BackgroundPeople living with severe asthma may have ongoing debilitating symptoms despite high‐dose treatment. Clinical guidelines for severe asthma recommend concepts such as patient centeredness, shared decision making and self‐management, at the heart of which lies autonomy.ObjectiveThis study aimed to explore the role of autonomy in patients’ narratives about their experiences of living with and managing severe asthma.MethodsIn‐depth semi‐structured interviews were video‐ and/or audio‐recorded and transcribed. Data were categorized using a hybrid approach to analysis incorporating both inductive and deductive methods, informed by the self‐determination construct of autonomy. Analysis and comparison across and within categories were conducted to develop final themes.ResultsTwenty‐nine face‐to‐face interviews, lasting 1.5‐4 hours, were conducted across Australia. Patients’ autonomy was enacted or challenged in a range of situations, such as interacting with health‐care providers, maintaining employment, managing symptoms, and dealing with threats to self‐identity. Two main themes were discerned from the analysis: (a) the desire to live an “unconstrained” life; and (b) preservation of self‐identity.ConclusionOur findings suggest that autonomy is broader than conventional medical concepts such as decision making and information seeking. Future research should consider these findings when developing and implementing patient‐driven self‐management interventions for those living with severe asthma.

When practising neurodevelopmental–behavioural paediatrics, responsibility rests with the individual clinician to interpret research evidence in their daily work. This is not necessarily an easy task. Children do not usually present with single, easily definable problems. Complexity and uncertainty are present from the outset due to heterogeneity inherent in the diagnoses available, patterns of comorbid problems and the unique challenges of each child's social context. This article examines the resulting clinical challenge and offers potential responses. Rather than striving to eliminate uncertainty with strategies such as extensive assessment, the goal is to work effectively and efficiently within the limits of what can be readily known. Suggested strategies address complexity by considering the components of what is going on (biological, developmental, transactional) as hypotheses shared within each child's system of care. These hypotheses can then be tested and revised systematically as further information arises along the journey of treatment and longitudinal care.

This research focuses on specific models of health and illness, explored by many researchers across the world. The sequential variations and critic of each model is summed up by researcher and the relevant theoretical orientations of beta thalassemia major have been tried to integrate. Beta thalassemia major is a common genetic disorder, due to abnormalities in human globin (alpha or beta). The highest prevalence rate of disease has been seen in Saudi Arabia, Jordon, India, Bangladesh and Pakistan, due to repeated cousin marriages, strong beliefs of cultural and traditional practices and lack of knowledge for the prevention and management of beta thalassemia major. The focus of epidemiologists remained on genetic causes and ignored the social, cultural, religious and psychological factors which preponderate over biological aspects of health. The academician and health experts lacked to focus the theoretical orientations of beta thalassemia major, this paper elucidates the models of health and illness and provides and logical theoretical itinerary for beta thalassemia major.