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Coelho C, Pinho J, Pinto M, Pedrosa C, Costa H, Romariz J, Carvalho MI. Pediatric asthma knowledge: Insights from a Portuguese central hospital study. Pediatr Pulmonol 2024. [PMID: 39073035 DOI: 10.1002/ppul.27196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 06/12/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Asthma is a common chronic condition in children, with parental and child health literacy affecting health outcomes and asthma control. This study examined pediatric asthma knowledge at a Portuguese central hospital and its determinants. METHODS We conducted a comparative cross-sectional study, applying the Asthma Knowledge Questionnaire (QCSA), answered by adolescents and/or caregivers. The sample was categorized into two groups based on the presence or absence of respiratory conditions, such as asthma or recurrent wheezing, in children. Those with such conditions (Group A) were further divided into two subgroups: those receiving general pediatric care (Group A2) and those receiving specialized care, followed in pulmonology or allergology consultations (Group A1). RESULTS The study involved 154 participants, predominantly female (74%) with an average age of 31.2 years ( ± 13.4). The average QCSA score was 14.8 ( ± 3.2), and Group A exhibited a statistically higher score, 15.5 points ±3.2 versus Group B, 14.2 points ± 3.2, p = .034. Group A1 achieved significantly better scores (16 points: range 4-21) than Group A2 (14 points: range 9-21) (p = .029). Scores were correlated positively with the duration of specialized follow-up (ρ = .326; p = .027). Asthma knowledge was correlated with the level of education (r = .468; p < .001). The number of wheezing episodes (r = -.466; p < .001) within the past year were associated to QCSA scores. CONCLUSION In summary, the presence of respiratory condition, the follow-up in specialized appointments and higher levels of education were associated with greater asthma knowledge.
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Affiliation(s)
- Cristina Coelho
- Department of Immunology and Allergology, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Joana Pinho
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Mariana Pinto
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Cláudia Pedrosa
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Pediatric Allergology and Pulmonology Unit, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Herculano Costa
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Pediatric Allergology and Pulmonology Unit, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Jorge Romariz
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Pediatric Allergology and Pulmonology Unit, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Maria I Carvalho
- Department of Pediatrics, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Pediatric Allergology and Pulmonology Unit, Unidade Local de Saúde Gaia e Espinho Vila Nova de Gaia, Vila Nova de Gaia, Portugal
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Eriksson S, Giezeman M, Hasselgren M, Janson C, Kisiel MA, Montgomery S, Nager A, Sandelowsky H, Ställberg B, Sundh J, Lisspers K. Risk Factors Associated with Asthma Control and Quality of Life in Patients with Mild Asthma Without Preventer Treatment, a Cross-Sectional Study. J Asthma Allergy 2024; 17:621-632. [PMID: 39006240 PMCID: PMC11246090 DOI: 10.2147/jaa.s460051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/31/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose To study risk factors for uncontrolled asthma and insufficient quality of life (QoL) in patients with mild asthma, ie those without preventer treatment. Patients and Methods Patients aged 18-75 years with a doctor's diagnosis of asthma randomly selected from primary and secondary care in Sweden. Mild asthma was defined as self-reported current asthma and no preventer treatment. Data were collected from self-completed questionnaires in 2012 and 2015. Well-controlled asthma was defined as Asthma Control Test (ACT) ≥20 points and no exacerbation and uncontrolled asthma as ACT<20 points and/or at least one exacerbation in the previous six months. QoL was measured by the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), where a total mean score of ≥ 6 indicated sufficient and < 6 insufficient QoL. Multivariate logistic regression analyses were performed using asthma control and Mini-AQLQ as dependent variables. Asthma control was dichotomized as controlled and uncontrolled asthma and the Mini-AQLQ as sufficient QoL (mean score ≥6) and insufficient QoL (mean score <6). Results Among 298 patients, 26% had uncontrolled asthma, 40% insufficient QoL and 20% both uncontrolled asthma and insufficient QoL. Age ≥60 years, obesity, daily smoking, rhinitis and inadequate knowledge of asthma self-management were independently associated with poor asthma control. Factors independently associated with insufficient QoL were age ≥60 years, overweight, obesity, rhinitis, sinusitis and inadequate knowledge of asthma self-management. Age ≥60 years, obesity, rhinitis and inadequate knowledge of asthma self-management were independently associated with both uncontrolled asthma and insufficient QoL. Conclusion Among asthma patients without preventer medication, 26% had uncontrolled asthma and 40% had insufficient asthma-related QoL. Older age, obesity, and rhinitis were risk factors for both poor asthma control and a reduced QoL, but having good knowledge of asthma self-management reduced this risk. Our findings suggest that this group of patients requires further attention and follow-up.
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Affiliation(s)
| | - Maaike Giezeman
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | - Mikael Hasselgren
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Marta A Kisiel
- Department of Medical Sciences, Occupational and Environment Medicine, Uppsala University, Uppsala, Sweden
| | - Scott Montgomery
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Public Health, University College, London, UK
| | - Anna Nager
- NVS, Section for Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Sandelowsky
- Department of Epidemiology and Public Health, University College, London, UK
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Björn Ställberg
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Josefin Sundh
- Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Karin Lisspers
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
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Salandi J, Hayden MC, Heinrichs K, Limbach M, Schultz K, Schwarzl G, Neumeister W, Loerbroks A. Can an educational intervention in the context of inpatient pulmonary rehabilitation improve asthma self-management at work? A study protocol of a randomized controlled trial. BMC Pulm Med 2024; 24:40. [PMID: 38233800 PMCID: PMC10795332 DOI: 10.1186/s12890-024-02847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Asthma self-management (e.g., trigger avoidance or correct medication use) is a cornerstone of therapy. Its successful implementation in everyday working life is determined by psychosocial working conditions, in particular by support from superiors and colleagues and the job decision latitude (i.e., when and how to carry out which tasks). To empower individuals with asthma to modify their working conditions, employees need to use certain communication skills and acquire specific knowledge. Both could be taught as part of patient education during pulmonary rehabilitation. Therefore, the aim of the planned study is the development and multicentre implementation of an education module for individuals with asthma during their rehabilitation and to generate evidence on its effectiveness. METHODS Participants (n ≥ 180) will be recruited, randomized into an intervention and a control group, trained and surveyed in two rehabilitation clinics. The intervention group will receive the supplementary patient education module "Asthma and Work" while the control group will participate in a program on " Eating behaviour" (both 2 × 50 min). The effectiveness of the intervention will be examined based on pre-post measurements (T1 and T2) and a 3-month follow-up (T3). We will consider behavioural intention (T2) and asthma self-management at work (T3) as primary outcomes. Secondary outcomes will include self-management-related knowledge, self-efficacy, number of sick days, number of exacerbations, asthma control (Asthma Control Test), asthma-related quality of life (Marks Asthma Quality of Life Questionnaire), and subjective employment prognosis (Brief Scale Measuring the Subjective Prognosis of Gainful Employment). The pre-post comparisons are to be evaluated using univariate analyses of covariance. DISCUSSION Improving asthma self-management at work could increase the work ability and social participation of employees with asthma. This could reduce costs, e.g. in terms of asthma-related sick leave. TRIAL REGISTRATION German Clinical Trials Register (ID: DRKS00031843).
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Markus C Hayden
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Limbach
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Konrad Schultz
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Gabriele Schwarzl
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | | | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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Köprülüoğlu M, Naz İ, Aktaş B, Kömürcüoğlu B, Özer Kaya D. Comparison of Self-Efficacy and Problem-Solving Skills Between Women with Asthma and Healthy Controls: A Cross-Sectional Study. THORACIC RESEARCH AND PRACTICE 2023; 24:304-308. [PMID: 37909829 PMCID: PMC10724732 DOI: 10.5152/thoracrespract.2023.23032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/15/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Problem-solving skills and self-efficacy are among the topics that are frequently investigated in people with various chronic conditions. However, there are limited studies on asthma patients. Our study aims to compare self-efficacy and problem-solving skills in asthma patients and healthy controls. MATERIAL AND METHODS We included 23 women with asthma [age: 39 (34-56) years] and 23 healthy controls [age: 42 (30-55) years] in the study. Participants' sociodemographic and disease-related characteristics, Asthma Control Test, and the Modified Medical Research Council Dyspnea Scale scores were recorded. We examined problem-solving skills with the Problem-Solving Inventory and self-efficacy with General Self-Efficacy Scale. We compared groups with the chi-square test, Mann-Whitney U-test, and Independent Sample t-test. RESULTS Age, body mass index, educational status, marital status, and occupational status were similar among the groups (P > .05). However, smoking was significantly higher in healthy controls (P < .05). It was found that women with asthma had worse self-efficacy and problem-solving skills compared to healthy controls (P < .05). CONCLUSION These results showed that there may be problems in socio-cognitive skills associated with the disease. Our study focused on the possibility that female asthma patients may have low levels of self-efficacy and problem-solving skills. Therefore, health professionals designing the rehabilitation program should take these skills into account while conducting the assessment as they may be useful in developing an efficient rehabilitation program.
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Affiliation(s)
- Melissa Köprülüoğlu
- Department of Physiotherapy and Rehabilitation, İzmir Katip Celebi University Faculty of Health Sciences, İzmir, Turkey
| | - İlknur Naz
- Department of Physiotherapy and Rehabilitation, İzmir Katip Celebi University Faculty of Health Sciences, İzmir, Turkey
| | - Büşra Aktaş
- Department of Physiotherapy and Rehabilitation, İzmir Katip Celebi University Faculty of Health Sciences, İzmir, Turkey
| | - Berna Kömürcüoğlu
- Chest Diseases Clinic, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Derya Özer Kaya
- Department of Physiotherapy and Rehabilitation, İzmir Katip Celebi University Faculty of Health Sciences, İzmir, Turkey
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Wang Y, Zhu J, Xu Z, Dai X, Chen K, Wang Y. Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students. Sci Rep 2023; 13:12320. [PMID: 37516775 PMCID: PMC10387080 DOI: 10.1038/s41598-023-39658-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/28/2023] [Indexed: 07/31/2023] Open
Abstract
Oral health is crucial for health-related quality of life. However, the research on the factors affecting oral health status is not comprehensive enough. This investigation aimed to evaluate the multifaceted determinants of college students' oral health status and explore the impact of social support, oral health literacy, attitudes, behaviors, and self-efficacy on OHRQoL. By surveying 822 students from a university. Baseline data included sociodemographics (gender, age), social support (MSPSS scale), oral health self-efficacy (SESS scale), oral health knowledge, attitudes, and practices (KAP questionnaire), and OHRQoL (OHIP-14 scale). Based on social cognitive theory, partial least squares structural equation modeling (PLS-SEM) and fuzzy set qualitative comparative analysis (fsQCA) were used to examine the relationship between the study variables. PLS-SEM results showed that knowledge, attitude, and practice predicted OHRQoL through self-efficacy. FsQCA results showed that the combination of different variables was sufficient to explain OHRQoL. The conclusion was that self-efficacy plays an important role and the combination of high-level knowledge, positive attitudes, and strong self-efficacy was important in improving OHRQoL. The results of this study provided a reference for the oral health strategy planning of college students in China.
