Management of Adolescent Asthma - Literature review Example

Name: Institution: Topic: Management of Adolescent Asthma Course Date: Management of Adolescent Asthma Introduction Asthma diagnosis in adolescence is prone to aggravate intense emotions because sickness compels the adolescence to rely on medication and doctors, and their sense of feeling ‘normal’ is kind of threatened. Asthma in teenager is common: nearly one in seven teenagers have wheezing at some point. Asthma may begin during the years of teenage, or it might progress from a younger age. Since adolescence is a moment of great transformations for young people, they require special understanding and support if they have a continuous health issue like asthma (Hennessy-Harstad, 2012). With this respect, this paper will provide an overview of the topic; describe the bioecological theory of human development; and how the theory can be integrated in nursing practice in order to promote health outcomes for adolescence health issues. Adolescent asthma Asthma is a universal lung disease that affects millions of individuals globally. It is characterized by airways’ narrowing within the lungs. The narrowing is moderately or completely reversible. Symptoms demonstrated by asthma include coughing, wheezing, shortness of breath, and chest tightness. These symptoms generally come and go, with regards to the extent of airway narrowing within the lungs (Shah, 2008). A number of stimuli make the airways to be sensitive. These include allergens, medicines, viral illnesses like common cold, environmental conditions, and exercise. Asthma can typically be treated effectively when one is well informed of the disease and participating in its management. A lot of young people suffering from asthma physically develop through puberty in the same manner as their age mates. A couple of them though, who suffer severe asthma, might have delayed puberty and development, and call for extra reassurance (Hennessy-Harstad, 2012). The findings of the study conducted in Australia to determine the prevalence of asthma in adolescents revealed that asthma prevalence reduced in males, but rose in females from 12-15 years of age (MacDonald, 2001). Aspects of the bioecological theory of human development and how it relates to adolescent developmental health outcomes According to Bronfenbrenner (2001), bioecological theory of human development explains the human development drivers as the interactions that take place between a person (biological being) and the interconnected structure surrounding them (ecology). In accordance with the theory of bioecology healthy adolescents are active participants within the bidirectional interactions which take place in the environment. The setting in which development takes place was conceptualized by Bronfenbrenner as a set of interacting systems. Development of human entails progressive, shared accommodation involving an active, developing human being and the transforming features of the immediate environment in which the person developing lives (Damon & Lerner, 2011). This interactions process is influenced by relations involving environments and by the broader perspective in which the environments are embedded. With regards to Bronfenbrenner’s environment’s structure, microsystem is the layer very close to the adolescent or child and entails the features which the child has direct relations. According to Damon & Lerner (2011), the microsystem involves the interactions and relationships a child has with his or her direct environment. Structures in this system encompass family, neighborhood, or school. At this point, relationships have effect in two directions as in both toward or away from the adolescent. For instance, a teenager’s parents might influence his behavior and belief; on the other hand, the teenager also influences the beliefs and behavior of the parent. This is what Bronfenbrenner calls bi-directional influences. At the level of microsystem, bi-directional influences are powerful and have the strongest effect on the teenage or child (Damon & Lerner, 2011). Nevertheless, relations at outer levels can as well influence the inner structures. Exosystems are environments that people experience explicitly and nonetheless they possess an impact that is direct on people. The macrosystem entails societal values, cultural beliefs, community happenings, and political trends. These systems have a strong foundation of energy in people’s lives. These systems influence how, what, where and when people carry out their relations. Mesosystems help to unite systems in which parent, child and family live. They facilitate moving beyond two-party union. With respect to chronosystems, framing every dynamic of relations is the historical perspective as it takes place in the different system (Swick & Williams, 2006). Every system influence functioning of the system, they are interactive and dynamic promoting a support for children and