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However, their lived experiences and unmet needs remain poorly understood. This descriptive phenomenological study aimed to explore the illness experiences, related barriers, and unmet needs of adults with moderate\u2010to\u2010severe asthma who remained persistently uncontrolled despite objectively verified high adherence to prescribed inhaled maintenance therapy. In\u2010depth, semi\u2010structured interviews were conducted with 14 adult patients between June and November 2025 in a specialty asthma clinic at a tertiary\u2010level hospital in China, and the data were analyzed using Colaizzi's seven\u2010step phenomenological method. Four overarching themes were identified, revealing a multidimensional hidden burden: (1) physiological instability, characterized by persistent symptoms and comorbidity\u2010driven symptom amplification; (2) life\u2010space constriction, involving occupational vulnerability, stigma, and defensive withdrawal; (3) psychological duality, in which fear and vigilance coexisted with resigned habituation; and (4) therapeutic dilemmas, including corticosteroid anxiety and dependence, financial toxicity, and fears of therapeutic futility. These findings show that persistent poor control in highly adherent patients is experienced not simply as ongoing symptoms, but as a multidimensional burden. This adherence paradox challenges the assumption that high adherence invariably indicates satisfactory control. The findings also highlight the need for nurse\u2010led follow\u2010up and future intervention studies focusing on symptom interpretation, uncertainty management, and treatment\u2010related concerns in this subgroup.<\/jats:p>","DOI":"10.1002\/nur.70099","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:56:31Z","timestamp":1783508191000},"page":"693-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Adherence Paradox in Uncontrolled Moderate\u2010To\u2010Severe Asthma: A Qualitative Study of Patient Experiences and Unmet Needs"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-4232","authenticated-orcid":false,"given":"Yuling","family":"Hu","sequence":"first","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"},{"name":"School of Nursing Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailun","family":"Huang","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5543-8426","authenticated-orcid":false,"given":"Meijia","family":"Chen","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqian","family":"Gong","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyu","family":"Yang","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisheng","family":"Lan","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenshan","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxi","family":"Cai","sequence":"additional","affiliation":[{"name":"Chronic Airways Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/arm92030019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.07.008"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01346-2017"},{"key":"e_1_2_11_5_1","first-page":"48","volume-title":"Existential\u2010Phenomenological Alternatives for Psychology","author":"Colaizzi P. 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