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Affiliation(s)
- Ying Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, China
| | - Jie Zhu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China
| | - Zeling Xu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China
| | - Xinyi Dai
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China
| | - Keda Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China.
| | - Ying Wang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310015, China.
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Tavakoly Sany SB, Aman N, Jangi F, Lael-Monfared E, Tehrani H, Jafari A. Quality of life and life satisfaction among university students: Exploring, subjective norms, general health, optimism, and attitude as potential mediators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1045-1052. [PMID: 34242514 DOI: 10.1080/07448481.2021.1920597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 02/23/2021] [Accepted: 04/18/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study aims to examine the association of quality of life (QOL) with life satisfaction, subjective norms, general health, optimism, and attitude among university students. PARTICIPANTS Respondents include 632 university students (Mage=21.36, SD = 2.86). METHODS This cross-sectional study was conducted on university students in Torbat Heydariyeh, Iran. Several statistical models were tested, including hierarchical regression and path analysis, to examine the direct or indirect association between a set of important variables. RESULTS According to the results of path analysis, constructs of subjective norms, general health, positive attitude, optimism, and life satisfaction were significant predictors of students' QOL. Compared with other constructs, general health status (p < 0.001, R2 = 0.548) and life satisfaction (p < 0.001, R2 = 0.253) showed the strongest association with QOL. CONCLUSIONS The results indicate that efforts to improve life satisfaction by targeting general health, subjective norms, optimism, and attitudes may provide promising ways to improve QOL.
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Affiliation(s)
- Seyedeh Belin Tavakoly Sany
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Aman
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Fatemeh Jangi
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Elaheh Lael-Monfared
- Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Jafari
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Saleem SS, Khan A, Aman R, Saleem SS, Bibi A, Ahmad N, Mushtaq S, Mehsud S, Green IR, Rashid SA, Khan A, Shah KU. Impact of pharmacist-led educational intervention on knowledge of self-management among asthmatic patients: a prospective cohort study. BMJ Open 2022; 12:e058861. [PMID: 35705337 PMCID: PMC9204400 DOI: 10.1136/bmjopen-2021-058861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Poor control of asthma in the majority of patients could be partly due to their lack of knowledge concerning disease management, its triggering agents and when to seek advice from the healthcare provider. This study aims to assess the impact of pharmacist-led educational intervention on knowledge of self-management among asthmatic patients. DESIGN A pre-post cohort study. SETTING Outpatient department of a tertiary care hospital affiliated with Quaid-i-Azam University, Pakistan. PARTICIPANTS Approximately 265 adult asthmatic patients selected through a spirometry process, aged ≥18 years, were approached. 240 patients gave consent to participate in the study and were divided into control and treatment groups. INTERVENTIONS The educational intervention consisted of individual patient counselling using educational material with time varied according to each patient's comprehension and previous knowledge. PRIMARY AND SECONDARY OUTCOME MEASURES Assessment consisted of a 14-item Asthma Self-Management Knowledge Questionnaire (ASMQ) quantifying a patient's self-management knowledge through an ASMQ score and its change following an educational intervention. RESULTS Disease self-management knowledge was low with an average raw ASMQ score of 4.1 (max 14); which equates to a transformed score of 29.34 (max 100) and the proportion of patients who correctly answered more than 50% of questions were 16.7% preintervention. More than half of the participants (55%) did not know that asthma cannot be cured. The administration of educational intervention protocols resulted in significantly improved level of knowledge of asthma self-management (<0.001) in the treatment group (mean ASMQ score improved from 4.20 to 9.77). CONCLUSION On baseline visit, patients possessed a poor knowledge about asthma self-management. Educational intervention protocols had a positive impact on improving patients' knowledge about disease self-management. This would suggest that education and self-management skills should be seen as an integral component of asthma management and should be incorporated in structured patient care to achieve optimal asthma control.
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Affiliation(s)
| | - Amjad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rubina Aman
- Department of Pulmonology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | - Ayesha Bibi
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Nafees Ahmad
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Saima Mushtaq
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Saifullah Mehsud
- Department of Pharmaceutical Sciences, Abbottabad University of Science and Technology, Havelian, Khyber Pakhtunkhwa, Pakistan
| | - Ivan R Green
- Department of Chemistry and Polymer Science, University of Stellenbosch, Stellenbosch, Western Cape, South Africa
| | - Sheikh Abdur Rashid
- Gomal Center of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Ahmad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
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Montalbano L, Ferrante G, Alesi M, La Grutta S. Integrating self-efficacy in the cyclical process of paediatric asthma management: a new perspective. PSYCHOL HEALTH MED 2022:1-9. [PMID: 35073809 DOI: 10.1080/13548506.2022.2029918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Asthma management consists of a cyclical process based on clinical assessment of the patient, the implementation of therapeutic adjustments, and evaluation of the patient's response. Self-efficacy is the person's confidence in his or her ability to successfully perform a behaviour and guides the patient's decisions for producing healthy behaviours.Studies have shown that asthma management is related to self-efficacy, which in turn can be influenced by various psychosocial factors. A literature search on the relationship between asthma and self-efficacy in paediatric age, has allowed us to hypothesize that adequate levels of self-efficacy might be achieved through a cyclical process, 'the self-efficacy cycle', taking into account assessment, identification of modifiable risk factors and patient's response. This would make it easier to identify the personal and social aspects on which to intervene to promote a proper management of the disease.
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Affiliation(s)
- Laura Montalbano
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Science and Human Movement (Sppeff), University of Palermo, Palermo, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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Dragonieri S, Quaranta VN, Scisci E, Capozza E, Barratta F, De Candia ML, Carpagnano GE. The role of education in the self-compilation of asthma control test score in patients with asthma. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022177. [PMID: 35775778 PMCID: PMC9335422 DOI: 10.23750/abm.v93i3.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Asthma Control Test (ACT) is a quick and easy tool that allows physicians to estimate the control of asthma symptoms. Previous studies showed that ACT can be self or physician-administered with similar results. AIM The aim of our study was to evaluate the role of instruction in the self-compilation of ACT and its difference with the physician-administered modality. METHODS We enrolled 114 patients with asthma from those attending our outpatient clinic. We divided our population into 3 groups, according to their level of education: 1) low level (primary, middle school; n= 34, age 54.3±11.1), 2) middle level (secondary school; n=44, age 38.2±13.8) and 3) high level (university degree; n=34, age 44.8±14.7). All participants answered the questionnaire in both self- and physician-administered ways. Then, we calculated the parameter ΔACT, defined as the difference between physician-administered and self-administered ACT score. The comparison of ΔACT among groups was assessed by Mann-Whitney U test. Moreover, Spearman correlation was used to assess linear relationship between physician- and self-administered ACT in the three groups. RESULTS Patients with low and middle education level had higher median ΔACT compared to individuals with high education level (2.17 and 2.15 vs 0.75, p<0.05 for both analysis). Moreover, the R2 value of the high education group (0.915) was higher than those with middle and low education (0.642 and 0.773, respectively). CONCLUSIONS Our data suggest that patients without high education levels tend to overestimate their perception of asthma symptoms. Thus, ACT should always be physician-administered in these asthmatic patients.
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Eassey D, Reddel HK, Ryan K, Smith L. Living with severe asthma: the role of perceived competence and goal achievement. Chronic Illn 2021; 17:416-432. [PMID: 31653174 DOI: 10.1177/1742395319884104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The overall aim of this study was to examine, among individuals living with severe asthma, the role of perceived competence in achieving their goals. METHODS Qualitative research methods were used to conduct in-depth semistructured interviews. Interviews were video and/or audio recorded, transcribed and analyzed inductively and deductively, informed by the self-determination theory construct of perceived competence. Thirty-six face-to-face interviews, lasting 1.5-4 h, were conducted across Australia. RESULTS Feeling competent to achieve asthma goals played a role in participants' ability to achieve broader goals. Their desire to achieve their broader goals was strongly driven by their perceived ability to master managing their condition, which at times required more than medical strategies. Two main themes were discerned from the analysis: (1) learning how to look after yourself: self-care is important and (2) reaching an agreement with severe asthma: being at one with the illness. DISCUSSION This study highlighted the influence of perceived competence on self-management and goal achievement in severe asthma. Healthcare providers could explore patients' perceived competence to set and achieve goals, as a self-management strategy. Future research should consider these findings when developing and implementing patient-driven, self-management interventions for those living with severe asthma.
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Affiliation(s)
- Daniela Eassey
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Kath Ryan
- School of Pharmacy, University of Reading, Reading, UK
| | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Maguire R, McKeague B, Kóka N, Coffey L, Maguire P, Desmond D. The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review. Mult Scler Relat Disord 2021; 56:103293. [PMID: 34624641 DOI: 10.1016/j.msard.2021.103293] [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] [Received: 08/31/2020] [Revised: 03/10/2021] [Accepted: 09/29/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Multiple Sclerosis (MS) is a highly variable condition characterised by uncertainty of disease course which can make formation of expectations about the future difficult. This systematic review aimed to examine associations between expectations, or Future Oriented Cognitions (FOCs), and Quality of Life (QOL) in people with MS (PwMS). METHODS Following PRISMA guidelines, literature up to October 2019 was searched using Medline, EMBASE, PsycINFO and Web of Science. Quantitative studies that investigated relationships between FOCs and QOL in PwMS (assessed using a standardised QOL assessment) were considered for inclusion. After data extraction, results were analysed using narrative synthesis, focusing on the valence of FOCs (positive, negative, unvalenced). Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). All stages of the review were patient-led by a person with MS. RESULTS A total of 13 studies met the review inclusion criteria, with a combined sample size of 4,179. Of these studies, 11 involved measures of positive FOCs, most commonly self-efficacy, one measured a negative FOC, with one FOC unclassified. Nine studies found significant associations between QOL and self-efficacy. Although other positively valenced constructs were less frequently reported, significant associations with higher QOL were also evidenced. CONCLUSIONS Identifying ways to foster positive FOCs, particularly self-efficacy, may have beneficial effects on QOL. More research is needed to understand the impacts of negative FOCs on QOL to determine whether these processes could be meaningfully targeted in interventions.
