Processes of change in an asthma self-care intervention.
In this article, we present a qualitative exploration of the psychological and communication processes that occur within an intervention to improve self-care for people with asthma. In the context of a primary-care-based trial of the intervention, we collected data at three time points for 21 patients, comprising 2 audiotaped consultations (nurse and patient together) and individual semistructured interviews 3 months after the second consultation. Using framework analysis, we identified both psychological processes (illness understanding, affective response to asthma, and reasoned motivation) and patient-provider interactions (active patient involvement and individual tailoring). We use these findings to extend and refine the pre-existing theoretical model of behavior change underpinning the intervention, in particular with relation to patient-provider interaction processes. We conclude that it is important for developers and providers of asthma self-care interventions to attend to the style of delivery as well as the behavior change techniques involved.
1University of Exeter, Exeter, Devon, United Kingdom.
Sarah
S
Denford
John L
JL
Campbell
Julia
J
Frost
Colin J
CJ
Greaves
D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000523:psychology; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D055815:Young Adult
D018927:Anti-Asthmatic Agents
asthma; behavior change; education, patient; qualitative analysis, self-care; theory development