or
are not able to attends colleges or universities.
Asthma does not know race, gender or ethnicity!
Final Thought
What people need to
know is that asthma isn’t
a minor ‘wheezedisease.’ It kills over five
thousand people in
America every year, and
It could’ve been
anyone!!!
World Asthma Day
Principles of nursing research class.
Presentation of qualitative research.
1. Carefully review each of the presentations.
2. Respond to at least 2 presenters in at least 15 sentences to each presenter:
a) Comment in at least 10 sentences on what was learned from the information presented and how the
information may help you in practice and/or your personal life. Reflect on how you felt reading the
experiences of the participants.
3. Comment in at least 5 sentences on how the information was presented (one strength and one
suggestion to improve).
Presentation 1 . Peer 1 . Boh
Presentation 2 . Peer Steph
LIVING THROUGH UNSUCCESSFUL
CONCEPTION ATTEMPTS: A GROUND
THEORY OF RESILIENCE AMONG
UNDERGOING FERTILITY TREATMENT.
OLA
Bailey, A., Ellis-Caird, H., & Croft, C. (2017). Living through unsuccessful conception attempts: a grounded theory of
resilience among women undergoing fertility treatment. Journal of Reproductive & Infant Psychology, 35(4), 324–333
AUTHOR(S) FULL NAMES, CREDENTIALS, AND
AFFILIATION
➢ Anna Bailey
Clinical Psychology, Canterbury Christ University, Tunbridge Wells, UK.
➢ Helen Ellis-Caird
Clinical Psychology, University of Hertfordshire, Hatfield, UK.
➢ Carla Croft
Principal Psychologist Specializing in Women’s Health, London, UK.
DESCRIBE WHY YOU HAVE CHOSEN THIS STUDY TO PRESENT.
➢ Personal experience with conception
➢ Use of fertility drugs
➢ Monthly disappointment
➢ Culture and family pressure
AIM/PURPOSE
“To provide a model of resilience among women undergoing fertility
treatments, who experience repeated unsuccessful conception attempts
(Bailey et. El, p. 324, 2017 ).”
Newlife Fertility Centre
CONCEPT BEING INVESTIGATED
➢ Resilience
➢ Fertility treatment
➢ Unsuccessful conception
QUALITATIVE APPROACH USED FOR THE STUDY
Grounded theory
➢ Used to generate an explanatory theory of resilience among women facing
repeated unsuccessful fertility treatment attempts in this study.
➢ A method of conducting qualitative research that focuses on creating conceptual
frameworks or theories through building inductive analysis from the data
➢ Underpinnings focus on how participants construct meaning in relation to their
concern
➢ Method of choice when there is no hypothesis to test.
SAMPLE SIZE AND A DETAILED DESCRIPTION OF
THE ACTUAL PARTICIPANTS
➢ Eleven
➢ Purposive sampling for the first three participants.
➢ And subsequent sampling for subsequent participants
➢ Women aged 24 to 42 years
➢ Fertility difficulties and seeking treatment to help achieve pregnancy
➢ One White Latvian, one white Irish, one mixed White Asian, and eight
White British
DESCRIBE HOW THE DATA WAS COLLECTED.
Participant Protection
➢ Received information about the study prior to giving consent according
to the researcher.
➢ Informed of the right to withdraw at any point during the study.
➢ Verbal and written debrief
Provide sources of support
DESCRIBE HOW THE DATA WAS COLLECTED- CONT.
Data
➢ Semi-structured interview
➢ Conducted separately for each participant
➢ Lasted between 55 and 90 min
DESCRIBE HOW THE DATA WAS COLLECTEDCONT.
➢ Choice of face-to-face or telephone interview.
➢ Two participants were interviewed in person and nine were interviewed
over the phone.
➢ Interviews were audio-recorded and transcribed subsequently.
DESCRIBE HOW THE DATA WAS ANALYZED
Data were analyzed using procedures associated with the GT method, such
as open, focused, axial, and theoretical coding.
DESCRIBE HOW THE DATA WAS ANALYZED- CONT.
Continuous comparisons between sets of data to find
conceptual similarities between codes and categories.
Utilization of memos throughout the research to guide the
process of data collection.
Coding and data collection was ended when theoretical
sufficiency was met
FINDINGS
Hope:
➢ Openness to the possibility of conception.
➢ Watchfulness for the success of the next treatment or conception
attempt.
➢ Strength and motivation to prepare themselves for the next treatment
attempts.
FINDINGS CONT.
Grieve:
➢ Conception failure
➢ Depletion(distress and despair)
➢ Frustration
➢ Isolation
➢ Lack of resources to continue with a further attempt
tern Fertility Institute
FEELINGS AFTER READING THE EXPERIENCES OF THE
PARTICIPANTS IN THE STUDY.
