The impact of thalassemia on Southeast Asian and Asian Indian families in the United States: a qualitative study.

OBJECTIVE To describe the challenges, including sociocultural and socioeconomic barriers, faced by an urban immigrant population in the United States affected by thalassemia major. DESIGN Ethnographic, semi-structured, 1-on-1 interviews using an interview guide developed for this study. Digital recordings were transcribed and data analyzed using constant comparative method. SETTING University-based, Comprehensive Thalassemia Program at Children's Memorial Hospital, Chicago, IL, USA. PARTICIPANTS Fourteen Southeast Asian and Asian Indian parents of children with transfusion dependent thalassemia. MAIN OUTCOME MEASURE Qualitative descriptions of parental experiences, frequency of codes applied to interviews and emergent themes. RESULTS Thalassemia has its greatest impact on the emotional and social well-being of affected children and their parents. Current and future concerns were related to disease-specific complications and challenges with management such as transfusions and chelation therapy. These perceptions were tied to parental hope for a cure, a frequently coded coping mechanism. Despite their availability, few parents relied on support systems beyond immediate family members due to perceived public knowledge gaps about thalassemia. Culturally based past experiences and barriers did not emerge as dominant themes in our analysis. CONCLUSION The impact of thalassemia is tremendous for affected children and their parents and is due more to factors that were either disease-specific or common to other chronic disease models rather than those influenced by culture. The unmet needs of these families require additional investigation to facilitate the development of initiatives aimed at improving quality of life and lessening overall impact of thalassemia