The scope of this paper is to discuss the pathophysiology of asthma in children regardless of their location, the psychosocial and cultural impact upon both the children themselves as well as caregivers, analyze the nurse's role in promoting self management, discuss the health promotion strategies of both Taiwan and the UK while applying them to patient needs and, finally, to provide an overview of the pharmacological agents available for treatment. Although they have different approaches, both Taiwan and the UK have workable health promotion strategies to assist asthmatic children.
Breathing is a process that most people take for granted; airway passages automatically carry air into our lungs where blood is oxygenated and, in a normal person, this process is only challenged under acute circumstances like smoke inhalation (Clark, 2003, p. 44). Asthma, however, "is a condition involving the branches (bronchioles) of the bronchial tree...in asthma, these bronchioles become narrowed for many reasons" (Lieberman, 1999, p. 10), making breathing something that cannot be taken for granted. Asthmatics have airways that are hyperreactive, and become inflamed in response to:
...seemingly modest irritants. ...
The linings of the airways swell, excessive amounts of mucus are produced, and the smooth muscle tissue of the airways tightens or constricts (Clark, 2003, p. 44).
Whether they reside in Asia or Europe, these characteristics in asthmatic children are the same. Accordingly, when assessing, planning and evaluating the care of the asthmatic child, the nurse must be especially aware of these conditions because the constriction of the circular muscles surrounding the bronchial tube can happen very quickly and, in severe cases, cause asphyxiation. Assessment should be based upon symptomatic presentation and observable behaviors of the child, paying particular attention to excess mucus production which con-tributes to wheezing and difficulty in breathing. Planning and evaluation of the care for the child should include not only an awareness of the generalities, but also any specific allergens or other causative agents that aggravate an asthmatic response. Since asthma is chronic condition, the bronchial tube wall can thicken over time, and aggravated edema of the lining can ultimately lead to fibrosis and tissue destruction (Lieberman, 1999, p. 12). Accordingly, the nurse must be "alert to the early signs of asthma and have a definite medical regimen to follow when an attack begins" (Zamula, 1990, p. 15). The key to addressing the physical condition of the child is having a plan in place; thus the need for a health promotion strategy.
Psychosocial and Cultural Impact
There is a significant impact on asthmatic children, as well as those who care for them, from psychological, social, and cultural points of view. Understanding