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Affiliation(s)
- Rebecca Maguire
- Department of Psychology, Maynooth University; Assisting Living and Learning Institute, Maynooth University.
| | | | | | - Laura Coffey
- Department of Psychology, Maynooth University; Assisting Living and Learning Institute, Maynooth University
| | - Phil Maguire
- Department of Computer Science, Maynooth University
| | - Deirdre Desmond
- Department of Psychology, Maynooth University; Assisting Living and Learning Institute, Maynooth University
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12
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Puspitasari AD, Prabawati BM, Rosyid AN. Community knowledge and attitude in recognizing asthma symptoms and using medication for asthma attacks: a cross-sectional study. J Basic Clin Physiol Pharmacol 2021; 32:467-472. [PMID: 34214341 DOI: 10.1515/jbcpp-2020-0466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/02/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Uncontrolled asthma may be life-threatening. Poor understanding of disease process and appropriate medication use appears to influence community attitude in facing asthmatic patients in an emergency, thereby contributing to increasing the risk of mortality. This study aimed to analyze community-level knowledge about asthma and attitude towards asthma management. METHODS This observational, cross-sectional study was conducted among the community in Gresik, Indonesia, from March to July 2019. Participants included in this study were adults, who could read, write, and communicate well. Data were collected through questionnaires to evaluate the level of knowledge and attitude towards asthma. RESULTS In total, 100 respondents were selected with 91% of women, with a mean age of 49.11 ± 14.42 years and with various levels of education. The respondents had good knowledge by getting a score of 76%. Knowledge regarding recognition of asthma symptoms was scored the highest (83%). However, knowledge about medication use for asthma was lacking, especially in identifying the medicine choice (21%) and inhaler use (48%). The respondents also showed a 'positive' attitude with a score of 89%. Most respondents (72%) agreed that when inhaled drugs were unable to relieve the asthma attack, they need to bring the patient to a hospital. CONCLUSIONS The level of respondent's knowledge in recognizing asthma symptoms was good, but there were misconceptions about asthma medication, especially in inhaler use. Overall, the respondents had a positive attitude towards asthma perception and management.
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Affiliation(s)
- Arina Dery Puspitasari
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | | | - Alfian Nur Rosyid
- Pulmonology and Respiratory Department, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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13
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Rhee H, Love T, Harrington D, Walters L, Mammen J, Sloand E. Long-term effects of a peer-led asthma self-management program on asthma outcomes in adolescent peer leaders. PATIENT EDUCATION AND COUNSELING 2021; 104:1415-1422. [PMID: 33339656 PMCID: PMC8164959 DOI: 10.1016/j.pec.2020.11.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To examine the long-term effects of a peer-led asthma self-management program on urban adolescent peer leaders with asthma. METHODS This longitudinal study includes 51 adolescents (16-20 years) enrolled in an asthma self-management program implemented at a one-day camp as peer leaders. Study outcomes, including quality of life, asthma control, asthma knowledge, and attitudes toward asthma were collected for 15 months post-intervention. Mixed-effects models were conducted to estimate time effects, and effect sizes were calculated for each model. RESULTS Of 51 enrolled, 41 completed the training, of which 35 successfully participated in the camp program. A total of 17 peer leaders withdrew between enrollment and 15-months follow-up. Quality of life, asthma control, and knowledge significantly improved after peer leader training and remained elevated for 15 months, while significant improvement in attitudes emerged immediately after camp, in which they served as leaders, and sustained for 15 months. CONCLUSION This study demonstrates the long-term positive effects of a peer-led program on a wide range of asthma outcomes in urban adolescent peer leaders. PRACTICE IMPLICATIONS A peer-led approach to asthma education providing peer leaders with intense training and leadership experience can be effective and sustainable in improving asthma outcomes among urban adolescents.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY, 14642, USA.
| | - Tanzy Love
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
| | - Donald Harrington
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
| | - Leanne Walters
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY, 14642, USA.
| | - Jennifer Mammen
- University of Rhode Island College of Nursing, 350 Eddy St., Providence, RI, 02905, USA.
| | - Elizabeth Sloand
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
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14
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Vaquero-Lozano P, Lassaletta-Goñi I, Giner-Donaire J, Gómez-Neira MDC, Serra-Batlles J, García-García R, Álvarez-Gutiérrez FJ, Blanco-Aparicio M, Díaz-Pérez D. [Asthma 2020 Nursing Consensus Document]. OPEN RESPIRATORY ARCHIVES 2021; 3:100079. [PMID: 37497358 PMCID: PMC10369614 DOI: 10.1016/j.opresp.2020.100079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
Asthma is a chronic respiratory disease which presents with a risk of exacerbations. Good patient management and continuous monitoring are crucial for good disease control, and pharmacological and non-pharmacological interventions are essential for proper treatment. Nurses specialised in asthma can contribute to the correct management of asthmatic patients. They play a key role in diagnostic tests, administration of medication, and patient follow-up and education. This consensus arose from the need to address an aspect of asthma management that does not appear in the specific recommendations of current guidelines. This document highlights and updates the role of specialized nurses in the care and management of asthma patients, offering conclusions and practical recommendations with the aim of improving their contribution to the treatment of this disease. Proposed recommendations appear as the result of a nominal consensus which was developed during 2019, and validated at the beginning of 2020.
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Affiliation(s)
- Paz Vaquero-Lozano
- Servicio de Neumología, CEP Hermanos Sangro, Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | - Jordi Giner-Donaire
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - Joan Serra-Batlles
- Servicio de Neumología, Hospital Universitario de Vic, Barcelona, España
| | - Rocío García-García
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | | | - David Díaz-Pérez
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de Candelaria, Sta. Cruz de Tenerife, España
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15
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Qu D, Zhong X, Lai M, Dai J, Liang H, Huang A. Influencing Factors of Pre-Exposure Prophylaxis Self-Efficacy Among Men Who Have Sex With Men. Am J Mens Health 2020; 13:1557988319847088. [PMID: 31030626 PMCID: PMC6488787 DOI: 10.1177/1557988319847088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research examines the level of pre-exposure prophylaxis (PrEP) self-efficacy among HIV-negative men who have sex with men (MSM) in China and identifies the influencing factors associated with the level of PrEP self-efficacy in terms of social-demographic characteristics and social psychological factors. The data were gathered from a baseline assessment of a longitudinal randomized controlled intervention trial. From April 2013 to March 2015, nonprobability sampling was used to recruit HIV-negative MSM at Chongqing, Guangxi, Xinjiang, and Sichuan in west China. A total of 1884 HIV-negative MSM were analyzed. Chi-square test and nonparametric rank sum test were used for univariate analysis. Multivariable linear regression analysis was used to discuss the factors that influence the level of PrEP self-efficacy. Overall levels of PrEP self-efficacy were low, and five factors were found to effect PrEP self-efficacy: age, residence, AIDS-related knowledge, PrEP-related motivation, and anxiety. Age and anxiety score were negatively related to PrEP self-efficacy. The higher the age and anxiety score, the lower the PrEP self-efficacy. AIDS-related knowledge and PrEP-related motivation were actively related to PrEP self-efficacy. The higher the knowledge and motivation score, the higher the PrEP self-efficacy. In addition, the PrEP self-efficacy level of MSM in rural areas is lower than that in urban areas. The lower level of self-efficacy in the MSM population needs to be improved. Pertinent interventions should be taken to promote the self-efficacy of PrEP in MSM, to enhance their willingness to take medicine, improve their medication adherence, and thus reduce HIV infection among MSM.
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Affiliation(s)
- Dou Qu
- 1 Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, China.,2 Research Center for Medicine and Social Development, Chongqing Medical University, China.,3 Innovation Center for Social Risk Governance in Health, Chongqing Medical University, China
| | - Xiaoni Zhong
- 1 Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, China.,2 Research Center for Medicine and Social Development, Chongqing Medical University, China.,3 Innovation Center for Social Risk Governance in Health, Chongqing Medical University, China
| | - Minqing Lai
- 1 Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, China.,2 Research Center for Medicine and Social Development, Chongqing Medical University, China.,3 Innovation Center for Social Risk Governance in Health, Chongqing Medical University, China
| | - Jianghong Dai
- 4 Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, China
| | - Hao Liang
- 5 Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, China
| | - Ailong Huang
- 6 Key Laboratory of Molecular Biology, Ministry of Molecular Biology, Infectious Diseases, Medical University of Chongqing, China
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16
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Crimi C, Campisi R, Noto A, Genco S, Cacopardo G, Nolasco S, Crimi N. Comparability of asthma control test scores between self and physician-administered test. Respir Med 2020; 170:106015. [PMID: 32843163 DOI: 10.1016/j.rmed.2020.106015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Asthma Control Test (ACT) is a tool that allows physicians to estimate the control of asthma symptoms on each patient in a quick way. METHODS We conducted a prospective single-center observational study enrolling 97 patients with asthma, selected from the Outpatient Respiratory Service of "Policlinico-Vittorio Emanuele" in Catania. Patients answered the ACT in full autonomy. Subsequently, the physician, blinded to the previous ACT evaluation, administered a new ACT and then assessed patients' medical condition during his/her visit. A second physician evaluated patients' level of symptom control according to GINA guidelines. Agreement in ACT score was analyzed using the Kendall coefficient of concordance (W) for ACT individual items and overall score. The impact of different education levels on the ACT was analyzed with the Mann-Whitney test. MAIN FINDINGS There was no significant difference in ACT total score obtained by either administration mode (p > 0.05). Responses to ACT single items showed a statistically significant difference between patients with lower and higher education levels in ACT items n°3 and 5, (p < 0.05), with lower education levels influencing patients symptom perception and disease control. Moreover, a significant difference in the evaluation of asthma control was found between ACT and GINA assessment of symptom control (p < 0.05).
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Affiliation(s)
- Claudia Crimi
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Via S. Sofia, 78, 95123, Catania, Italy.
| | - Raffaele Campisi
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Via S. Sofia, 78, 95123, Catania, Italy.
| | - Alberto Noto
- Anesthesia and Intensive Care, AOU Policinico "G.Martino", Via Consolare Valeria 1, Messina, Italy.
| | - Sabrina Genco
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Giulia Cacopardo
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Santi Nolasco
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Nunzio Crimi
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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17
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Rhee H, Love T, Harrington D, Walters L. Comparing Three Measures of Self-Efficacy of Asthma Self-Management in Adolescents. Acad Pediatr 2020; 20:983-990. [PMID: 32194214 PMCID: PMC7483287 DOI: 10.1016/j.acap.2020.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study examines the relationships between 3 measures of asthma-related self-efficacy and compares them by their relationships to quality of life, medication adherence, asthma control, asthma knowledge, and attitudes in adolescents. METHODS Participants included 371 urban adolescents (age 12-20 years) with asthma. Three self-efficacy measures included the Asthma Outcome Expectation-self-efficacy subscale (AOE-SE), Asthma Management Index-self-efficacy subscale (AMI-SE), and the Asthma Self-Efficacy scale (ASE). RESULTS The sample included 50% male, predominantly African American (78.4%) participants. All 3 measures of self-efficacy were positively correlated with each other (r = 0.46-0.54, P < .001). After controlling for gender, age, race, and health insurance type, all 3 self-efficacy measures predicted the symptom domain of quality of life, adherence, asthma control, and knowledge. Activity limitation was predicted by AMI-SE (B = 0.19, P = .008) and ASE (B = 0.38, P < .001) but not by AOE-SE, while emotional function associated only with ASE (B = 0.37, P < 0.001). Attitudes were positively associated with AOE-SE and ASE (B = 1.83 and 2.87, respectively, P < 0.001 for both), but not with AMI-SE. CONCLUSIONS Medication adherence and symptom control in adolescents were predicted by self-efficacy measured by the 3 measures, while these measures differed in their performance in predicting psychosocial outcomes. ASE appears the measure of choice in measuring adolescents' self-efficacy given its association with all outcome measures of the study. Further research is needed to investigate the generalized use of the self-efficacy measures in populations with varying demographic or asthma characteristics.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing (H Rhee and L Walters), Rochester, NY.
