THE EXPERIENCE OF ADULT OMANI WOMEN LIVING WITH ASTHMA: AN EXPLORATORY STUDY

Abstract

Background: Asthma morbidity in women is increasing. Women report greater severity of asthma symptoms and their utilisation of acute health services is high. Asthma prevalence is high in the Middle East region. In Gulf countries, and Oman in particular, there is a dearth of data regarding women’s experience of living with chronic illness in general and asthma specifically. This is an important omission, as cultural context plays a key role in how long-term conditions are experienced. Aim: The study aims to explore in detail the experiences of adult Omani women living with asthma. Method: The study used a qualitative research design, guided by constructivist grounded theory. Women were recruited initially through purposive sampling from asthma clinics in three healthcare institutions in Oman and participated in in-depth face-to-face interviews. Theoretical sampling was employed as categories emerged from the data analysis, with the topic guide developing accordingly. Interviews were transcribed verbatim and translated into English. Data were inductively analysed using the constant comparative method. Findings: Twenty-nine adult Omani women with mild to severe asthma (age range 18- 50 yrs; disease duration 2 and 20 years) were interviewed on one occasion. Four interrelated categories that explained the women’s experience of living with asthma emerged: making sense of illness; how asthma disrupted the women’s lives; women’s decisions in managing asthma; and women’s choice of healthcare services. The study’s key finding was that these women’s understanding and experience of asthma was socially embedded and negotiated. The findings also revealed dualism (both help and hindrance) regarding the role of families in respect of how the women managed their condition within their day-to-day lives. Most of the women interviewed reported sub-optimal asthma management. Asthma interrupted the women’s lives, presenting challenges for them, heightening their anxieties about fulfilling their social role, and thus threatening their identity as women. They also felt concern about the perceptions of others; their accounts consequently related their fear of stigma and, especially, experience of felt stigma. Discussion: The women interviewed drew on sociocultural influences that they described as shaping their asthma experience. They evaluated themselves based on the attributes they perceived were set by their social context. Anxieties about the fulfilment of their social duties challenged their sense of coherence of self and identity as women. All of these factors were inter-woven in the ways the women managed their asthma and how they used healthcare services Conclusions: The study’s findings highlight the centrality of sociocultural influences on how women in Oman experience and manage asthma. These findings may have relevance in other Gulf countries. Consideration of sociocultural influences is necessary for delivery of asthma care which meets Omani women’s needs and should also inform development of asthma guidelines for this cultural context.

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Hannah Cooke (Supervisor) & Ann-Louise Caress (Supervisor)