parents. Ecological theory stipulates that development is controlled by a number of environmental systems as discussed above. This theory is among the various theories that relates to human development. It highlights environmental features as playing the key responsibility to growth (Swick & Williams, 2006). Nonetheless this theory differs amongst cultures. Adolescence is a period when people acquire significant new cognitive abilities and become more established in their abilities of reasoning and solving problems. One of the established developmentalists describes adolescence as a phase of cognitive development where an adolescent transforms from physical operations to formal operations, that is, systematic and abstractive thinking (Bronfenbrenner, 2001). Through this, an adolescent is able to make the right decisions about his or her health development outcomes. A couple of other theorists consider the adolescence cognitive accomplishments as rational progressions from the childhood skills instead of a particular phase or period of human development. Bioecological theory of human development relates to adolescent development health outcomes. For instance, the actual burden of asthma is felt with respect to its effect on daily life, with regular college or school absences, disturbances at night and limited participation in daily activities like sport and dancing (Hennessy-Harstad, 2012). Self-esteem might be destroyed by nonattendance to social activities work or school. A puberty delay can happen, making the adolescence smaller as well as less sexually established than peers without asthma. Healthy teenagers frequently do not comprehend asthma and the restrictions it can inflict; therefore there might be poor tolerance at school. The risk of severe behavioral issues in teenagers who have severe asthma is approximately three times much more than in teenagers who do not suffer from asthma (O’Donohue & Tolle, 2009). In older teenagers, irritants exposure within the place of work might precipitate symptoms of asthma. Siblings and parents may feel the teenager’s asthma controls their lives, causing resistance in the family (Drotar, 2000). There may be dislike concerning extra chores, like reduction of house-dust mite exposure, whilst the obligation to take time off duty in acute episodes can bring problems, specifically for single parents. Either of these reasons can provoke feelings of anger, worry, guilt, frustration and resentment in adolescents. The elimination of symptoms and effective management are the goals of treatment of asthma. The adolescent with asthma should know the fundamental facts concerning asthma and the environmental control practices, techniques of self-monitoring, medication role and the appropriate use of inhalers (O’Donohue & Tolle, 2009). On the other hand, non-compliance in this at risk age group is considerably high and the capability to comprehend information concerning asthma’s nature frequently yields little relations to compliance. Integrating theory into nursing practice in an acute care setting Applying this theory of human development to nursing practice might promote a holistic technique that facilitates effective management of issues in adolescents and promotes health outcomes. The inter-connectedness involving the proximal processes and the interacting systems is essential to the theory of bioecology (Bronfenbrenner, 2001). Without the other, one is ineffectual. Good environments with no efficient proximal processes do not realize positive outcomes. Together, functional environment and connected relationships are influential in attaining positive developmental and health outcomes. It is hard for adolescents to be autonomous of their kin when they have asthma, and they might feel offended the moment they are not able to talk privately concerning their troubles. On the other hand nurses overlook parents’ needs; the price is frequently the loss of a teenager patient. Talking to parents and addressing their fears is very essential, although nurses can explain from the beginning that teenagers might wish to talk about a couple of matters in private and that she will finally be seen independently (MacDonald, 2001). According to Moyse (2009), nurses should regularly present themselves from a perspective of empathy and knowledge, and display a willingness to listen to the perspective of the patient. However it may not be easy to get teenagers to talk. Attempting to communicate with a bored, lethargic adolescent whose eyes glaze over when the name asthma is mentioned is likely to provoke anxiety. Nurses, who are seen as parental figures who lecture, criticize, dominate and indoctrinate, need to use a different method. This is because working with teenagers calls for flexibility so as to attain a positive health outcome (Hennessy-Harstad, 2012). It is important to be prepared for instabilities in the relations with teenagers and to be alert for other