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Rothman I, Tennant A, Mills RJ, Young CA. The Association of Health Locus of Control with Clinical and Psychosocial Aspects of Living with Multiple Sclerosis. J Clin Psychol Med Settings 2023; 30:821-835. [PMID: 36745302 DOI: 10.1007/s10880-023-09938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 02/07/2023]
Abstract
Health Locus of control (LOC) refers to one's beliefs regarding control over one's health. This study aimed to determine the relationship between LOC on clinical and psychosocial aspects associated with multiple sclerosis (MS). 5059 participants with MS completed a questionnaire pack including the Multidimensional Health Locus of Control Scale. Associations between LOC and sociodemographic (age, gender, educational level) and clinical variables (duration, disability, depression, anxiety, self-efficacy, QoL) were explored. LOC was found to be significantly associated with all of the clinical variables and age, but not gender or educational level. When controlling for level of disability, Chance (CLOC) was associated with higher self-efficacy, lower anxiety and higher QoL than Powerful Others (PLOC), while Internal (ILOC) had no association. The proportion with ILOC preference was lower in increased disability. In MS, believing that health is controlled mainly by chance confers the most benefit with regard to quality of life. There is prima-facie evidence that LOC preference changes with MS progression, in a pattern that is protective against psychological distress.
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Affiliation(s)
- I Rothman
- Liverpool University Hospitals Foundation Trust, Prescot Street, Liverpool, L7 8XP, UK
| | - A Tennant
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - R J Mills
- University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, UK
| | - C A Young
- University of Liverpool, Liverpool, UK.
- Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, UK.
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2
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Jia Y, Wang H, Zhang Z, Wang J, Yi M, Chen O. Parenting style and child asthma control in families of school-age children with asthma: The mediating effects of children's general self-efficacy and medication adherence. J Pediatr Nurs 2023; 73:e293-e301. [PMID: 37805379 DOI: 10.1016/j.pedn.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Parenting style plays a pivotal role in children's chronic disease control. However, the relationship and underlying mechanism between parenting style and asthma control remain unclear. This study investigated the effects of parenting style on children's general self-efficacy, medication adherence and asthma control and the mediating effects of general self-efficacy and medication adherence among school-age children with asthma. DESIGN AND METHODS A cross-sectional study with a convenience sampling approach was conducted. This study followed the STROBE guidelines. School-age children with asthma and their parents (N = 211) from pediatric respiratory clinics in China completed the General Questionnaire, Short-Egna Minnen av. Barndoms Uppfostran-Chinese, General Self-Efficacy Scale, Medication Adherence Questionnaire and Childhood Asthma Control Test. Structural equation modeling was used to examine the mediation models. RESULTS Positive parenting style was positively correlated with child general self-efficacy, medication adherence and asthma control (r = 0.602, 0.572, 0.613, p < 0.001). Negative parenting style was negatively correlated with child general self-efficacy, medication adherence and asthma control (r = -0.535, -0.598, -0.586, p < 0.001). Structure Equation Modle (SEM) results indicated that the relationships between positive parenting style, negative parenting style and child asthma control were mediated by general self-efficacy (Effect Size [ES]: 0.209, 95%CI [0.075, 0.372]; and ES: -0.229, 95%CI [-0.387, -0.103], respectively) and medication adherence (ES: 0.128, 95%CI [0.032, 0.322]; and ES: -0.190, 95%CI [-0.432, -0.071], respectively) and together in serial (ES: 0.177, 95%CI [0.076, 0.295]; and ES: -0.118, 95%CI [-0.235, -0.020], respectively). CONCLUSIONS Parenting style may impact child asthma through both child general self-efficacy and medication adherence. The study may provide useful intervention targets for improving asthma control. PRACTICE IMPLICATIONS Nurses should encourage parents to increase positive parenting style while decreasing negative parenting style. Family interventions focusing on general self-efficacy and medication adherence may be advantageous to improve asthma control.