| | - Tanzy Love
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY14642, USA
| | - Donald Harrington
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY14642, USA
| | - Leanne Walters
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY 14642, USA
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18
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Holley S, Knibb R, Latter S, Liossi C, Mitchell F, Radley R, Roberts G. Development and validation of the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ). Eur Respir J 2019; 54:13993003.01375-2018. [PMID: 31048348 DOI: 10.1183/13993003.01375-2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 04/09/2019] [Indexed: 11/05/2022]
Abstract
Perceived self-efficacy is the belief that one can manage prospective situations. Good asthma self-management self-efficacy is associated with better asthma outcomes. However, a well-developed and validated tool to measure adolescent asthma self-management self-efficacy is lacking. Our objective was to develop and validate an Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).The first stage of the study included a review of the literature, interviews with adolescents with asthma and consultations with parents and relevant healthcare professionals to develop a prototype scale. To assess reliability and validity, a further group of adolescents completed the prototype scale, the General Self-Efficacy Scale and KidCOPE (measures coping styles). Retesting was undertaken to assess longitudinal validity.Interviews with 28 adolescents and consultations with other stakeholders resulted in a 38-item prototype scale. Key themes were medication, symptom management, triggers, knowledge, attitude and beliefs around asthma, supportive relationships, schools and healthcare professionals. The prototype scale was completed by 243 adolescents. Factor and reliability analysis reduced it to a 27-item scale with four subsections: symptom management; medication; friends, family and school; and asthma beliefs. The 27-item scale had respectable to excellent internal consistency (α's 0.78-0.91) with results that were stable over time (intra-class correlation=0.82) in 63 subjects who completed it twice. Better adolescent asthma self-efficacy was associated with better general self-efficacy and indices of better asthma management.The AASEQ is a reliable and valid tool that is likely to aid future research and practice focused on adolescent asthma self-management and could be a useful intermediate outcome measure to assess the impact of behavioural interventions.
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Affiliation(s)
- Simone Holley
- Clinical and Experimental Sciences and Human Development in Health, University of Southampton, Southampton, UK.,Both authors contributed equally
| | - Rebecca Knibb
- Dept of Psychology, Aston University, Birmingham, UK.,Both authors contributed equally
| | - Sue Latter
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Christina Liossi
- School of Psychology, University of Southampton, Southampton, UK.,Dept of Paediatric Psychology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Frances Mitchell
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - Ruth Radley
- Dept of Paediatrics, Salisbury NHS Foundation Trust, Salisbury, UK.,NIHR/Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development in Health, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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19
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Livadiotis C, Lambrinou E, Raftopoulos V, Middleton N. Evaluation of the psychometric properties of the Greek version of the Active Life with Asthma (Gr-ALMA) review: a descriptive methodological study. BMC Health Serv Res 2019; 19:322. [PMID: 31117994 PMCID: PMC6530081 DOI: 10.1186/s12913-019-4155-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 05/08/2019] [Indexed: 12/18/2022] Open
Abstract
Background Regular asthma reviews are recommended by international guidelines to improve the quality of life of asthma patients. To facilitate these reviews in primary care practice, there is a need for structured asthma review tools. Aim The aim of this study was to assess the metric properties of the Greek-translated version of the Active Life with Asthma (ALMA) review. Methods A convenience sample of 156 asthmatic patients from three public hospitals participated in this methodological study with a descriptive cross-sectional correlation design. Participants responded to the 19-item ALMA questionnaire and provided socio-demographic and clinical information. The construct validity of the tool was explored in exploratory factor analysis and the internal consistency of scale and sub-scales was estimated using Cronbach’s α. Convergence validity was assessed using the Asthma Control Questionnaire (ACQ), a commonly used asthma control measure, and concurrent criterion validity was assessed using the MiniAQoL, an asthma-specific quality of life questionnaire. Known-group validity was assessed based on observed differences in terms of frequency of hospitalizations or emergency visits in the past year. Results Amongst 156 participants, 95 (60.9%) were women and the median age was 50–65 years old. Exploratory factor analysis (KMO = 0.83 and Bartlett test < 0.001) with principal component extraction and orthogonal rotation revealed a clear structure of three factors with little cross-loading: physical, environmental and mental domains, as in the original study. Cronbach’s alpha coefficient for internal consistency for the whole scale was 0.85, while for the sub-scales, these were: environmental a = 0.69, mental a = 0.76 and physical a = 0.85. Test-retest reliability based on the correlation between scores of 20 participants responding twice two weeks apart was r = 0.92. There was stong correlation in the expected direction between ALMA and ACQ (r = − 0.70) as well as miniAQoL (r = 0.71). Finally, there were statistically significant higher ALMA scores in participants who reported emergency visits and hospital admissions in the past year. Conclusion In general, the ALMA showed good metric properties. It appears to be a reliable and valid tool which can be used as a measure for asthma control and self-management in clinical practice as well as future descriptive or intervention research studies.
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Affiliation(s)
- Chris Livadiotis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,Emergency Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Vasilios Raftopoulos
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,Hellenic Centre of Disease Control and Prevention, Athens, Greece
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
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20
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Melgarejo González-Conde V, Pérez-Fernández V, Ruiz-Esteban C, Valverde-Molina J. Impact of Self-Efficacy on the Quality of Life of Children With Asthma and Their Caregivers. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.arbr.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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21
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Melgarejo González-Conde V, Pérez-Fernández V, Ruiz-Esteban C, Valverde-Molina J. Impact of Self-Efficacy on The Quality of Life of Children With Asthma and Their Caregivers. Arch Bronconeumol 2018; 55:189-194. [PMID: 30119934 DOI: 10.1016/j.arbres.2018.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/08/2018] [Accepted: 07/13/2018] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Health-related quality of life is an important outcome measurement in the monitoring of asthma control. Self-efficacy is a determinant of self-management behaviors that can contribute to the improvement of asthma control and quality of life. Our objective was to analyze the relationship between self-efficacy and quality of life in children with asthma and their caregivers. METHODS We included 176 patients aged 6-14 years with asthma, and determined their level of self-efficacy according to three groups (low, medium and high levels). Each child and their main caregiver completed the PAQLQ and PACQLQ questionnaires, respectively. RESULTS PAQLQ range=1-7: 5.61±1.11; PACQLQ range=1-7: 5.42±1.35; self-efficacy range=0-60: low level 28.44±4.58; average level 37.41±1.7, and high level 47.50±5.5. Significant differences were observed in quality of life according to low-medium vs. high levels of self-efficacy. Specific related domains: PAQLQ emotions and PAQLQ symptoms with self-efficacy in problem-solving skills related to asthma and treatment self-efficacy; PACQLQ emotions with self-efficacy in problem-solving skills related to asthma. CONCLUSIONS A high level of self-efficacy is associated with a better quality of life for children and their caregivers. Based on these results, the measurement of self-efficacy could be incorporated in the assessment of educational interventions in self-management targeted at the quality of life of the patient and his or her family.
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Affiliation(s)
| | - Virginia Pérez-Fernández
- Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, IMIB, Facultad de Medicina, Universidad de Murcia , El Palmar, Murcia, España
| | - Cecilia Ruiz-Esteban
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Murcia, Espinardo, Murcia, España
| | - José Valverde-Molina
- Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, IMIB, Facultad de Medicina, Universidad de Murcia , El Palmar, Murcia, España; Unidad de Neumología Pediátrica, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, España
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22
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Young Muslim Women Living with Asthma in Denmark: A Link between Religion and Self-Efficacy. PHARMACY 2018; 6:pharmacy6030073. [PMID: 30041428 PMCID: PMC6165087 DOI: 10.3390/pharmacy6030073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 11/17/2022] Open
Abstract
Asthma is a chronic respiratory disease that can be controlled with appropriate medicinal treatment. Adherence to pharmacological treatment is therefore critical. Self-efficacy plays a key role in adherence to medicine in chronic diseases, including asthma. Additionally, ethnic minorities have poor adherence to medicines. However, the impact of religion on self-efficacy and adherence is understudied. Therefore, the aim of this study was to explore the role of self-efficacy in adherence to asthma medicine treatment and the influence of religion on self-efficacy among young, Muslim minority women. A focus group and individual interviews with 10 Muslim minority women (14–24 years of age) living in Denmark were conducted. Data analysis was deductive using Bandura’s theory of self-efficacy and modes of agency. Overall, religion was shown to affect self-efficacy. The women reported changes in self-perceived self-efficacy during the holy month of Ramadan. In addition, praying was used as an alternative to medicine for controlling asthma symptoms. However, the women did not perceive religion and treating asthma with medicine as mutually exclusive, but rather as coexisting for the shared goal of controlling asthma symptoms. It is important for healthcare professionals (HCPs) to be aware of the link between self-efficacy, religion and adherence to asthma medicine treatment. This awareness can aid HCPs in giving advice regarding adherence to asthma treatment, and when monitoring treatment to improve the quality of asthma care for young Muslim minority women.
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Sherman KA, Kilby CJ, Elder E, Ridner SH. Factors associated with professional healthcare advice seeking in women at risk for developing breast cancer-related lymphedema. PATIENT EDUCATION AND COUNSELING 2018; 101:445-451. [PMID: 29107400 DOI: 10.1016/j.pec.2017.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/27/2017] [Accepted: 10/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Approximately 6-20% of breast cancer patients undergoing lymph node surgery will develop lymphedema. At-risk individuals are encouraged to seek professional healthcare advice if symptoms arise. This study aimed to identify cognitive and affective factors associated with professional healthcare advice (PHCA) seeking behavior in women with heightened lymphedema risk. METHODS Women with increased lymphedema risk (N=462) completed an online survey measuring cognitive and affective responses to lymphedema risk, including the Illness Perception Questionnaire (Revised), and adherence to seeking PHCA. RESULTS Overall, 62% of women reported seeking professional healthcare advice if symptoms arose. Logistic regression analysis indicated that adherence to seeking PHCA if lymphedema symptoms arise was associated with greater illness coherence, belief in the efficacy of seeking PHCA, and lymphedema risk-related emotional distress. CONCLUSION Women were more likely to seek PHCA if symptoms arose if they held a coherent understanding of lymphedema and believed in the usefulness of seeking PHCA. For these women, psychological distress associated with lymphedema risk was associated with enhanced adherence to seeking PHCA. PRACTICE IMPLICATIONS Health professionals should target lymphedema education to ensure at-risk women have a coherent understanding of lymphedema and that they believe in the effectiveness of seeking PHCA to help manage lymphedema symptoms.