The findings of the study are not much of a surprise to me due to personal
experience. But it amazed me that despite a very low success rate and many
emotional and practical costs associated with IVF, some participants went as
far as four attempts.
For everyone who desires to conceive and bear their children, the problem
of infertility is worrisome and should be challenging to one mental, physical
and social health.
NURSING IMPLICATION
Regardless of how minimal patient condition is, being mindful of patient
needs and allowing them to gain control over their treatment/care is how I
could use the result of this study in my practice.
ONE WEAKNESS OF THE STUDY
The study sample is limited to one ethnic group. Which could prevent the
study from being accepted widely.
OVERALL OPINION OF THE STUDY.
It is impressive to see a study on this aspect of women’s reproductive lives.
The thought of conceiving alone can create anxiety, talkless of undergoing
fertility treatment that refuses to yield success.
I think a broader and diverse study of unsuccessful conception treatment
will further and effectively identify how women/families of different
ethnicities and backgrounds are affected during such treatment.
REFERENCES:
Bailey, A., Ellis-Caird, H., & Croft, C. (2017). Living through unsuccessful
conception attempts: a grounded theory of resilience among women
undergoing fertility treatment. Journal of Reproductive & Infant
Psychology, 35(4), 324–333
Bologna, C. (2022, February 22). How to cope with the disappointment of
fertility struggles. HuffPost. https://www.huffpost.com/entry/how-to-copedisappointment-infertility_l_620d3f40e4b0557b5a3e1c07
REFERENCES- CONT.
Chun Tie,Y., Birks, M., & Francis, K. (2019, January 2). Grounded Theory
Research: A design framework for novice researchers. SAGE open medicine.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318722/#:~:text=Charmaz1
6%20defines%20GT%20as,from%20the%20analysis%20of%20data.
IVF centre in Siliguri helping you to experience parenthood. IVF Centre
Siliguri|Best IVF Centre Siliguri – India – New Life Fertility Centre. (n.d.).
https://www.newlifefertilityclinic.com/
Being Unprepared: A grounded theory of the transition of
asthma Self-Care in College students.
Presentation
By
Steph
Velsor-friedrich, B., & Hogan, N. S. (2021). Being Unprepared: A Grounded Theory of the Transition of Asthma Self-Care in
College Students [Review of Being Unprepared: A Grounded Theory of the Transition of Asthma Self-Care in College
Students]. Journal of Pediatric Nursing, Nov2021(61: 305-311), 7(p). CINAHL Complete.
https://doi.org/10.1016/j.pedn.2021.08.019
The Authors
•
Barbara Velsor-Friedrich, PhD RN FAAN
– Professor Emerita, Marcella Niehoff School of
Nursing, Loyola University Chicago, IL, United States
of America
•
Nancy S. Hogan, PhD RN FAAN
– Professor Emerita, Marcella Niehoff School of
Nursing, Loyola University Chicago, CA, United States
of America
Asthma in Adolescence
The rebelliousness and need for independence that
comes with adolescence can be especially difficult
for teens with asthma and their families. Children
who have been responsibly managing their asthma
for years may start to have more problems with
symptoms. This could be caused by hormonal
changes, or by attitude and behavioral changes or by
just going off to college.This study addresses this
transition, self-care, self-management and more!
The Purpose
“The purpose of this study was to conceptualize the
basic social process of how college students transition
from home-based asthma management to
independent self-care management. An empirically
derived substantive theory to conceptualize the
process of transitioning to asthma self-management
for college-bound students will fill a gap in the
understanding of how this chronic disease is managed
by undergraduate students.”
( Journal of Pediatric Nursing 61 (2021)-page 306)
The concept
•
Self- Care And Self-management
– coping with long term health condition or chronic
disease i.e asthma
– managing the emotional and practical issues that
arise around the condition
– focusing on the treatment and being able to be
independent and responsible about it.
The Qualitative approach
•
A classical grounded theory ( CGT design)
•
Also called Glaserisn design- discovery of theory
from data- systemically obtained and analyzedproviding us with relevant predictions and
interpretations.
•
Audiotaped in-depth, open ended interviews,
transcribed verbatim and analyzed into a basic
social process.
