Behavioural effect of self-treatment guidelines in a self-management program for adults with asthma

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 a dult asthmatics, leads to greater behavioural changes than a program withou t these guidelines. Patients were randomised into a self-treatment group (n = 123) or an active control group (n = 122). All subjects received self-ma nagement training. Discussed topics included the pathophysiology of asthma, medication and side-effects, triggers, symptoms, smoking, physical exercis e, and compliance. The only difference was that the self-treatment group re ceived instructions about self-treatment of exacerbations and the control g roup did not. At I year of follow-up asthma-specific self-efficacy expectan cies, outcome expectancies, and asthma-specific knowledge improved signific antly in all patients. Only self-treatment group patients demonstrated favo urable changes in generalised self-efficacy, social support, and self-treat ment and self-management behaviour, in case of a hypothetical scenario of a slow-onset exacerbation. We conclude that our self-management program is e ffective in changing the behavioural variables, and including self-treatmen t guidelines (action plans) has added benefit. (C) 2001 Elsevier Science Ir eland Ltd. All rights reserved.