Paper Title
Whammy Of Stigmatisation In Adults Living With Asthma: Qualitative Study

Abstract
Latest asthma global report and clinical management guidelines have accentuated on the stigmatisation of asthma among paediatrics and adults since stigmatisation has caused a lot of boundaries in their psychosocial activities consequently affecting their asthma control. In Malaysia however, paucity of the nature of stigmatisation and its possible consequences especially in adult asthmatics remained unexplored. Therefore this qualitative study explored the stigmatisation of asthma among adults (≥ 18 years old) living with asthma. Thirty adult asthmatics attending a community pharmacy in Selangor, Malaysia, were interviewed. Data obtained were coded independently to be under relevant themes. Findings demonstrated that majority of patients showed either a refutation to asthma diagnosis or an endeavour to conceal or simplify their severity of symptoms due to stigma. Patients� disclosure of diagnosis was a subject of extreme difficulty and scarcity for them. Most of them regard asthma as a mild breathing problem that is linked with weather changes or diet. The limitation in physical activity, missing number of working days and social isolation were the main features being expressed by them. Some patients described the overuse of bronchodilator inhaler to pretend to be as normal as possible however the use of inhaler is cloak-and-dagger especially in public and social gatherings. Stigma towards corticosteroids hindered them to administer it daily as part of preventer regime. Some patients also said their asthma symptoms are temporarily age related and will disappeared when getting older. Few patients reported the hidden fear of being talked down or feeling of embarrassment at their workplace and community whether they experienced it practically or not. Every patient personalized to hidden stigma of their illness in their own way. As a result, patients� response varies from taking better care of themselves with the intent to cope their illness to social isolation depending on assorted personal and community ridden characteristics of that specific patient. Index Terms�Adult Asthma, Stigmatisation