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Affiliation(s)
- Yuanmin Jia
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Haixia Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zeyi Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Jingjing Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Mo Yi
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
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3
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Feldman JM, Arcoleo K, Greenfield N, Styke S, Becker J, Jariwala S, Federman AD, Wisnivesky JP. Under-perception of airflow limitation, self-efficacy, and beliefs in older adults with asthma. J Psychosom Res 2023; 170:111353. [PMID: 37178474 PMCID: PMC10247476 DOI: 10.1016/j.jpsychores.2023.111353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Under-perception of airflow limitation is more common in older adults with asthma and may lead to under-reporting of asthma symptoms. Asthma management self-efficacy is linked with better asthma control and quality of life (QoL). We sought to examine asthma and medication beliefs as a mediator in the relationship between both under-perception and self-efficacy with asthma outcomes. METHODS This cross-sectional study recruited participants with asthma ≥60 years from hospital-affiliated practices in East Harlem and the Bronx, New York. Perception of airflow limitation was measured for 6 weeks by having participants enter peak expiratory flow (PEF) estimates into an electronic peak flow meter followed by PEF blows. We used validated instruments to assess asthma and medication beliefs, asthma management self-efficacy, asthma control, and QoL. Asthma self-management behaviors (SMB) were quantified by electronic and self-report measures of inhaled corticosteroid (ICS) adherence and observation of inhaler technique. RESULTS The sample comprised 331 participants (51% Hispanic, 27% Black, 84% female). Beliefs mediated the relationship between greater under-perception and better self-reported asthma control (β = -0.08, p = .02) and better asthma QoL (β =0.12, p = .02). Higher self-efficacy was also associated with better reported asthma control (β = -0.10, p = .006) and better asthma QoL (β =0.13, p = .01) in this indirect effect through beliefs. Accurate perception of airflow limitation was associated with higher adherence to SMB (β = 0.29, p = .003). CONCLUSIONS Less threatening asthma beliefs may be maladaptive in under-perception of airflow limitation by contributing to under-reporting of asthma symptoms, but adaptive in the context of higher self-efficacy and better asthma control.
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Affiliation(s)
- Jonathan M Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America; Albert Einstein College of Medicine, Children's Hospital at Montefiore, Department of Pediatrics and Department of Psychiatry and Behavioral Sciences, Division of Academic General Pediatrics, Bronx, NY, United States of America.
| | - Kimberly Arcoleo
- The University of Rhode Island, College of Nursing, Kingston, RI, United States of America
| | - Naomi Greenfield
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
| | - Sarah Styke
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
| | - Jacqueline Becker
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY, United States of America
| | - Sunit Jariwala
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Allergy/Immunology, Bronx, NY, United States of America
| | - Alex D Federman
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY, United States of America
| | - Juan P Wisnivesky
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY, United States of America; Icahn School of Medicine at Mount Sinai, Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY, United States of America
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4
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Tang Y, He W. Relationship between emotional intelligence and learning motivation among college students during the COVID-19 pandemic: A serial mediation model. Front Psychol 2023; 14:1109569. [PMID: 37008860 PMCID: PMC10050401 DOI: 10.3389/fpsyg.2023.1109569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
The vital influence of emotional intelligence on college students' learning motivation has received considerable attention. This study analyzed not only the relationship between emotional intelligence and college students' learning motivation during the COVID-19 pandemic, but also the serial mediating roles that self-efficacy and social support play in this relationship. Using a cross-sectional survey design, we collected data from 336 college students across 30 provinces in China, using four well-established scales measuring emotional intelligence, learning motivation, self-efficacy, and social support. We analyzed the mediating effects using the Bootstrap method. The results showed that emotional intelligence positively predicted learning motivation, and that self-efficacy and social support played serial mediating roles between emotional intelligence and learning motivation. This finding suggests the need for interventions to help college students develop emotional intelligence during the COVID-19 pandemic, and that fostering college students' self-efficacy and providing multiple social supports would help improve their motivation and academic performance.
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Affiliation(s)
| | - Weiguang He
- College of Social Sciences, Shenzhen University, Shenzhen, China
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Salandi J, Vu-Eickmann P, Apfelbacher C, Sheikh A, Loerbroks A. Implementing the Patient Needs in Asthma Treatment (NEAT) questionnaire in routine care: a qualitative study among patients and health professionals. BMC Pulm Med 2023; 23:21. [PMID: 36650461 PMCID: PMC9843883 DOI: 10.1186/s12890-022-02293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Many patients with asthma report unmet health care needs. The Patient Needs in Asthma Treatment (NEAT) questionnaire is a validated instrument to quantify these unmet needs. We explored how health professionals evaluated the instrument's utility as well as patients' and professionals' perspectives of how NEAT could be incorporated into routine clinical practice. METHODS Qualitative interviews were conducted by telephone between February and September 2021 with 19 patients with asthma and 21 health professionals (i.e., general practitioners, pneumologists, health professionals in pulmonary rehabilitation, and medical assistants). Interview recordings were transcribed verbatim and content-analyzed using both deductive and inductive approaches using MAXQDA. RESULTS Health professionals could see the potential value of using NEAT to inform clinical decisions. However, health professionals tended to be skeptical towards the routine use of NEAT in outpatient settings, mainly due to a lack of time. Implementation of NEAT was seen as more valuable in the context of patient education (i.e., in Disease Management Programs [DMPs] or pulmonary rehabilitation) by patients and health professionals alike, because it offered greater opportunities to address any unmet needs identified. Both patients and health professionals considered it more useful to use the questionnaire for the first time some time after the initial diagnosis has been made (e.g., when the treatment regime is found rather than at time of initial diagnosis). In the context of DMPs and pulmonary rehabilitation, NEAT could be used twice, i.e., before and after patient education to support patient-centered planning and evaluation. CONCLUSION Both patients and health professionals consider the use of the NEAT, in particular in educational programs (i.e., during DMPs or pulmonary rehabilitation), as feasible and useful. There is now a need to undertake a feasibility trial in routine care.