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Affiliation(s)
- Kerry A Sherman
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
| | - Christopher J Kilby
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
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Nguyen VN, Huynh TTH, Chavannes NH. Knowledge on self-management and levels of asthma control among adult patients in Ho Chi Minh City, Vietnam. Int J Gen Med 2018; 11:81-89. [PMID: 29520161 PMCID: PMC5833772 DOI: 10.2147/ijgm.s157050] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Most asthma patients in Vietnam have poorly controlled asthma. Besides reasons related to the health care system and health care providers, knowledge on the self-management of patients has also contributed to this situation. PURPOSE To assess knowledge on asthma self-management among adult asthma patients in Ho Chi Minh City. PATIENTS AND METHODS A cross-sectional study with convenience sampling was conducted among 322 ambulatory patients using questionnaires filled in via a face-to-face interview. The questionnaires enquired about: 1) sociodemographic details, 2) the Global Initiative for Asthma 2017 criteria of asthma control, 3) the Asthma Control Test, and 4) the Asthma Self-Management Questionnaire (ASMQ). Knowledge on asthma self-management was determined by the ASMQ score. The relationship between this knowledge and demographic factors and asthma control levels was determined. RESULTS The knowledge on asthma self-management was low, with a mean raw ASMQ score of 4.3 (maximum 14); this is equivalent to 30 in a transformed score (maximum 100). Only 0.3% of these patients had good knowledge, 16.2% had adequate knowledge, and 83.5% had poor knowledge. Of all participants, 52% stated erroneously that asthma can be cured, 30% were confused about control and rescue medications, 68% failed to correctly describe the inhalation technique, and only 15.5% could answer correctly about the management of an exacerbation. Although most participants had poor asthma control, the higher the patient's level of control, the better the ASMQ score. Conversely, patients with better knowledge of asthma self-management (ASMQ score ≥50) had better asthma control based on the Asthma Control Test score. Also, a higher education level was associated with more knowledge on asthma self-management. CONCLUSION In these patients, the level of knowledge on asthma self-management was low and significantly correlated with the level of asthma control. There is a clear need to improve knowledge in order to improve asthma control in Vietnam.
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Affiliation(s)
- Vinh Nhu Nguyen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
- Department of Respiratory Functional Exploration, University Medical Center, Ho Chi Minh City, Vietnam
| | - Thuong Thi Hoai Huynh
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
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Luckie K, Pang TC, Kritikos V, Saini B, Moles RJ. Systematic review and content analysis of asthma knowledge questionnaires: A focus on the knowledge surrounding acute exacerbation management. J Asthma 2017; 55:615-628. [PMID: 28759285 DOI: 10.1080/02770903.2017.1355380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Asthma education is a key component of asthma management. Asthma education around the management of a person who is having an acute exacerbation of asthma (often referred to as asthma first aid (AFA) training) is important, particularly in a school setting. There is no gold standard assessment of asthma knowledge and also there is no specific tool to measure the knowledge of AFA. Our aim was to identify asthma knowledge questionnaires and perform a content analysis. We were interested in evaluating the number, the type and the format of AFA questions. METHOD A literature search was performed to identify the instruments which were able to assess asthma knowledge of people with asthma and/or caregivers of people with asthma. An electronic database search was performed in EMBASE, IPA, MEDLINE and PUBMED. Articles which described the development or psychometric testing of an asthma knowledge questionnaire were included. The content of questions in each instrument was analysed and categorised using the NVivo software, and a secondary analysis was performed to identify knowledge questions relevant to the management of an acute asthma exacerbation. RESULTS Forty-four papers with 37 different instruments met the inclusion criteria. The majority of the instruments contained a relatively low proportion of questions related to the management of acute asthma, i.e., only 162 of the 780 questions (21%). No questionnaire had sufficient specific emphasis on acute asthma management knowledge to test the impact of AFA training. CONCLUSION There is a scope to develop an up-to-date validated acute asthma management knowledge questionnaire for use in research and clinical settings.
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Affiliation(s)
- Kate Luckie
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia
| | - Tsz Chun Pang
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.,b Faculty of Pharmacy , University of Nottingham , Nottingham , UK
| | - Vicky Kritikos
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.,c Woolcock Institute of Medical Research , Sydney , NSW , Australia
| | - Bandana Saini
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia
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van der Laan J, Boersma SN, van Straaten B, Rodenburg G, van de Mheen D, Wolf JRLM. Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy? HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1265-1275. [PMID: 28122408 DOI: 10.1111/hsc.12429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 06/06/2023]
Abstract
Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = -0.45, P < 0.001), income (β = 0.14, P = 0.002) and being institutionalised (β = 0.12, P = 0.004). In conclusion, the majority of homeless adults entering the social relief system have personal goals regarding socioeconomic resources and their goal-related self-efficacy is positively related to QoL. It is therefore important to take the personal goals of homeless people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions.
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Affiliation(s)
- Jorien van der Laan
- Impuls - Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Sandra N Boersma
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara van Straaten
- IVO, Addiction Research Institute, Rotterdam, The Netherlands
- Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Gerda Rodenburg
- IVO, Addiction Research Institute, Rotterdam, The Netherlands
- Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Dike van de Mheen
- IVO, Addiction Research Institute, Rotterdam, The Netherlands
- Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Health Promotion, Maastricht University, the Netherlands
| | - Judith R L M Wolf
- Impuls - Netherlands Center for Social Care Research, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Callander EJ, Schofield DJ. The Potential for Poverty to Lower the Self-Efficacy of Adults With Asthma: An Australian Longitudinal Study. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 8:141-5. [PMID: 26739407 PMCID: PMC4713877 DOI: 10.4168/aair.2016.8.2.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/10/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE It is known that strong feelings of self-efficacy are linked with better management of asthma. However, it is not known whether the experience of poverty can detrimentally impact the self-efficacy feelings of asthma patients. This paper aims to determine whether falling into income or multidimensional poverty lowers self-efficacy among people diagnosed with asthma. METHODS Longitudinal analysis of Waves 7 to 11 (2007 to 2011) of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey using generalized linear models. The analysis was limited to those who had been diagnosed with asthma. The Freedom Poverty Measure was used to identify those in multidimensional poverty. RESULTS People with asthma who fell into income poverty had significantly lower self-efficacy scores-23% lower (95% CI: -35.1 to -9.1), after falling into income poverty for 3 or 4 years between 2007 and 2011 compared to those who were never in income poverty. Those who fell into multidimensional poverty also had significantly lower self-efficacy scores-25% lower (95% CI: -42.8 to -2.0), after being in multidimensional poverty for 3 or 4 years between 2007 and 2011 compared to those who were never in poverty. CONCLUSIONS Asthmatics who fall into poverty are likely to experience a decline in their feelings of self-efficacy. The findings of this study show that experiencing poverty should be a flag to identify those who may need extra assistance in managing their condition.
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Londoño AMM, Schulz PJ. Influences of health literacy, judgment skills, and empowerment on asthma self-management practices. PATIENT EDUCATION AND COUNSELING 2015; 98:908-917. [PMID: 25907737 DOI: 10.1016/j.pec.2015.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 03/04/2015] [Accepted: 03/07/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED Asthma self-management has been recognized as an essential factor for the improvement of asthma outcomes and patients' quality of life (WHO, 2013). Likewise, empowerment and health literacy have been noted as important elements for the management of chronic diseases. OBJECTIVE To study the influence of health literacy and empowerment on asthma self-management. METHODS This cross-sectional study used a self-reported questionnaire assessing health literacy, judgment skills, empowerment, and asthma self-management; 236 patients were recruited from medical offices in Switzerland and Italy. RESULTS Judgment skills (B=2.28, p<0.001) and empowerment (B=0.19, p<0.05) have a significant and positive influence on several asthma self-management practices such as use of medicines, timely medical consultation, and asthma triggers control whereas health literacy (B=-0.15, p<0.175) appeared to have a negative effect on self-management practices. However, this was not significant. CONCLUSIONS These findings suggest that empowered patients with adequate judgment skills carry out key self-management tasks more appropriately, which in turn will potentially result in better asthma control. PRACTICE IMPLICATIONS This study recommends that both empowerment and judgment skills should be addressed in patient education as they serve as essential motivators to engage patients in these behaviors.
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Affiliation(s)
| | - Peter J Schulz
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland.
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Lowther H, Newman E, Sharp K, McMurray A. Attentional bias to respiratory- and anxiety-related threat in children with asthma. Cogn Emot 2015; 30:953-67. [PMID: 25966340 DOI: 10.1080/02699931.2015.1036842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated attentional biases in children with asthma. The study aimed at testing whether children with asthma are vigilant to asthma and/or anxiety cues. Thirty-six children (18 with asthma and 18 healthy controls) aged 9-12 completed a computerised dot probe task designed to measure attentional bias to three different categories of words: asthma, anxiety symptom and general negative emotion. Main caregiver anxiety was also assessed, as was frequency of inhaler use for those with asthma. Children with asthma showed an attentional bias towards asthma words but not anxiety or general negative emotion words. Children without asthma showed no significant attentional biases to any word categories. Caregiver anxiety was correlated with asthma word attentional bias in the asthma group. The findings indicate that attentional bias is present in children with asthma. Further research is required to ascertain if this exacerbates or maintains health-related problems.
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Affiliation(s)
- Helen Lowther
- a Department of Paediatric Clinical Psychology , Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde , Glasgow , Scotland.,b Department of Clinical and Health Psychology , School of Health in Social Science, University of Edinburgh , Edinburgh , Scotland
| | - Emily Newman
- b Department of Clinical and Health Psychology , School of Health in Social Science, University of Edinburgh , Edinburgh , Scotland
| | - Kirstin Sharp
- c Department of Paediatric Clinical Psychology , Andrew Lang Unit, Selkirk, NHS Borders , Edinburgh , Scotland
| | - Ann McMurray
- d Department of Respiratory and Sleep Medicine , Royal Hospital for Sick Children, NHS Lothian , Edinburgh , Scotland
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Psychosocial factors associated with adherence for self-management behaviors in women with breast cancer-related lymphedema. Support Care Cancer 2015; 24:139-146. [DOI: 10.1007/s00520-015-2766-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
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Zarei AR, Jahanpour F, Alhani F, Razazan N, Ostovar A. The Impact of Multimedia Education on Knowledge and Self-efficacy among Parents of Children with Asthma: A Randomized Clinical Trial. J Caring Sci 2014; 3:185-92. [PMID: 25276762 PMCID: PMC4171813 DOI: 10.5681/jcs.2014.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 06/08/2014] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Asthma is one of the most common chronic disease among children, and is considered as a global health problem. According to the guidelines of childhood Asthma, parental education in order to improve their knowledge and self-efficacy should be considered in clinical care. Therefore, this study was performed with the purpose of investigating the influence of multimedia education on knowledge and self-efficacy of the parents of children with Asthma. METHODS This study is a clinical trial which was carried out on 50 parents of children with Asthma. Data collection instrument included the demographic questionnaires, assessing knowledge and self-efficacy of the parents of children with Asthma. Reliability and validity of the instruments were assessed and the multimedia education was carried out for the experimental group. Data analysis was done using SPSS 13 and descriptive inferential statistical tests (independent t-test and Mann-Whitney). RESULTS History of Asthma was present in majority 52% of the families of the children and 54% reported smoking in their home. The average scores of knowledge and self-efficacy of the study samples in the experimental group showed an increase after multimedia education methods, so that there was a statistically significant difference between the experimental and control groups. CONCLUSION The results obtained in this study also demonstrate that educating parents through multimedia technology increase their knowledge and self-efficacy in their care of children.
