title: Behavioural effect of self-treatment guidelines in a self-management program for adults with asthma.
abstract: To assess the efficacy of self-management programs it is important to know what behavioural changes take place. This paper assesses whether including self-treatment guidelines (action plans) in a self-management program for adult asthmatics, leads to greater behavioural changes than a program without these guidelines. Patients were randomised into a self-treatment group (n=123) or an active control group (n=122). All subjects received self-management training. Discussed topics included the pathophysiology of asthma, medication and side-effects, triggers, symptoms, smoking, physical exercise, and compliance. The only difference was that the self-treatment group received instructions about self-treatment of exacerbations and the control group did not. At 1 year of follow-up asthma-specific self-efficacy expectancies, outcome expectancies, and asthma-specific knowledge improved significantly in all patients. Only self-treatment group patients demonstrated favourable changes in generalised self-efficacy, social support, and self-treatment and self-management behaviour, in case of a hypothetical scenario of a slow-onset exacerbation. We conclude that our self-management program is effective in changing the behavioural variables, and including self-treatment guidelines (action plans) has added benefit.
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Postbus 50000, 7500KA, Enschede, The Netherlands. vdpalen@euronet.nl
authors.forename: J
authors.initials: J
authors.lastname: van der Palen
authors.forename: J J
authors.initials: JJ
authors.lastname: Klein
authors.forename: G A
authors.initials: GA
authors.lastname: Zielhuis
authors.forename: C L
authors.initials: CL
authors.lastname: van Herwaarden
authors.forename: E R
authors.initials: ER
authors.lastname: Seydel
mesh_terms: D000328:Adult; D001249:Asthma / Q000628:therapy*; D005260:Female; D017408:Guidelines as Topic; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care; D020377:Self Efficacy