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Affiliation(s)
- Julia Salandi
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Patricia Vu-Eickmann
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Christian Apfelbacher
- grid.5807.a0000 0001 1018 4307Institute of Social Medicine and Health Systems Research (ISMHSR), Medical Faculty, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Asthma UK Centre for Applied Research, Usher Institute, Old Medical School, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG UK
| | - Adrian Loerbroks
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
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Turi ER, Reigada LC, Liu J, Leonard SI, Bruzzese JM. Associations among anxiety, self-efficacy, and self-care in rural adolescents with poorly controlled asthma. Ann Allergy Asthma Immunol 2021; 127:661-666.e1. [PMID: 34547441 PMCID: PMC8627490 DOI: 10.1016/j.anai.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/17/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rural adolescents are vulnerable to asthma; good self-care can reduce morbidity. The subtypes of anxiety (eg, asthma-related, generalized) may have differential associations with asthma self-care. Low self-efficacy, a determinant of behavior, is associated with increased anxiety. Little is known regarding these relationships in rural adolescents. OBJECTIVE To evaluate whether anxiety symptoms are associated with asthma symptom prevention and management among rural adolescents and whether self-efficacy mediates these relationships. METHODS We used baseline data from 197 rural adolescents (mean age = 16 years; 69% girls; 62% Black) who were part of a trial that tested the effectiveness of a school-based asthma intervention. Adolescents completed the Youth Asthma-Related Anxiety Scale, Screen for Child Anxiety and Emotional Disorders, Asthma Management Self-efficacy Index, and Asthma Prevention and Management Indices. Linear regression was performed to test whether: (1) asthma-related and generalized anxiety had curvilinear relationships with self-care; (2) social and separation anxiety had linear relationships with self-care; and (3) self-efficacy mediated relationships. RESULTS Asthma-related anxiety had a significant curvilinear relationship with prevention (P = 0.001) and a linear association with management (P = .01). Generalized anxiety had a significant curvilinear association with management (P = .03), whereas social anxiety had a significant linear relationship with prevention (P = .04). Self-efficacy partially or fully mediated these relationships. CONCLUSION Anxiety symptoms were associated with asthma self-care among this sample of rural adolescents, with differing roles for prevention and management. Self-efficacy may be a mechanism to improve asthma self-care among rural adolescents with anxiety. With a lack of self-efficacy, asthma-related, generalized, or social anxiety may motivate adolescents to take steps to care for their asthma.
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Affiliation(s)
- Eleanor R Turi
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Laura C Reigada
- Department of Psychology, Brooklyn College and The Graduate Center, The City University of New York, New York, New York
| | - Jianfang Liu
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Sarah I Leonard
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Jean-Marie Bruzzese
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York.
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Mokros Ł, Witusik A, Szydłowska D, Jankowski KS, Kuna P, Pietras T. Mental health indices may fully mediate the relationship between morningness-eveningness and disease control among adult asthma patients. J Asthma 2021; 59:1923-1932. [PMID: 34606405 DOI: 10.1080/02770903.2021.1989463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The aim of this study was to assess the association between morningness-eveningness and disease control with consideration of mental state as a mediator and the control of confounding factors among adult asthma patients.Methods: This is a cross-sectional study, which included a nonrandom sample of N = 66 patients from an outpatient unit with a confirmed asthma diagnosis, who gave an informed consent and completed a set of questionnaires: a survey comprising questions about sociodemographic and clinical characteristics, the Asthma Control Test (ACT), the Composite Scale of Morningness (CSM), and the General Health Questionnaire (GHQ-28). Mediation models were created separately for each GHQ-28 dimension (somatic symptoms, anxiety/insomnia, social dysfunction and depressive symptoms), for a total score and for four GHQ-28 dimensions together, considered as mediators.Results: Low morning affect was related to poor disease symptom control among patients with asthma. The effect was fully mediated by non-psychotic mental health indices. Evening-time preference was associated with a rise in asthma control, and mediated by somatic symptoms and anxiety/insomnia, when controlled for morning affect.Conclusions: The current study underlines the significance of assessment of both individual morningness-eveningness preference and mental health in the management of asthma symptoms.