features that might be controlling a teenager’s life. Teenagers may offer clues regarding personal opinions of their emotions or their lives, thus creating opportunities to display nurses understanding and reinforce relationship with them. Making observations and asking questions that are open-ended creates dialogue and promotes an exploration of hardships. If a teenager feels that the nurse is adequately interested and cares sufficiently, there will be development of therapeutic alliance thus making the teenager to be receptive to education and advice (MacDonald, 2001). Information should be provided personally instead of other means like leaflets, even though other aids like audio-visual can be helpful as well. Adolescence is a period of extreme sensitivity to issues like personal embarrassment therefore being marked as a medication user may not be tolerated by some (American Academy Of Pediatrics, et al, 2010). When nurses give teenagers who suffer from asthma inhalers that are not difficult to use and can be used inconspicuously, a positive health outcome is likely to be achieved because the embarrassment of being seen taking medication will be reduced (Hennessy-Harstad, 2012). To promote this, teenagers should be provided with a variety of accessible devices and be permitted to make choices on what they like better and can correctly use. It is very important to consider the health beliefs and objectives of the teenager in question, and to a wider extent tailor treatment accordingly (Philadelphia Citizens for Children and Youth, 2003). Teenagers who are regarded non-compliant might become very compliant with a course of therapy of their own preference, and talking through every day routines can offer clues to the methods in which devotion can be enhanced (Drotar, 2000). For instance, medication regimes like twice-daily, which can be practiced in private at home, are highly preferable. Nurses can elaborate that effective control at home will avert the embarrassment someone can feel while using reliever treatments publicly. Moyse (2009), argues that it is important to engage teenage clients in planning and implementing process because it motivates them to make treatment objectives that have been negotiated instead of being dictated thus promoting their developmental health outcome. Application of bioecological development theory in nursing practice requires a concentration on the mechanisms together with the framework of adolescent developmental health as equal drivers of the health outcome (Damon & Lerner, 2011). This therefore establishes the foundation of understanding teenagers in their ecology as active respondents in their process of learning, where maximum learning takes place via interactions that are both bidirectional and mutual. Conclusion As discussed above, teenage is indeed a hard phase for some children especially those with continuous health issues like asthma because of emotional disturbances than their peers. With respect to bioecological theory of human development which is about a child’s interaction with the environment, it is important for nurses to consider the adolescents beliefs about asthma so as to implement an effective management of asthma in adolescents. Bibliography American Academy Of Pediatrics, Wood, R. A., & Casella, S. J., 2010, Asthma and diabetes in adolescents, Elk Grove Village, Ill, American Academy of Pediatrics. Bronfenbrenner, U, 2005, Making human beings human: bioecological perspectives on human development, Thousand Oaks, Sage Publications. Drotar, D, 2000, Promoting adherence to medical treatment in chronic childhood illness concepts, methods, and interventions, Mahwah, N.J., L. Erlbaum Associates. Damon, W., & Lerner, R, M, 2011, Theoretical models of human development, Hoboken, N.J., John Wiley & Sons. Hennessy-Harstad, E, 2012, Asthma and Adolescents: Review of Strategies to Improve Control, The Journal of School Nursing, Retrieved on January 18, 2013, from http://jsn.sagepub.com/content/early/2012/07/17/1059840512454546.abstract?rss=1 MacDonald, P, 2001, Managing asthma in adolescence, NursingTimes.net, Vol. 97, Issue: 38, pp 40. Moyse, K, 2009, Promoting health in children and young people the role of the nurse, Chichester, U.K., Wiley-Blackwell. O'Donohue, W. T., & Tolle, L. W, 2009, Behavioral approaches to chronic disease in adolescence a guide to integrative care, Dordrecht, Springer. Philadelphia Citizens for Children and Youth, 2003, Getting health care for children and teens: a manual for school nurses and counselors. Philadelphia, PA, Philadelphia Citizens for Children and Youth. Shah, S, 2008, Adolescent asthma action, Wentworthville, N.S.W., Sydney West Area Health Service. Swick, K, & Williams, R, 2006, An Analysis of Bronfenbrenner’s Bio-Ecological Perspective for Early Children Educators: Implications for Working with Families Experiencing Stress, Early Childhood Education Journal, Vol. 33, No. 5, pp 371-378. Read More