Are high generalised and asthma-specific self-efficacy predictive of adequate self-management behaviour among adult asthma patients?

Author(s): Klein, J. J., Seydel, E. R.

Journal/Book: Patient Educ Couns. 1997; 32: Customer Relations Manager, Bay 15, Shannon Industrial, Estate Co, Clare, Ireland. Elsevier Sci Ireland Ltd. S35-S41.

Abstract: In asthma self-management training, often self-treatment guidelines are included, because increased knowledge of asthma alone is not sufficient to change behaviour. One way to achieve behavioural changes is by increasing the patient's general and asthma-specific self-efficacy expectancies. This refers to beliefs in one's capabilities to execute the recommended course of action successfully. We wanted to assess whether high generalised and asthma-specific self-efficacy expectancies were predictive of adequate self-management and self-treatment behaviour. A questionnaire was sent to 4563 persons (18-65 years) who had used inhaled medication in 1993. Self-management and self-treatment behaviour were operationalised through a hypothetical scenario of a slow-onset asthma exacerbation. Of all 1262 asthmatic patients, 39.3% showed adequate self-treatment behaviour (self-adjusting their inhaled or oral steroids when appropriate). Age, asthma-specific outcome expectancies and knowledge were predictive of adequate self-treatment. Adequate self-management behaviour (self-treatment or seeking medical help) was observed in 56.4% of patients. Intentions towards self-management and asthma-specific knowledge were significant. Only knowledge has a relevant influence on both. Asthma-specific knowledge is the only factor that seems relevant for adequate self-management and self-treatment behaviour, which might be explained by the hypothetical nature of the scenario. When patients experience a real asthma exacerbation, self-efficacy expectancies will become more important. Only if knowledge of what to do is present will patients be able to show proper self-management and self-treatment behaviour. Our results suggest that self-treatment guidelines are only effective in combination with patient education, which is important for optimal control of their disease.

Note: Article vanderPalen J, Med Spectrum Twente, Afd Longziekten, Dept Pulm Med, Postbus 50 000, NL-7500 KA Enschede, NETHERLANDS

Keyword(s): asthma; self-management; adult patients; self-efficacy

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