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Affiliation(s)
- Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Witusik
- Faculty of Composition, Theory of Music, Conducting, Eurhythmics and Music Education, Music Therapy Course, Grazyna and Kiejstut Bacewicz Memorial Academy of Music in Lodz, Lodz, Poland
| | - Dorota Szydłowska
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Piotr Kuna
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Rolland-Debord C, Goriounov I, Pitron V. [The psychological burden of asthma]. Rev Mal Respir 2021; 38:721-732. [PMID: 33992494 DOI: 10.1016/j.rmr.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/31/2021] [Indexed: 10/21/2022]
Abstract
The experience of living with asthma varies between patients. In some cases, the psychological experience can take a central place and determine the course of asthma. Asthmatic disease can be complicated by adaption disorders that hamper the treatment, or genuine anxiety and depressive disorders that require the intervention of mental health specialists. Even more, the psychological experience can influence the intensity and frequency of the physical symptoms themselves, for example when asthma is associated with a hyperventilation syndrome worsening the functional impact and complicating the treatment. In this article, we underline the significance of the psychological experience through several clinical vignettes of patients suffering from asthma. In particular, we discuss the role of denial, or conversely identification with the status of being a patient, and the importance of the emotional experience associated with the symptoms of asthma. We highlight the relevance of therapeutic education programs as well as cognitive-behavioral therapies and psycho-corporal techniques, such as relaxation, for the psychological care of asthmatic disease. Finally, we detail how to better recognize a hyperventilation syndrome associated with asthma, how it can be approached with the patient and the treatment options. Through these examples, we illustrate the relevance of a comprehensive approach that integrates the psychological experience into the care of asthmatic disease.
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Affiliation(s)
- C Rolland-Debord
- Service de pneumologie, médecine intensive et réanimation (SPMIR), département R3S, groupe hospitalier Pitié-Salpêtrière, Sorbonne université, AP-HP, 75013 Paris, France.
| | - I Goriounov
- Service de pneumologie, médecine intensive et réanimation (SPMIR), département R3S, groupe hospitalier Pitié-Salpêtrière, Sorbonne université, AP-HP, 75013 Paris, France
| | - V Pitron
- UMR 8129, ENS/EHESS/CNRS, IEC, PSL, institut Jean-Nicod, 29, rue d'Ulm, 75005 Paris, France; Service de psychiatrie adulte, groupe hospitalier Pitié-Salpêtrière, Sorbonne université, AP-HP, 75013 Paris, France
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Robles G, Sauermilch D, Starks TJ. Self-efficacy, social distancing, and essential worker status dynamics among SGM people. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2020; 1:300-317. [PMID: 33829212 PMCID: PMC8022856 DOI: 10.1891/lgbtq-2020-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As of October 2020, the COVID-19 pandemic has accounted for over 210,000 deaths in the U.S. Sexual and gender minority populations are more likely to work in essential industries while bearing a disproportionate burden of the virus. Constructs consistent with Protection Motivation Theory (perceived severity, vulnerability, self-efficacy, and response efficacy) were measured using an abridged version of Kleczkowski et al.'s 4-factor Protection Motivation Theory Psychological Measures to examine social distancing behaviors of these populations. 32.6% of the sample were essential workers. Greater self-efficacy predicted stricter social distancing behaviors. Non-essential and unemployed worker statuses were associated with increased odds of stricter social distancing behaviors relative to essential worker status. Essential worker status predicted lower self-efficacy. The indirect effect of essential worker status on social distancing through self-efficacy was significant. Findings suggest that interventions that encourage social distancing through enhanced self-efficacy may optimize health for sexual and gender minority essential workers.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ. United States
| | | | - Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY. United States
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY. United States