The sample Size
•
17 college students, ages 18-22, in a Midwestern Urban University
•
13/17 were Females, 4/17 were males
•
16/17 were Caucasians, 1/17 was Hispanic
•
13/17 had early onset asthma, Most had exercise-induced, all used
emergency inhaler
•
3/17 in nursing, 2/17 in biology, 1/17 in each psychology, math,
engineering, physics, spanish, political science, marketing, education,
business, environmental and communication studies, film production
•
12/17 lived in the Midwest, 5/17 lived in other parts of the country
The Data Collection
•
Semi-structured interviews with college students with
asthma
•
Completed in person by the Co-PIs and audiotaped
•
45-60 min interview length
•
Participation was voluntary, no coercion
•
Audiotapes destroyed at the end of study
•
$30 gift card was given to each participant afterwards
The Interview Questions
1) Do you know how old you were when you were diagnosed with asthma?
(Probe on history).
2) By the time you graduated from high school, how much of your asthma management did you perform by yourself and with the help of others? (Probe on
family and health care assisted management).
3) During the past year, while in college, did you see a health care professional or
an urgent care facility for your asthma? If so, can you tell me about that/those
experiences?
4) How would you describe symptoms associated with a mild asthma episode?
(probe on a severe asthma episode)
5) Can you describe how you have managed your asthma since starting college?
6) What are some of the most challenging aspects of living away from home for
the first time and managing your asthma?
The Data Analysis
•
Each interview was transcribed verbatim
•
Data deidentified during transcription process
•
Authors review transcriptions for any missed identifiers
•
Data analyzed individually by the Co-PIs
•
Data simultaneously collected and analyzed using constant comparison methods.
•
Discrepancies were reconciled by consulting audiotapes and data for accuracy
•
When data showed sufficient saturation of key concepts, recruitment ceased.
•
CGT ors not use partitioning of concepts by demographic variables or numbers
The 5 Result Themes:
•
Relying on others
•
Lacking preparation for self-management in college
•
Dealing with the unexpected stressors associated with
starting college
•
Managing asthma episodes safely and effectively as
students
•
Becoming better prepared for their own safe asthma selfmanagement
1. Relying on others:
– becoming more independent on managing asthma in
high school
-relying on mother particularly for day-to-day asthma
management
-relying on coaches and teammates when playing
sports to provide backup
-swapping inhalers with other students is “not a good
idea”
2. Lacking preparation for asthma self-management
in college
– did not recall receiving information from parents or
HCPS about independently managing asthma in
college
-no asthma action plan for a serious episode or flareup
-all participants had PCPs but not frequently
contacted
3. Dealing with the unexpected
– dealing with college stressors including lack of
sleep negatively impacted their asthma
-new asthma triggers imposed additional stressors
-particular stressor with problematic dorm conditions
such as mold in shower, dust in air vents.
4. Managing Severe episodes
– symptoms of severe episodes could be frightening
-no thought out asthma plan for seeking help,
especially at night or evening
– not certain about hospital or urgent care locations in
the area
– unsure of the name of their medications to inform
HCPs in acute settings
5. Becoming Better Prepared
-recalled getting an information packet about healthcare
resources during orientation but could not recall the information
or where they placed the packet
-remembered about hearing of a wellness center on campus
but could not remember their locations
-participants concluded that becoming better prepared for their
own asthma self-management was necessary.
-recommended that transition information be given in incoming
orientation, to allow time for better preparation and selfmanagement during college years.
My feelings
Most college students were unprepared to deal with any kind of medical
emergencies while away from their families and parents.
After reading the participants experiences, I felt , as a medical professional,
that I can do better.
These students are not used to autonomy, self-care, self-awareness and a
sense of responsibility.
I hope that this study was an eye opener to all the participants and readers
as well when it comes to chronic conditions, transitioning to self- care and
management.
My Nursing Practice
My Ultimate goal is to have my own Practice that
ensures equality, awareness, and proper education.
This study would help my nursing practice by helping
me understand that adolescent patients , no matter
how stubborn or nonchalant, still need someone to
guide them ,someone to be there in emergent and
non-emergent situations.
The weakness
This study was done in a rural college, predominantly
white Caucasian females. Studies have shown that
there is a higher rate of asthma in inner city colleges
and schools. I hope that further studies focus on
teenagers or adolescents who reside in inner cities, or
are not able to attends colleges or universities.
Asthma does not know race, gender or ethnicity!
Final Thought
What people need to
know is that asthma isn’t
a minor ‘wheezedisease.’ It kills over five
thousand people in
America every year, and
It could’ve been
anyone!!!
World Asthma Day
Principles of nursing research class.
Presentation of qualitative research.
1. Carefully review each of the presentations.
2. Respond to at least 2 presenters in at least 15 sentences to each presenter:
a) Comment in at least 10 sentences on what was learned from the information presented and how the
information may help you in practice and/or your personal life. Reflect on how you felt reading the
experiences of the participants.
3. Comment in at least 5 sentences on how the information was presented (one strength and one
suggestion to improve).
Presentation 1 . Peer 1 . Boh
Presentation 2 . Peer Ola

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