ARE HIGH GENERALIZED AND ASTHMA-SPECIFIC SELF-EFFICACY PREDICTIVE OF ADEQUATE SELF-MANAGEMENT BEHAVIOR AMONG ADULT ASTHMA PATIENTS

In asthma self-management training, often self-treatment guidelines ar e included, because increased knowledge of asthma alone is not suffici ent to change behaviour. One way to achieve behavioural changes is by increasing the patient's general and asthma-specific self-efficacy exp ectancies. This refers to beliefs in one's capabilities to execute the recommended course of action successfully. We wanted to assess whethe r high generalised and asthma-specific self-efficacy expectancies were predictive of adequate self-management and self-treatment behaviour. A questionnaire was sent to 4563 persons (18-65 years) who had used in haled medication in 1993. Self-management and self-treatment behaviour were operationalised through a hypothetical scenario of a slow-onset asthma exacerbation. Of all 1262 asthmatic patients, 39.3% showed adeq uate self-treatment behaviour (self-adjusting their inhaled or oral st eroids when appropriate). Age, asthma-specific outcome expectancies an d knowledge were predictive of adequate self-treatment. Adequate self- management behaviour (self-treatment or seeking medical help) was obse rved in 56.4% of patients. Intentions towards self-management and asth ma-specific knowledge were significant. Only knowledge has a relevant influence on both. Asthma-specific knowledge is the only factor that s eems relevant for adequate self-management and self-treatment behaviou r, which might be explained by the hypothetical nature of the scenario . When patients experience a real asthma exacerbation, self-efficacy e xpectancies will become more important. Only if knowledge of what to d o is present will patients be able to show proper self-management and self-treatment behaviour. Our results suggest that self-treatment guid elines are only effective in combination with patient education, which is important for optimal control of their disease. (C) 1997 Elsevier Science Ireland Ltd.