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Salandi J, Icks A, Gholami J, Hummel S, Schultz K, Apfelbacher C, Sheikh A, Loerbroks A. Impact of pulmonary rehabilitation on patients' health care needs and asthma control: a quasi-experimental study. BMC Pulm Med 2020; 20:267. [PMID: 33059650 PMCID: PMC7559596 DOI: 10.1186/s12890-020-01301-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary rehabilitation offers potential benefits to people with asthma. It is however unknown if rehabilitation favourably affects patients' health care needs. We therefore examined if rehabilitation reduced needs and, in addition, if it improved asthma control. METHODS One hundred fifty patients with asthma were surveyed in three rehabilitation clinics at admission and at discharge. Additionally, we surveyed 78 participants with asthma twice 4 weeks apart. The latter sample (i.e. the control group) was recruited through other pathways than rehabilitation clinics. The Patient Needs in Asthma Treatment (NEAT) questionnaire and the Asthma Control Test (ACT) were completed at baseline and follow-up. Differences between baseline and follow-up and between rehabilitation and control group were examined by t-tests and chi-squared-tests. Univariate ANCOVAS were used to examine if NEAT and ACT follow-up scores differed significantly between groups. Within the rehabilitation group, linear regressions were used to examine if self-reported utilization of more interventions that addressed needs were associated with NEAT scores at follow-up. RESULTS At baseline, there were no differences between the rehabilitation and the control group regarding needs and asthma control. At follow-up, the rehabilitation group showed reduced needs (t(149) = 10.33, p < 0.01) and increased asthma control (t(130) = -6.67, p < 0.01), whereas members of the control group exhibited no changes. Univariate ANCOVAS showed that unmet follow-up needs (F(1, 212) = 36.46, p < 0.001) and follow-up asthma control (F(1, 195) = 6.97, p = 0.009) differed significantly between groups. In the rehabilitation group, self-reported utilization of more interventions was associated with reduced needs (β = 0.21; p = 0.03). CONCLUSIONS This study provides preliminary evidence suggestion that pulmonary rehabilitation in adults with asthma may reduce asthma-related needs and confirms previous findings that rehabilitation may improve asthma control.
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- Institute of Health Services Research and Health Economics, German Diabetes Center, Medical Faculty, University of Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland, Bubertstraße 4, 26757, Borkum, Germany
| | - Stefan Hummel
- MEDIAN Klinik Heiligendamm, Kinderstrand 1, 18209, Bad Doberan, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd, Salzburger Str. 8-11, 83435, Bad Reichenhall, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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Reznik M, Greenberg E, Cain A, Halterman JS, Ivanna Avalos M. Improving teacher comfort and self-efficacy in asthma management. J Asthma 2019; 57:1237-1243. [PMID: 31314614 DOI: 10.1080/02770903.2019.1640732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Asthma is common among urban school-age children. Though teachers should be prepared to assist children during an asthma attack, studies show they lack self-efficacy in managing asthma.Objective: To assess feasibility of implementing an asthma workshop for elementary school teachers, describe themes of questions raised, and determine workshop's impact on teachers' comfort and self-efficacy in asthma management.Methods: We developed and implemented an asthma workshop for teachers from four Bronx elementary schools (2012-2014). Teachers completed a questionnaire evaluating their comfort and self-efficacy in asthma management before and after the workshop. Questions asked during the sessions were recorded and analyzed for themes. Paired t-test and McNemar tests compared before/after scores.Results: 65 out of 70 teachers (92.9%) participated in the educational sessions. Teachers asked questions about school policy for inhalers, medication administration guidelines, and physical activity and asthma. 64/65 (98.5%) teachers completed pre/post surveys (mean age 39.7 years; mean years at the school 8.0). Post-intervention, more teachers reported knowing how to manage an asthma attack (93.8% vs. 64.1%, p < .0001); and felt comfortable assessing (50.8% vs. 30.8%, p = 0.019) and handling an asthma attack (52.3% vs. 33.8%, p = .023). The overall mean self-efficacy score increased post-intervention (43.0 vs. 38.1, p < .0001), as did 8/12 individual self-efficacy items. Post-workshop, 95.3% of teachers agreed that teacher in-service asthma education should be done annually.Conclusions: An asthma workshop was successfully implemented in the school setting and improved teacher comfort and self-efficacy in managing asthma. Annual training may improve teachers' confidence in assisting students with asthma.
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Affiliation(s)
- Marina Reznik
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Elana Greenberg
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA.,Colorado Center for Reproductive Medicine in New York, New York, NY, USA
| | | | - Jill S Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Maria Ivanna Avalos
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
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