农村青少年哮喘控制不佳与焦虑、自我效能和自我护理的关系。
Associations among anxiety, self-efficacy, and self-care in rural adolescents with poorly controlled asthma.
机构信息
Office of Scholarship and Research, Columbia University School of Nursing, New York, New York.
Department of Psychology, Brooklyn College and The Graduate Center, The City University of New York, New York, New York.
出版信息
Ann Allergy Asthma Immunol. 2021 Dec;127(6):661-666.e1. doi: 10.1016/j.anai.2021.09.010. Epub 2021 Sep 20.
BACKGROUND
Rural adolescents are vulnerable to asthma; good self-care can reduce morbidity. The subtypes of anxiety (eg, asthma-related, generalized) may have differential associations with asthma self-care. Low self-efficacy, a determinant of behavior, is associated with increased anxiety. Little is known regarding these relationships in rural adolescents.
OBJECTIVE
To evaluate whether anxiety symptoms are associated with asthma symptom prevention and management among rural adolescents and whether self-efficacy mediates these relationships.
METHODS
We used baseline data from 197 rural adolescents (mean age = 16 years; 69% girls; 62% Black) who were part of a trial that tested the effectiveness of a school-based asthma intervention. Adolescents completed the Youth Asthma-Related Anxiety Scale, Screen for Child Anxiety and Emotional Disorders, Asthma Management Self-efficacy Index, and Asthma Prevention and Management Indices. Linear regression was performed to test whether: (1) asthma-related and generalized anxiety had curvilinear relationships with self-care; (2) social and separation anxiety had linear relationships with self-care; and (3) self-efficacy mediated relationships.
RESULTS
Asthma-related anxiety had a significant curvilinear relationship with prevention (P = 0.001) and a linear association with management (P = .01). Generalized anxiety had a significant curvilinear association with management (P = .03), whereas social anxiety had a significant linear relationship with prevention (P = .04). Self-efficacy partially or fully mediated these relationships.
CONCLUSION
Anxiety symptoms were associated with asthma self-care among this sample of rural adolescents, with differing roles for prevention and management. Self-efficacy may be a mechanism to improve asthma self-care among rural adolescents with anxiety. With a lack of self-efficacy, asthma-related, generalized, or social anxiety may motivate adolescents to take steps to care for their asthma.
背景
农村青少年易患哮喘；良好的自我护理可以降低发病率。焦虑的亚型（如与哮喘相关的、广泛性的）可能与哮喘自我护理有不同的关联。行为的决定因素——低自我效能感与焦虑增加有关。在农村青少年中，这些关系知之甚少。
目的
评估农村青少年的焦虑症状是否与哮喘症状预防和管理有关，以及自我效能感是否在这些关系中起中介作用。
方法
我们使用了一项针对农村青少年（平均年龄 16 岁；69%为女孩；62%为黑人）的基于学校的哮喘干预试验的基线数据。青少年完成了青少年哮喘相关焦虑量表、儿童焦虑和情绪障碍筛查、哮喘管理自我效能指数和哮喘预防和管理指数。线性回归用于检验以下假设：（1）与哮喘相关的和广泛性的焦虑与自我护理呈曲线关系；（2）社交和分离焦虑与自我护理呈线性关系；（3）自我效能感在这些关系中起中介作用。
结果
与哮喘相关的焦虑与预防（P = 0.001）和管理（P = 0.01）有显著的曲线关系。广泛性焦虑与管理有显著的曲线关系（P = 0.03），而社交焦虑与预防有显著的线性关系（P = 0.04）。自我效能感部分或完全中介了这些关系。
结论
在这个农村青少年样本中，焦虑症状与哮喘自我护理有关，预防和管理的作用不同。自我效能感可能是提高农村青少年焦虑症患者哮喘自我护理的一种机制。由于缺乏自我效能感，与哮喘相关的、广泛性的或社交焦虑可能会促使青少年采取措施来照顾自己的哮喘。
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