Barriers to asthma self-management in adolescents: Relationships to psychosocial factors.
Barriers to asthma self-management in adolescents: Relationships to psychosocial factors.
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DOI：
10.1002/ppul.20972
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发表时间：
2009-02
影响因子：
3.1
通讯作者：
Brasch, Judith
中科院分区：
文献类型：
--
作者：
Rhee, Hyekyun;Belyea, Michael J.;Ciurzynski, Susan;Brasch, Judith
青少年的哮喘发病率往往是哮喘自我管理不足的结果。本研究旨在探讨青少年自我管理的障碍及其与知识、态度、自我效能等心理社会因素的关系。这项横断面研究包括126名患有哮喘的青少年(13-21岁)，他们代表具有广泛社会经济地位的不同种族/民族群体。采用描述性统计、因素分析和分层回归等方法对自报数据进行分析。最常被认可的障碍(63%)是青少年不愿放弃“医生说我必须放弃的东西”，其次是难以记住照顾他们的哮喘(53%)，然后是“试图忘记”他们患有哮喘(50%)。心理社会因素解释了总障碍知觉差异的32%。因素分析发现，在四个方面存在障碍，包括对提供者和用药方案的消极态度、认知困难、同伴/家庭影响和否认。自我效能感被发现是最有影响力的因素，与哮喘控制水平和社会人口学特征无关的所有四个障碍分量表都显示出强烈的负相关。在调整了其他因素后，对哮喘的不良态度也与认知障碍和社会影响有关。男性总是报告更高的总障碍和消极、社会影响和否认障碍。性别差异不能用心理社会和社会人口因素来解释。这项研究表明，心理社会因素是青少年自我管理障碍的有力预测因素。特别是，提高自我效能感可能有助于解决这些障碍。需要特别注意解决男性障碍倾向较高的问题。
Asthma morbidity in adolescents often results from inadequate asthma self-management. This study was to explore barriers to self-management perceived by adolescents and to examine the associations between barriers and psychosocial factors including knowledge, attitude and self-efficacy. This cross-sectional study included a total of 126 adolescents with asthma (13–21 years) representing diverse race/ethnicity groups with a wide range of socioeconomic status. Self-reported data were analyzed using descriptive statistics, factor analysis and hierarchical regression. The most frequently endorsed barrier (63%) was adolescents’ unwillingness to give up “the things the doctors say I have to give up,” followed by difficulty in remembering to take care of their asthma (53%), and then “trying to forget” that they have asthma (50%). Psychosocial factors accounted for 32% of the variance in total barrier perceptions. Factor analysis revealed barriers in four domains including negativity toward providers and the medication regimen, cognitive difficulty, peer/family influence and denial. Self-efficacy was found to be the most influential factor that showed strong negative association with all four barrier subscales independent of the levels of asthma control and sociodemographic characteristics. Poor attitudes toward asthma were also associated with barriers of cognitive difficulty and social influence after adjusting for other factors. Males consistently reported higher total barriers and barriers of negativity, social influence and denial. The gender differences were not explained by psychosocial and sociodemographic factors. This study suggests that psychosocial factors are strong predictors of barriers to self-management in adolescents. Particularly, promoting self-efficacy may be beneficial in addressing the barriers. Special attention is needed to address the higher propensity for barriers in males.
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影响因子：
14.2
作者：
George, M;Freedman, TG;Apter, AJ
通讯作者：
Apter, AJ
影响因子：
5.9
作者：
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2.2
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通讯作者：
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作者：
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影响因子：
3.4
作者：
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通讯作者：
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