Columbia University School of Nursing, New York, NY, USA.
Medical University of South Carolina, Charleston, SC, USA.
J Sch Nurs. 2024 Dec;40(6):608-617. doi: 10.1177/10598405221116017. Epub 2022 Jul 25.
Rural adolescents with asthma are a disparate group. Self-management is essential to asthma control. We describe asthma knowledge, self-efficacy, and self-management behaviors among 198 rural adolescents with poorly controlled asthma, exploring demographic differences; we also test the application of Social Cognitive Theory to asthma self-management examining if self-efficacy mediates associations between knowledge and self-management. Asthma knowledge and self-management were relatively poor in our sample, particularly among male and White adolescents; greater knowledge was significantly associated with better symptom prevention and management. Self-efficacy partially mediated the association between knowledge and symptom prevention, but not acute symptom management, suggesting that knowledge may not improve symptom prevention behaviors without confidence to implement such behaviors and that factors beyond knowledge and self-efficacy likely play a role in asthma self-management in this population. Addressing asthma knowledge and self-efficacy could improve self-management and, ultimately, enhance asthma control among rural adolescents with poorly controlled asthma.
农村青少年哮喘患者是一个多样化的群体。自我管理对于哮喘控制至关重要。我们描述了 198 名农村青少年哮喘患者的哮喘知识、自我效能感和自我管理行为，这些患者的哮喘控制不佳，探讨了人口统计学差异；我们还应用社会认知理论检验了自我效能感是否在哮喘自我管理中调节了知识和自我管理之间的关联，考察了自我效能感是否在知识和症状预防之间起中介作用。在我们的样本中，哮喘知识和自我管理都相对较差，特别是在男性和白人青少年中；更多的知识与更好的症状预防和管理显著相关。自我效能感部分中介了知识和症状预防之间的关联，但与急性症状管理无关，这表明在没有实施这些行为的信心的情况下，知识可能不会改善症状预防行为，而且在这一人群中，可能有知识和自我效能感之外的因素在哮喘自我管理中发挥作用。提高哮喘知识和自我效能感可以改善自我管理，最终提高农村青少年哮喘患者的哮喘控制水平。
