Patient and Family Management of Asthma: Theory-Based Techniques for the Clinician

Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor 48109-2029.
Journal of Asthma (Impact Factor: 1.83). 07/2009; 31(6):427-435. DOI: 10.3109/02770909409089484

ABSTRACT Several model asthma education programs are available to improve patient self-management, and elements of these models are discussed as they relate to the teaching role of health-care providers. Self-regulation is being explored in current asthma education research, and preliminary findings of a study are presented that show self-regulation behaviors to be associated with more frequent use of asthma management strategies by patients. Using more management strategies was associated with being observant of symptoms (p = .0001) and feeling confident to manage them (p = .01). Taking more preventive actions was associated with being observant (p = .001) and feeling confident to keep the child out of the triggering situation (p = .02) and prevent symptoms (p = .001). Important issues arising from recent psychosocial research are outlined for consideration by the clinician. These include ways that counseling by the health professional can encourage self-regulation and better at-home management of asthma.

  • Health Education &amp Behavior 10/2014; 41(5):476-84. DOI:10.1177/1090198114549157 · 1.54 Impact Factor
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    ABSTRACT: Asthma is a common disease. World-wide experience has shown an increase in prevalence and severity, although whether the natural history of the disease is changing is unknown. International practice guidelines are presented for a stepwise treatment approach, emphasising the chronic nature of the inflammatory component of the disease. Compliance is a major issue. Physicians need to understand the problem and be actively involved in improving compliance. Merely creating a treatment plan is insufficient, and a broad understanding of the problems in dealing with a chronic disease is required. Methods to assess compliance have been developed. Biochemical measurements of biological fluids are familiar to most physicians. Significant limitations are found with their usefulness, including drug interactions, biological variability and practicality. Electronic monitoring of inhaler usage and pulmonary function can help evaluate compliance and effectiveness of treatment. An ideal way to monitor treatment has yet to be developed. Improving compliance has 3 important components: education, skills training and behaviour modification. Programmes for education about the illness, methods to control it and skills training needed for effective use of inhalers and peak flow meters have been developed. Behavioural changes are difficult to achieve and require a multifaceted approach. A self-management programme promotes patient involvement and a sense of control. Effective physicians are acquainted with their patients’ health beliefs and life circumstances. Promotion of compliance is a dynamic process that requires the physician to think in a patient-centred approach. Practical suggestions are made to identify areas where compliance is a problem and how to deal with it. Outcomes management will be assessed as reduced mortality and morbidity, and an improved quality of life.
    03/1996; 5(3). DOI:10.1007/BF03259082
  • Health Education &amp Behavior 10/2014; 41(5):469-75. DOI:10.1177/1090198114550471 · 1.54 Impact Factor