THE DILEMMA OF SEEKING URGENT CARE - ASTHMA EPISODES AND EMERGENCY SERVICE USE

Asthma is an invisible and unpredictable chronic illness characterized by recurrent episodes of airflow obstruction and airway inflammation. Until recently, psychological factors were thought to play a major ro le in this condition. The notion of an emotionally-based illness serve s to discredit asthma as a 'real' illness among health professionals a nd patients alike, contributes to the sense of stigma that persons who have asthma experience, and impedes effective management. Findings fr om research with a sample of 95 adults with physician diagnosed and do cumented asthma indicate that persons who have asthma walk, a tightrop e between delaying formal medical intervention and seeking treatment t oo soon. Uncertainty about the quality and speed of care available in an emergency department shapes, in part, the nature of the lived exper ience of asthma and affects feelings of control over the illness. Thes e concerns create a push-pull dynamic, as individuals struggle to make decisions about emergency department use that will provide relief, en sure autonomy, deter the experience of stigma, and diminish the threat of death.