The Impact of Various Influences on Self-Management of Adult African-Americans with Asthma

Tuesday, 10 November 2015: 10:20 AM

James Daniel Holland, PhD, MSN, RN, CNL, RRT, RCP
School Of Nursing, Valdosta State University, Valdosta, GA, USA

There are approximately 22.2 million Americans who are living with asthma and of those 18.4 millon are adults. African Americans are more likely to be diagnosed with asthma comparted to Caucasions and experience more asthma attacks. This research study used the Social Cognitive Theory to examine relationships among personal characteristics, environment factors, asthma self-efficacy, self-management behaviors, and quality of life (QOL) in African Americans adults with asthma. A correlational design was used. Data were collected from a non-random sample of adult African Americans with asthma (N=39) using the following self-report questionnaires: the Knowledge, Attitude, and Self-Efficacy of Asthma Questionnnaire (KASE), the short form of the Rapid Estimate of Adult Literacy in Medicine (REALM-SF), the Medical Outcomes Study (MOS) for social support, the Asthma Trigger Inventory (ATI), the Morisky Medication Adherence Questionnaire, Asthma Self-Management (ASMQ), the Modified Pittsburgh Sleep Quality Index (PSQI), the Asthma Control Test (ACT), and the Asthma Quality of Life Standardized (AQLQ-S). Data analyses included descriptive statistics, Pearson Product correlations, and hierarchical multiple regression. On average, participants (N=39) were middled aged (M=55.9±7.9) years, female (65%), did not smoke (87%), did not use a peak flow meter (PEFR) to self-manage their asthma (72%) and were obese (M = 34.96, SD=10.78). Partcipants reported high confidence in asthma self-management; however, had low medication adherence and scores indicating uncontrolled asthma (M=16.10, SD = 4.29). More than half (67%) of the participants reported poor sleep quality (PSQI). BMI and sleep quality accounted for significant variance (38%) in asthma QOL (F (2,38) = 7.08, p = .001). Social support was an independent predictor of asthma self-efficacy (F (2,38) = 5.65, p = .02). Better control of weight and asthma symptoms may improve sleep quality. Health care providers need to address the ongoing challenges of asthma self-manage and monitor sleep quality. Encouraging the use of peak flow meters, which have been shown to improve self-management an asthm control, may result in better quality of life for African Americans with asthma.