Lemaigre Valentine, Van den Bergh Omer, Van Hasselt Katrien, De Peuter Steven, Victoir An, Verleden Geert
Department of Respiratory Diseases, University Clinic Gasthuisberg, Leuven, Belgium.
Chest. 2005 Nov;128(5):3133-9. doi: 10.1378/chest.128.5.3133.
Asthma education programs improve asthma treatment results significantly. Low participation rate is a recurrent problem that impedes the efficiency of those programs. The purpose of this study was to investigate social cognitive determinants of the intention to participate in an asthma self-management program.
Structured interview.
Outpatient clinic, University Hospital Gasthuisberg, Leuven, Belgium.
One hundred seven asthmatic outpatients (mean age 42 years; 35% male).
Patients received a standard explanation about the asthma program, were invited to participate, and were questioned about their beliefs about the program offered.
A social cognitive framework (attitude, social influence, and self-efficacy model) was used to compose a structured interview that was administered to assess the patients' attitude toward the program (perceived benefits), their social influence, and self-efficacy expectations to participate (perceived barriers). Asthma-related health behavior and clinical and demographic characteristics were evaluated by means of questionnaires. Fifty-nine percent of the patients expressed the intention to participate. Logistic regression analysis resulted in a model explaining 72% of the variance of intentions (Nagelkerke R(2) = 0.72). Having few structural barriers to participate was a significant predictor of participation (odds ratio [OR], 12.5; 95% confidence interval, 5.2 to 19.3), next to believing in the personal benefits of the program (OR, 7.6; 95% confidence interval, 2.4 to 12.5), social influence (OR, 3.3; 95% confidence interval, 1.3 to 8.4), and education level (OR, 2.7; 95% confidence interval, 1.3 to 5.6).
Recruitment of patients with asthma for an educational program should emphasize personal benefits of the program, should include patients' social network, and should consider the impact of structural barriers on participation behavior.
哮喘教育项目能显著改善哮喘治疗效果。参与率低是一个反复出现的问题，阻碍了这些项目的效率。本研究的目的是调查参与哮喘自我管理项目意愿的社会认知决定因素。
结构化访谈。
比利时鲁汶大学医院加斯豪斯贝格门诊。
107名哮喘门诊患者（平均年龄42岁；35%为男性）。
患者接受了关于哮喘项目的标准解释，被邀请参与，并被询问他们对所提供项目的看法。
采用社会认知框架（态度、社会影响和自我效能模型）编制结构化访谈，以评估患者对该项目的态度（感知益处）、社会影响以及参与的自我效能期望（感知障碍）。通过问卷评估哮喘相关健康行为以及临床和人口统计学特征。59%的患者表示有参与意愿。逻辑回归分析得出一个模型，该模型解释了意愿差异的72%（Nagelkerke R² = 0.72）。参与的结构性障碍少是参与的一个重要预测因素（比值比[OR]，12.5；95%置信区间，5.2至19.3），此外还有相信项目的个人益处（OR，7.6；95%置信区间，2.4至12.5）、社会影响（OR，3.3；95%置信区间，1.3至8.4）和教育水平（OR，2.7；95%置信区间，1.3至5.6）。
招募哮喘患者参加教育项目应强调项目的个人益处，应纳入患者的社交网络，并应考虑结构性障碍对参与行为的影响。
