Journal of Asthma and Allergy (Dec 2021)
The Experience of Living with Severe Asthma, Depression and Anxiety: A Qualitative Art-Based Study
Abstract
Michelle A Stubbs,1– 3 Vanessa L Clark,1– 3 Melissa Mei Yin Cheung,4 Lorraine Smith,5 Bandana Saini,5,6 Janelle Yorke,7,8 Eleanor C Majellano,1– 3 Peter G Gibson,1,2,9 Vanessa M McDonald1– 3,9 1National Health and Medical Research Council Centre for Research Excellence in Severe Asthma, The University of Newcastle, Newcastle, New South Wales, Australia; 2The Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; 3School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia; 4The University of Sydney Children’s Hospital Westmead, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia; 5School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia; 6Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; 7School of Health Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; 8Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK; 9Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, AustraliaCorrespondence: Vanessa M McDonaldLevel 2 West Wing, Hunter Medical Research Institute, Locked Bag 1000, New Lambton, New South Wales, 2305, AustraliaFax +6140420046Email [email protected]: Severe asthma, depression and anxiety often co-exist and increase disease burden. Currently there are no published studies investigating severe asthma and psychological comorbidity using arts-based methodology. We aimed to (i) illustrate the individual experience of adults living with severe asthma, with and without symptoms of depression and/or anxiety and (ii) to explore common characteristics depicted in artworks between those groups.Patients and Methods: A qualitative arts-based study was conducted. Adults with severe asthma were categorised into two groups according to Hospital Anxiety and Depression Scale scores (< 8 on either subscale [SA-D/A] (N=15) or (≥ 8 on one or both subscales [SA+D/A] (N=15). Art thematic analysis was undertaken using a hybrid approach. The Common-Sense Model of Self-Regulation was used to examine frequencies in artworks.Results: Participants with severe asthma alone and severe asthma with depression/anxiety were of older age (median 67 and 63 years respectively). There was greater asthma QoL impairment in participants with psychological comorbidity than without (4.7 ± 8.3 versus 5.8 ± 0.85, p=< 0.01). Analysis of art works identified three themes: (1) “darkness” depicting misery, isolation and sadness; (2) “impacts” describing physical and social consequences; and (3) “resilience” illustrating acceptance and perseverance of living with all three conditions.Conclusion: Art-based research in severe asthma facilitates detailed exploration of intimate and individual experiences. Darkness, impacts and resilience are common themes emerging from artworks. Understanding these experiences may help guide assessment and treatment of psychological comorbidity in the clinic.Keywords: mental health, severe asthma, artworks, anxiety, depression
