Ann McMurray Headshot
PhD Title
Parent and patient perspectives of fatal and near fatal asthma, a qualitative study.
Funded by
University of Edinburgh
Supervisors
Steve Cunningham, Marilyn Kendall (Edinburgh), Louise Fleming (Imperial College)
Based at
University of Edinburgh

Parent and patient perspectives of fatal and near fatal asthma, a qualitative study.

According to the National Review of Asthma Deaths (NRAD) report a substantial proportion of asthma deaths are neither identifiable by clinical algorithms nor by patient understanding of personal risk: 58% of patients who die from asthma were classed as mild/moderate asthma and 43% had not had primary care contact for review of asthma in the previous year. Severe asthma exacerbations are difficult for patients to gauge as they are typically a continuum of symptoms experienced at other times – even very severe symptoms get better with time, especially in children. Although there have been a number of reports into asthma deaths and near fatal asthma events, they are all from a medical perspective. There are no studies that have looked to use the experience of those who have had near fatal attacks to identify key factors (social, behavioural and symptoms) that could inform patients with asthma of a critical opportunity to seek help.

Aims/ objectives

1. To provide a consensus definition of near fatal asthma.

2. To identify key time-critical experiences of those who suffer near fatal asthma (or their parents) that may provide a window of opportunity to seek help.

3. To elucidate family circumstances and behaviours that may place children and young people at greater risk of asthma death/near fatal asthma and enable these behaviours to inform education, primary care severe asthma registries and emergency service responses.

Study design

1. Literature review

2. An e-Delphi survey of clinicians. Key clinicians will be identified (approx. 100) who have experience of caring for children and young adults following near fatal asthma and develop a Delphi Network.

3. Qualitative study of children, young people and parents to assess experiences of near fatal asthma (15-20 children and young people aged 5-25 years and their parents where appropriate) and parents with experience of fatal asthma (approx 10-15 parents). The qualitative studies will include interviews.

More information

The study is now open for recruitment, for further details please contact Ann directly (ann.mcmurray@ed.ac.uk).

Download the Patient Information Leaflet for the study

About me

I began my nursing career in Belfast in 1989 where I completed my Adult training. I moved to Edinburgh in 1993 and completed my Sick Children’s training at the Royal Hospital for Sick Children. I completed my first degree in Child Health Nursing at Edinburgh Napier University in 2010. I have worked as an Asthma Nurse Specialist since 2002 and developed a keen interest in research over the years. I am currently on secondment from the hospital to complete my PhD at the University of Edinburgh. I am a member of the faculty for the Scottish Allergy and respiratory Academy (SARA) and regularly contribute to the successful study days run throughout Scotland.

Publications

The availability and use of oxygen saturation monitoring in primary care in order to assess asthma severity. Cunningham S, McMurray A. Primary Care Respiratory Journal. 2006 Apr;15(2):98-101.

Cluster randomized controlled trial of the effect of introduction of an acute wheeze/asthma integrated care pathway on patient outcome. [Abstract] Logan C; McMurray A; Dunn M; Richardson N; Lockerbie L; Prescott R; Cunningham S, European Respiratory Journal, 2006, 28, (Suppl 50): 481s [P2779]

Integrated care pathways significantly reduce drug dosing and administration errors in patients with acute asthma. [Abstract] McMurray A, Logan C, Dunn MJ, Richardson N, Lockerbie L, Prescott RJ, Cunningham S. European Respiratory Journal 2006, 28 (suppl 50) :481s [P2777].

Strategies to screen for adrenal suppression in children with asthma should take account of compliance with inhaled corticosteroids. Brodie M, McMurray A, Crofton PM, Bath L, Cunningham S. European Journal of Pediatrics. 2007 May;166(5):493-4.

Effect of an integrated care pathway on acute asthma/wheeze in children attending hospital: cluster randomized trial. Cunningham S, Logan C, Lockerbie L, Dunn MJ, McMurray A, Prescott RJ. Journal of Paediatrics 2008 Mar;152 (3):315-20.

Observational study of two oxygen saturation targets for discharge in bronchiolitis. Cunningham S, McMurray A. Archives of Disease in Childhood. 2012 Apr;97(4):361-3.

Attentional bias to respiratory- and anxiety-related threat in children with asthma. Lowther, H; Newman, E; Sharp, K; McMurray, A. Cognition & Emotion, May, 2015.

Asthma in children. Daines L, McMurray A InnovAiT 2016 10 (1) 5-14

A Young child with a history of wheeze. Paton J, Bindels P, McMurray A, Biggins J, Nantanda R, Stubbe Østergaard M Primary Care Respiratory Medicine 2017 http://rdcu.be/p8Qm

British Journal of School Nursing

McMurray A

Asthma in schools: a Scottish Perspective (2008)

Asthma part 1: signs, symptoms and diagnosis (2010)

Asthma part 2: managing treatment in schools (2011)

Asthma 3: common misperceptions and stigma (2011)

Supporting children and young people with asthma (2014)

Managing asthma attacks in the school environment (2016)

Smart Asthma – what connected devices can mean for care (2017)

McMurray A Wark S. Responding to the needs of adolescents with asthma (2014)

McMurray A Westwood J. Teaching children good inhaler technique (2016)

Independent Nurse

McMurray A. Treating Asthma in Children: the stepwise approach (2012)

Oxford Handbook of Clinical Skills for Children’s and Young People’s Nursing

Dawson P Cook L Holliday LJ Reddy H

2012 Chapter 12 Respiratory System

Published sections

History taking and assessment

Oxygen saturation monitoring

Recording Peak Flow

Recording Spirometry

Recorded Workshops delivered at Scottish Allergy and Respiratory Academy (SARA) training days

Asthma inhalers and nasal sprays: 

https://www.youtube.com/watch?v=44kqE-DPQ3Y

https://www.youtube.com/watch?v=2lOM1sqs4MM

© 2015 AUKCAR