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Affiliation(s)
- Ahmad Reza Zarei
- Departement of Nursing, Faculty of Nursing & Midwifery, Bushehr University of
Medical Sciences, Bushehr, Iran
| | - Faezeh Jahanpour
- Departement of Nursing, Faculty of Nursing & Midwifery, Bushehr University of
Medical Sciences, Bushehr, Iran
| | - Fatemeh Alhani
- Departement of Nursing, Faculty of Medicine, Tarbiat Modares University, Tehran,
Iran
| | - Najmeh Razazan
- Departement of Nursing, Faculty of Nursing & Midwifery, Bushehr University of
Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Departement of Epidemiology, Persian Gulf Tropical Medicine Research Center,
Bushehr University of Medical Sciences, Bushehr, Iran
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Ejebe IH, Jacobs EA, Wisk LE. Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma. J Asthma 2014; 52:105-13. [PMID: 25050834 DOI: 10.3109/02770903.2014.947429] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. METHODS We conducted a secondary data analysis of asthma self-efficacy using the 2009 and 2011-2012 California Health Interview Survey, in adults with asthma (n=7874). In order to examine if and how the effect of race/ethnicity and income on asthma self-efficacy may have been altered by health status, acculturation, and health care factors, we used staged multivariable logistic regression models. We conducted mediation analyses to evaluate which of these factors might mediate disparities in self-efficacy by race/ethnicity and income. RESULTS 69.8% of adults reported having high asthma self-efficacy. Latinos (OR 0.66; 95% CI 0.51-0.86), African-Americans (OR 0.50; 95% CI 0.29-0.83), American Indian/Alaskan Natives (OR 0.55; 95% CI 0.31-0.98) and Asian/Pacific Islanders (OR 0.34; 95% CI 0.23-0.52) were less likely to report high self-efficacy compared to Whites. Individuals with income below the federal poverty level (OR 0.56; 95% CI 0.40-0.78) were less likely to report high self-efficacy compared to higher income individuals. The relationship between income and self-efficacy was no longer significant after further adjustment for health care factors; however, the differences in race and ethnicity persisted. Receiving an asthma management plan mediated the relationship in certain subgroups. CONCLUSIONS Addressing modifiable health care factors may play an important role in reducing disparities in asthma self-efficacy.
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Affiliation(s)
- Ifna H Ejebe
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
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Abstract
People with bipolar disorders report a lower quality of life than the general population does, and few mutable factors associated with health-related quality of life (HRQoL) among people with bipolar disorders have been identified. Using a cross-sectional design, these analyses examined whether self-efficacy was associated with mental and physical HRQoL in a sample of 141 patients with bipolar disorder who completed baseline assessments for two randomized controlled trials. Multiple linear regression analyses indicated that higher levels of self-efficacy were associated with higher mental and physical HRQoL, after controlling for demographic factors and clinical factors (including mood symptoms, comorbid medical conditions, and substance use). Future research should examine whether targeted treatments that aim to improve self-efficacy (such as self-management interventions) lead to improvements in HRQoL among people with bipolar disorder and other serious mental illnesses.
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Shanmugam S, Varughese J, Nair MAS, Balasubramanian R, Velu S, Bhojan C, Devarajan V, Sabzghabaee AM. Pharmaceutical care for asthma patients: A Developing Country's Experience. J Res Pharm Pract 2014; 1:66-71. [PMID: 24991592 PMCID: PMC4076865 DOI: 10.4103/2279-042x.108373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: This study aims at the outcome of providing pharmaceutical care service for asthma patients through an active partnership between clinical pharmacist and patients, for an optimal pharmacotherapy and a better quality of life (QoL). Methods: In this controlled clinical trial, which was conducted for 8 months (2009) in the Institute of Pulmonary Medicine and Research Centre of a 550-bedded multispecialty tertiary care teaching hospital in India, all patients diagnosed with asthma at least 6 months before getting enrolled in this study were included (n = 66). Patients were divided into the intervention group who received pharmaceutical care through asthma education, medication counselling, instructions on lifestyle modifications, asthma care diary, etc., and the control group who were not provided any pharmaceutical care. Asthma control in the two groups was assessed using Asthma Control Test (ACT) at regular intervals. QoL in both groups was assessed at regular intervals using standardized Asthma Quality of Life Questionnaire (AQLQ). Findings: The mean AQLQ scores for the intervention group at the baseline were changed to significantly higher amounts in the final visit indicating overall, activity, symptoms, emotional, and environmental domains, respectively (P < 0.05). The mean ACT scores for intervention group at baseline were also increased in statistically significant amounts in the final visit for all the five ACT questions (P < 0.05). Conclusion: Our pharmaceutical care program showed a positive impact in improving patient's asthma-related QoL, lung function, and asthma control. By providing structured pharmaceutical care, clinical pharmacists can help asthma patients to achieve desired health outcomes.
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Affiliation(s)
- Sriram Shanmugam
- Department of Pharmacy Practice, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, India
| | - Jane Varughese
- Department of Pharmacy Practice, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, India
| | | | | | - Shivashankar Velu
- Department of Pharmacy Practice, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, India
| | - Chitra Bhojan
- Department of Pharmacy Practice, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, India
| | - Vidhya Devarajan
- Department of Pharmacy Practice, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, India
| | - Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, India
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Dowse R, Barford K, Browne SH. Simple, illustrated medicines information improves ARV knowledge and patient self-efficacy in limited literacy South African HIV patients. AIDS Care 2014; 26:1400-6. [PMID: 24975116 PMCID: PMC4124945 DOI: 10.1080/09540121.2014.931559] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Few studies have investigated antiretroviral (ARV) knowledge and self-efficacy in limited literacy patients. Using a randomized controlled study design, we investigated the influence of a simple pre-tested patient information leaflet (PIL) containing both text and illustrations on HIV- and ARV-related knowledge and on self-efficacy over six months in a limited literacy African population. The recruited patients were randomly allocated to either control (standard care) or intervention group (standard care plus illustrated PIL). HIV and medicines-related knowledge was evaluated with a 22-question test at baseline, one, three, and six months. Self-efficacy was assessed using a modified version of the HIV Treatment Adherence Self-Efficacy Scale. Two-thirds of the patients were female, mean age was 39.0 ± 9.6 years and mean education was 7.3 ± 2.8 years. Patients who received the PIL showed a significant knowledge increase over the six-month period (62.0-94.4%), with improvement at each subsequent interview whereas the control group showed no improvement. At baseline, side effect knowledge was the lowest (50-56%) but increased in the intervention group to 92%. Similarly, other medicine-related knowledge at baseline (57-67%) improved significantly (93%) and was sustained over six months. Cohen's d values post-baseline ranged between 1.36 and 2.18, indicating a large intervention effect. Self-efficacy improved significantly over six months in intervention but not control patients. At baseline, patients with ≤ 3 years of education had lower knowledge and self-efficacy but this was not observed post-intervention, which we attribute to the PIL mitigating the effect of limited education. Knowledge and self-efficacy were significantly correlated in the intervention group. In conclusion, a low-cost intervention of a well-designed, pre-tested, simple, illustrated PIL significantly increased both ARV knowledge and self-efficacy in HIV patients with limited education.
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Affiliation(s)
- R Dowse
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
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Cheung MMY, LeMay K, Saini B, Smith L. Does personality influence how people with asthma manage their condition? J Asthma 2014; 51:729-36. [PMID: 24690024 DOI: 10.3109/02770903.2014.910220] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Personality traits have been found to be associated with the management of chronic disease, however, there is limited research on these relationships with respect to asthma. Asthma management and asthma control are often suboptimal, representing a barrier to patients achieving good health outcomes. This explorative study aimed to investigate the relationship between correlates of asthma management and personality traits. METHODS Participants completed a postal survey comprising validated self-report questionnaires measuring personality traits (neuroticism, extraversion, openness to experiences, agreeableness, conscientiousness), asthma medication adherence, asthma control and perceived control of asthma. Relationships between asthma management factors and personality traits were examined using correlations and regression procedures. RESULTS A total of 77 surveys were returned from 94 enrolled participants. Significant relationships were found between personality traits and (i) adherence to asthma medications, and (ii) perceived control of asthma. Participants who scored high on the conscientiousness dimension of personality demonstrated higher adherence to their asthma medications. Women who scored low on the agreeableness dimension of personality and high on the neuroticism dimension had significantly lower perceived confidence and ability to manage their asthma. No statistically significant associations were found between asthma control and personality traits. CONCLUSIONS Three of the five personality traits were found to be related to asthma management. Future research into the role of personality traits and asthma management will assist in the appropriate tailoring of interventional strategies to optimize the health of patients with asthma.
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Predictors of perceived asthma control among patients managed in primary care clinics. Qual Life Res 2014; 24:55-65. [PMID: 24806353 DOI: 10.1007/s11136-014-0700-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To estimate the extent to which symptom status, physical activity, beliefs about medications, self-efficacy, emotional status, and healthcare utilization predict perceived asthma control over a period of 16 months among a primary care population. METHODS The current study is a secondary analysis of data from a longitudinal study that examined health outcomes of asthma among participants recruited from primary care clinics. Path analysis, based on the Wilson and Cleary and International Classification of Functioning, Disability and Health frameworks, was used to estimate the predictors of perceived asthma control. RESULTS The path analysis identified initial perceived asthma control asthma (β = 0.43, p < 0.0001), symptoms (β = 0.35, p < 0.0001), physical activity (β = 0.27, p < 0.0001), and self-efficacy (β = 0.29, p < 0.0001) as significant predictors of perceived asthma control (total effects, i.e., direct and indirect), while emotional status (β = 0.08, p = 0.03) was a significant indirect predictor through physical activity. The model explained 24 % of the variance of perceived asthma control. Overall, the model fits the data well (χ (2) = 6.65, df = 6, p value = 0.35, root-mean-square error of approximation = 0.02, Comparative Fit Index = 0.999, and weighted root-mean-square residual = 0.27). CONCLUSION Initial perceived asthma control, current symptoms status, physical activity, and self-efficacy can be used to identify individuals likely to have good perceived asthma control in the future. Emotional status also has an impact on perceived asthma control mediated through physical activity and should be considered when planning patient management. Identifying these predictors is important to help the care team tailor interventions that will allow individuals to optimally manage their asthma, to prevent exacerbations, to prevent other respiratory-related chronic disease, and to maximize quality of life.
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Federman AD, Wolf MS, Sofianou A, Martynenko M, O’Connor R, Halm EA, Leventhal H, Wisnivesky JP. Self-management behaviors in older adults with asthma: associations with health literacy. J Am Geriatr Soc 2014; 62:872-9. [PMID: 24779482 PMCID: PMC4024064 DOI: 10.1111/jgs.12797] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine self-management behaviors, including medication adherence and inhaler technique, in older adults with asthma and their association with health literacy. DESIGN Observational cohort study. SETTING Primary care and pulmonary specialty practices in two tertiary academic medical centers and three federally qualified health centers in New York, New York, and Chicago, Illinois. PARTICIPANTS Adults with moderate or severe persistent asthma aged 60 and older (N = 433). MEASUREMENTS Outcomes were adherence to asthma controller medications, metered dose inhaler (MDI) and dry powder inhaler (DPI) techniques, having a usual asthma physician, and avoidance of four common triggers. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults. RESULTS The mean age was 67, and 36% of participants had marginal or low health literacy. Adherence was low (38%) overall and worse in individuals with low health literacy (22%) than in those with adequate literacy (47%, P < .001) and after adjusting for demographic factors and health status (odds ratio (OR) = 0.48, 95% confidence interval (CI) = 0.31-0.73). Similarly, inhaler technique was poor; only 38% and 54% had good MDI and DPI technique, respectively. Technique was worse in those with low health literacy (MDI technique: OR = 0.57, 95% CI = 0.38-0.85; DPI technique: OR = 0.42, 95% CI = 0.25-0.71). Asthma self-monitoring and avoidance of triggers occurred infrequently but were less consistently associated with low health literacy. CONCLUSION Adherence to medications and inhaler technique are poor in older adults with asthma and worse in those with low health literacy. Clinicians should routinely assess controller medication adherence and inhaler technique and use low-literacy communication strategies to support self-management in older adults with asthma.
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Affiliation(s)
- Alex D. Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai
| | - Michael S. Wolf
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University
| | - Anastasia Sofianou
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai
| | - Melissa Martynenko
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai
| | - Rachel O’Connor
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University
| | - Ethan A. Halm
- Division of General Internal Medicine, University of Texas Southwestern Medical Center
| | - Howard Leventhal
- Institute of Health, Health Care Policy and Aging Research, Rutgers University
| | - Juan P. Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai
- Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai School of Medicine
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Young HN, Larson TL, Cox ED, Moreno MA, Thorpe JM, MacKinnon NJ. The active patient role and asthma outcomes in an underserved rural community. J Rural Health 2013; 30:121-7. [PMID: 24689537 DOI: 10.1111/jrh.12031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Patient activation, an individual's knowledge, skills, and confidence for managing their own health and health care, can play an important role in the management of chronic conditions. However, few studies have examined patient activation in underserved rural communities. The purpose of this study was to describe patient activation and examine how patient activation is associated with adherence to asthma maintenance medication and disease control in a low-income rural population with asthma. METHODS We conducted a cross-sectional telephone survey with 98 adults. Patient activation was assessed with the Patient Activation Measure. Adherence to long-term controller (LTC) medications and asthma control were examined using the Morisky Medication Adherence Scale (MMAS) and Asthma Control Test (ACT). Multivariate regression analyses were used to assess the associations between patient activation and: (1) adherence to LTC medications and (2) asthma control. FINDINGS The majority of participants (50%) were classified in the highest level of patient activation. The least activated participants had lower mean MMAS and ACT scores in comparison to participants who were classified in higher patient activation levels. Multivariate analyses found significant positive associations between patient activation and adherence and asthma control. CONCLUSIONS Patient activation may be instrumental in low-income rural patients' use of asthma medication and disease control. Study results inform interventions to help patients use asthma medications appropriately and achieve better asthma control. In addition to increasing access to health care services in rural communities, health care professionals also may develop and implement strategies to positively impact rural patients' involvement in care.
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Affiliation(s)
- Henry N Young
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, Wisconsin
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Baptist AP, Ross JA, Yang Y, Song PXK, Clark NM. A randomized controlled trial of a self-regulation intervention for older adults with asthma. J Am Geriatr Soc 2013; 61:747-53. [PMID: 23617712 DOI: 10.1111/jgs.12218] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate a self-regulation intervention for asthma for older adults. DESIGN A blinded randomized controlled trial. SETTING Single-center tertiary care academic center. PARTICIPANTS Seventy older adults aged 65 and older with persistent asthma randomized to an intervention or control group. INTERVENTION Participants participate in a six-session program conducted over the telephone and in group sessions. Participants selected an asthma-specific goal, identified problems, and addressed potential barriers. MEASUREMENTS Outcomes were assessed at 1, 6, and 12 months and included the mini-Asthma Quality of Life Questionnaire (mAQLQ), Asthma Control Questionnaire (ACQ), healthcare utilization, exhaled nitric oxide (FENO), and percentage of predicted forced expiratory volume in 1 second (FEV1%). RESULTS The mAQLQ score was significantly higher in the intervention group at 1, 6, and 12 months, even after controlling for confounding factors. The between-group difference decreased over time, although at 12 months, it remained greater than 0.5 points. The ACQ was better in the intervention group than in the control group at 1, 6, and 12 months. At 12 months, those in the intervention group were 4.2 times as likely as those in the control group to have an ACQ score in the controlled range. Healthcare utilization was lower in the intervention group, although no difference was observed in FENO or predicted FEV1%. CONCLUSION A self-regulation intervention can improve asthma control, quality of life, and healthcare utilization in older adults.
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Affiliation(s)
- Alan P Baptist
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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Belanger HG, Barwick FH, Kip KE, Kretzmer T, Vanderploeg RD. Postconcussive Symptom Complaints and Potentially Malleable Positive Predictors. Clin Neuropsychol 2013; 27:343-55. [DOI: 10.1080/13854046.2013.774438] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vasbinder EC, Janssens HM, Rutten-van Mölken MPMH, van Dijk L, de Winter BCM, de Groot RCA, Vulto AG, van den Bemt PMLA. e-Monitoring of Asthma Therapy to Improve Compliance in children using a real-time medication monitoring system (RTMM): the e-MATIC study protocol. BMC Med Inform Decis Mak 2013; 13:38. [PMID: 23514242 PMCID: PMC3637240 DOI: 10.1186/1472-6947-13-38] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many children with asthma do not have sufficient asthma control, which leads to increased healthcare costs and productivity loss of parents. One of the causative factors are adherence problems. Effective interventions improving medication adherence may therefore improve asthma control and reduce costs. A promising solution is sending real time text-messages via the mobile phone network, when a medicine is about to be forgotten. As the effect of real time text-messages in children with asthma is unknown, the primary aim of this study is to determine the effect of a Real Time Medication Monitoring system (RTMM) with text-messages on adherence to inhaled corticosteroids (ICS). The secondary objective is to study the effects of RTMM on asthma control, quality of life and cost-effectiveness of treatment. METHODS A multicenter, randomized controlled trial involving 220 children (4-11 years) using ICS for asthma. All children receive an RTMM-device for one year, which registers time and date of ICS doses. Children in the intervention group also receive tailored text-messages, sent only when a dose is at risk of omission. Primary outcome measure is the proportion of ICS dosages taken within the individually predefined time-interval. Secondary outcome measures include asthma control (monthly Asthma Control Tests), asthma exacerbations, healthcare use (collected from hospital records, patient reports and pharmacy record data), and disease-specific quality of life (PAQLQ questionnaire). Parental and children's acceptance of RTMM is evaluated with online focus groups and patient questionnaires. An economic evaluation is performed adopting a societal perspective, including relevant healthcare costs and parental productivity loss. Furthermore, a decision-analytic model is developed in which different levels of adherence are associated with clinical and financial outcomes. Also, sensitivity analyses are carried out on different price levels for RTMM. DISCUSSION If RTMM with tailored text-message reminders proves to be effective, this technique can be used in daily practice, which would support children with suboptimal adherence in their asthma (self)management and in achieving better asthma control and better quality of life. TRIAL REGISTRATION Netherlands Trial Register NTR2583.
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Affiliation(s)
- Erwin C Vasbinder
- Department of Hospital Pharmacy, Erasmus Medical Center, Nc-212, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
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Zhao J, Shen K, Xiang L, Zhang G, Xie M, Bai J, Chen Q. The knowledge, attitudes and practices of parents of children with asthma in 29 cities of China: a multi-center study. BMC Pediatr 2013; 13:20. [PMID: 23379859 PMCID: PMC3577449 DOI: 10.1186/1471-2431-13-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asthma is becoming increasingly prevalent among children in China. Poor parent knowledge and attitudes often contribute to inappropriate management practices, leading to deficiencies in the care process. We aimed to document the knowledge, attitudes and practices (KAP) of parents of children with asthma and analyze how knowledge and attitudes relate to practices. Our secondary objective was to identify the factors associated with parent KAP scores. METHODS A KAP questionnaire was distributed to parents caring for 2960 children (0-14 years) diagnosed with asthma for at least 3 months from China's 29 provinces. A 50-item questionnaire was devised for this cross-sectional survey based on a comprehensive review of the subject. Questionnaires were scored on 30 items regarding parent asthma-related KAP, with one point for every correct response and a possible range of 0-13 for knowledge, 0-7 for attitudes and 0-10 for practices. Higher scores indicated better KAP. Chi-squared tests and logistic regression were used to identify factors associated with practices and combined KAP scores. RESULTS The response rate was 83.95% (2485/2960). Only 18.31% (455/2485) of parents correctly answered ≥ 60% of the knowledge questions (mean = 5.69). Most (89.85%; 2226/2485) gave positive responses to ≥ 60% of the attitude questions (mean = 5.23) while 67.89% (1687/2485) correctly answered ≥ 60% of the practices questions (mean = 6.19). Knowledge and attitudes were positively associated with pulmonary function testing, regular physician visits, monitoring with a peak flow meter and the Children's Asthma Control Test questionnaire, avoidance of asthma triggers, using an inhaled β2 receptor agonist and adherence to medication regimen (p ≤ 0.05). Attitudes were also associated with allergen testing. In logistic regression analysis, high KAP scores (dichotomized by a cut-off score of 18) were positively associated with food allergy, rhinitis, physician visits, frequency of visits and parent education (p < 0.05, OR > 1). CONCLUSIONS Generally, the parents' KAP were poor. A gap between recommended and actual practice was observed, which may be related to inadequate knowledge about and poor attitudes toward childhood asthma. Improving knowledge and attitudes may encourage better practices among parents of children with asthma.
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Affiliation(s)
- Jing Zhao
- Capital Institute of Pediatrics, Beijing, China
| | | | - Li Xiang
- Beijing Children’s Hospital, Beijing, China
| | | | - Meng Xie
- Capital Institute of Pediatrics, Beijing, China
| | - Juan Bai
- Capital Institute of Pediatrics, Beijing, China
| | - Qiyi Chen
- Capital Institute of Pediatrics, Beijing, China
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Sofianou A, Martynenko M, Wolf MS, Wisnivesky JP, Krauskopf K, Wilson EAH, Goel MS, Leventhal H, Halm EA, Federman AD. Asthma beliefs are associated with medication adherence in older asthmatics. J Gen Intern Med 2013; 28:67-73. [PMID: 22878848 PMCID: PMC3539042 DOI: 10.1007/s11606-012-2160-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 06/04/2012] [Accepted: 06/12/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Empirical research and health policies on asthma have focused on children and young adults, even though asthma morbidity and mortality are higher among older asthmatics. OBJECTIVE To explore the relationship of asthma-related beliefs and self-reported controller medication adherence in older asthmatics. DESIGN An observational study of asthma beliefs and self-management among older adults. PARTICIPANTS Asthmatics ages ≥ 60 years (N = 324, mean age 67.4 ± 6.8, 28 % white, 32 % black, 30 % Hispanic) were recruited from primary care practices in New York City and Chicago. MAIN MEASURES Self-reported controller medication adherence was assessed using the Medication Adherence Report Scale. Based on the Common Sense Model of Self-Regulation, patients were asked if they believe they only have asthma with symptoms, their physician can cure their asthma, and if their asthma will persist. Beliefs on the benefit, necessity and concerns of treatment use were also assessed. Multivariate logistic regression was used to examine the association of beliefs with self-reported medication adherence. KEY RESULTS The majority (57.0 %) of patients reported poor adherence. Poor self-reported adherence was more common among those with erroneous beliefs about asthma illness and treatments, including the "no symptoms, no asthma" belief (58.7 % vs. 31.7 %, respectively, p < 0.001), "will not always have asthma" belief (34.8 % vs. 12.5 %, p < 0.001), and the "MD can cure asthma" belief (21.7 % vs. 9.6 %, p = 0.01). Adjusting for illness beliefs, treatment beliefs and demographics, patients with a "no symptoms, no asthma" belief had lower odds of having good self-reported adherence (odds ratio [OR] 0.45, 95 % confidence interval [CI] 0.23-0.86), as did those with negative beliefs about the benefits (OR 0.73, 95 % CI 0.57-0.94) and necessity (OR 0.89, 95 % CI 0.83-0.96) of treatment. CONCLUSIONS Illness and treatment beliefs have a strong influence on self-reported medication adherence in older asthmatics. Interventions to improve medication adherence in older asthmatics by modifying illness and treatment beliefs warrant study.
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Affiliation(s)
- Anastasia Sofianou
- Division of General Internal Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA
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Talreja N, Soubani AO, Sherwin RL, Baptist AP. Modifiable factors associated with severe asthma exacerbations in urban patients. Ann Allergy Asthma Immunol 2012; 109:128-32. [PMID: 22840254 DOI: 10.1016/j.anai.2012.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 05/24/2012] [Accepted: 06/05/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Rates of asthma morbidity, mortality, and resource use are highest among African American individuals residing in inner-city locations, yet factors associated with adverse outcomes are not well established. OBJECTIVE To identify modifiable factors associated with asthma exacerbations. METHODS A total of 104 adult patients who presented to an inner-city hospital or emergency department (ED) with an asthma exacerbation from October 1, 2009, through June 31, 2010, completed surveys of clinical status, acute events, sociodemographic characteristics, current asthma knowledge, self-efficacy, attitudes toward asthma self-management, and perceived barriers to asthma care questionnaires. Associations with asthma hospitalizations and ED visits were assessed. RESULTS The mean age of the patients was 42 years, 91% were African American, 33% were insured, 57% were taking a controller medication, and 63% had an income level below the federal poverty line. On bivariate analysis, males, years of asthma, history of smoking, self-classification of asthma severity, history of admission to intensive care unit or intubation, use of peak flow meter or asthma action plan, controller medication use, and history of oral corticosteroid bursts were positively associated, whereas self-efficacy was negatively associated with number of ED visits or hospitalizations. No association was found for asthma knowledge, perceived barriers to care, or attitudes toward asthma management. On multivariate analysis, low self-efficacy remained associated with both asthma hospitalizations and ED visits. CONCLUSION Short-term use of health services for asthma is negatively associated with asthma self-efficacy. Self-management programs that enhance self-efficacy, rather than those that focus on knowledge or attitudes, may be effective in reducing adverse asthma outcomes for inner-city, predominantly African American populations.
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Affiliation(s)
- Neetu Talreja
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Tampa, Florida 33612, USA.
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Lau Y. Traditional Chinese Pregnancy Restrictions, Health-Related Quality of Life and Perceived Stress among Pregnant Women in Macao, China. Asian Nurs Res (Korean Soc Nurs Sci) 2012; 6:27-34. [PMID: 25030688 DOI: 10.1016/j.anr.2012.02.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 02/21/2012] [Accepted: 02/22/2012] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The objectives of this study were to identify the prevalence and rationales of traditional Chinese pregnancy restrictions and to investigate the relationship between pregnancy restriction, health-related quality of life, and perceived stress level at a two-stage design. METHODS Stage I consisted of exploring the traditional Chinese pregnancy restrictions and their underlying beliefs based on extensive literature review followed by in-depth interviews with 30 pregnant women. Stage II investigated the relationship between pregnancy restrictions, health-related quality of life, and perceived stress among 1,151 women. Self-developed traditional Chinese pregnancy restrictions lists were measured on adherence towards the traditional Chinese pregnancy restriction. Perceived stress and health-related quality of life were measured by the Perceived Stress Scale and the Short Form-12 (SF-12) Health Survey, respectively. RESULTS The majority of the women adhered to traditional Chinese pregnancy restrictions in order to protect the unborn child from danger and to avoid the problems associated pregnancy and birth, such as miscarriage, stillbirth, death of the mother, and imperfections in the newborn. Pregnant women who adhered to behavioral restrictions were more likely to associate with poor physical component of health-related quality of life. However, there was no significant difference between pregnancy restrictions and Perceived Stress Scale scores. CONCLUSION The findings provided cultural rationales of pregnancy restrictions within a Macao context that may assist health professionals to better understand women from different cultures. It is essential in the development of culturally appropriate healthcare to support women in making a healthy transition to motherhood.
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Affiliation(s)
- Ying Lau
- School of Health Sciences, Macao Polytechnic Institute, Macao Special Administrative Region, China
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Mancuso CA, Peterson MGE, Gaeta TJ, Fernández JL, Birkhahn RH. Time to seeking emergency department care for asthma: self-management, clinical features at presentation, and hospitalization. J Asthma 2012; 49:275-81. [PMID: 22356431 DOI: 10.3109/02770903.2012.661011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Understanding the events preceding emergency department (ED) asthma visits can guide patient education regarding managing exacerbations and seeking timely care. The objectives of this analysis were to assess time to seeking ED care, self-management of asthma exacerbations, and clinical status on presentation. METHODS A total of 296 patients was grouped according to time to seeking ED care: ≤1 day (22%), 2-5 days (44%), and >5 days (34%) and was compared for clinical and psychosocial characteristics. Asthma severity at presentation was obtained from patient report with the Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ) and from physicians' ratings using decision to hospitalize as an indicator of worse status. RESULTS. Mean age was 44 years, 72% were women, 10% had been in the ED in the prior week, and 28% came to the ED by ambulance. Patients who waited longer were more likely to be older, have more depressive symptoms, and have been in the ED in the prior week. They also were more likely to have taken more medications, but they were not more likely to have visited or consulted their outpatient physicians. Patients who waited longer reported worse ACQ (p < .0001) and AQLQ (p = .0002) scores and were more likely to be hospitalized for the current exacerbation (odds ratio 1.9, 95% CI 1.1, 3.2, p = .03). CONCLUSIONS Patients who waited longer to come to the ED had worse asthma on presentation, had more functional limitations, and were more likely to be hospitalized. The ability to gauge severity of exacerbations and the use of the ED in a timely manner are important but often overlooked are self-management skills that patients should be taught.
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Affiliation(s)
- Carol A Mancuso
- Department of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY 10021, USA.
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Ahmed S, Bartlett SJ, Ernst P, Paré G, Kanter M, Perreault R, Grad R, Taylor L, Tamblyn R. Effect of a web-based chronic disease management system on asthma control and health-related quality of life: study protocol for a randomized controlled trial. Trials 2011; 12:260. [PMID: 22168530 PMCID: PMC3268749 DOI: 10.1186/1745-6215-12-260] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 12/14/2011] [Indexed: 11/24/2022] Open
Abstract
Background Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Effective patient self-management is critical for improving health outcomes. However, key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Health information technology (HIT) provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team, and access to their health information, presented in personalized ways that can alert them when there is a need for action. The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system, My Asthma Portal (MAP), linked to a case-management system on asthma control, and asthma health-related quality of life. Methods The trial is a parallel multi-centered 2-arm pilot randomized controlled trial. Participants are randomly assigned to one of two conditions: a) MAP and usual care; or b) usual care alone. Individuals will be included if they are between 18 and 70, have a confirmed asthma diagnosis, and their asthma is classified as not well controlled by their physician. Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug database, and asthma quality of life using the Mini Asthma Related Quality of Life Questionnaire. Power calculations indicated a needed total sample size of 80 subjects. Data are collected at baseline, 3, 6, and 9 months post randomization. Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010. Discussion Self-management support from the care team is critical for improving chronic disease outcomes. Given the high volume of patients and time constraints during clinical visits, primary care physicians have limited time to teach and reinforce use of proven self-management strategies. HIT has the potential to provide clinicians and a large number of patients with tools to support health behaviour change. Trial Registration Current Controlled Trials ISRCTN34326236.
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Affiliation(s)
- Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, 3654 Prom. Sir William Osler, Montreal, QC, Canada.
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Saini B, LeMay K, Emmerton L, Krass I, Smith L, Bosnic-Anticevich S, Stewart K, Burton D, Armour C. Asthma disease management-Australian pharmacists' interventions improve patients' asthma knowledge and this is sustained. PATIENT EDUCATION AND COUNSELING 2011; 83:295-302. [PMID: 21621947 DOI: 10.1016/j.pec.2011.05.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 04/28/2011] [Accepted: 05/02/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To assess any improvements in knowledge of asthma patients after a tailored education program delivered by pharmacists and measure the sustainability of any improvements. To ascertain patients' perceptions about any changes in their knowledge. METHODS Ninety-six specially trained pharmacists recruited patients based on their risk of poor asthma control. A tailored intervention was delivered to patients based on individual needs and goals, and was conducted at three or four time points over six months. Asthma knowledge was assessed at the beginning and end of the service, and six and 12 months after it had ended. Patients' perceptions of the impact of the service on their knowledge were explored qualitatively in interviews. RESULTS The 96 pharmacists recruited 570 patients, 398 (70%) finished. Asthma knowledge significantly improved as a result of the service (7.65 ± 2.36, n=561, to 8.78 ± 2.14, n=393). This improvement was retained for at least 12 months after the service. Patients reported how the knowledge and skills gained had led to a change in the way they managed their asthma. CONCLUSION Improvements in knowledge are achievable and sustainable if pharmacists used targeted educational interventions. PRACTICE IMPLICATIONS Pharmacist educational interventions are an efficient way to improve asthma knowledge in the community.
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Affiliation(s)
- Bandana Saini
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
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