{"title":"泰国青少年哮喘患者自我管理行为、症状控制、健康相关生活质量及其影响因素之间的因果关系","authors":"Jinnaphat Sangngam , Tassanee Prasopkittikun , Apawan Nookong , Punchama Pacharn , Chalermpol Chamchan","doi":"10.1016/j.ijnss.2023.06.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To examine causal relationships among asthma self-management behaviors, asthma symptom control, health-related quality of life and the influencing factors among Thai adolescents.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted using convenience sampling. A total of 240 adolescent-caregiver dyads from three tertiary hospitals in Bangkok, Thailand was ultimately included. Interviews and self-administered questionnaires assessing health-related quality of life, asthma symptom control, asthma self-management behaviors, health literacy, depression, comorbidities, family support, peer support, home environmental management, and relationships with health care providers were administered between November 2020 and July 2021. A hypothesized model based on the revised self- and family-management framework was proposed. Data were analyzed using descriptive statistics and path analysis.</p></div><div><h3>Results</h3><p>It was shown that the proposed model was a good fit for the empirical data and accounted for 67.2% of the variance in health-related quality of life. Depression and asthma symptom control directly affected quality of life (<em>β</em> = −0.132, <em>P</em> < 0.05; and <em>β</em> = 0.740, <em>P</em> < 0.05, respectively), while asthma self-management behaviors did not. Both depression and asthma self-management behaviors had indirect effects on the quality of life through asthma symptom control (<em>β</em> = −0.382, <em>P</em> < 0.05; and <em>β</em> = 0.225, <em>P</em> < 0.05, respectively). Health literacy (<em>β</em> = 0.343, <em>P</em> < 0.05), family support (<em>β</em> = 0.167, <em>P</em> < 0.05), peer support (<em>β</em> = 0.163, <em>P</em> < 0.05), and relationships with health care providers (<em>β</em> = 0.181, <em>P</em> < 0.05) also showed direct effects on asthma self-management behaviors.</p></div><div><h3>Conclusion</h3><p>The findings confirmed the causal relationships among asthma symptom control, self-management behaviors, depression and health-related quality of life. Health literacy, support from family and peers, and relationships with health care providers were also found to influence asthma self-management behaviors. To achieve effective asthma control and good quality of life, a nursing intervention promoting asthma self-management for Thai adolescents should be developed. Early detection and intervention of depressive symptoms are also suggested.</p></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401355/pdf/","citationCount":"1","resultStr":"{\"title\":\"Causal relationships among self-management behaviors, symptom control, health-related quality of life and the influencing factors among Thai adolescents with asthma\",\"authors\":\"Jinnaphat Sangngam , Tassanee Prasopkittikun , Apawan Nookong , Punchama Pacharn , Chalermpol Chamchan\",\"doi\":\"10.1016/j.ijnss.2023.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To examine causal relationships among asthma self-management behaviors, asthma symptom control, health-related quality of life and the influencing factors among Thai adolescents.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted using convenience sampling. A total of 240 adolescent-caregiver dyads from three tertiary hospitals in Bangkok, Thailand was ultimately included. Interviews and self-administered questionnaires assessing health-related quality of life, asthma symptom control, asthma self-management behaviors, health literacy, depression, comorbidities, family support, peer support, home environmental management, and relationships with health care providers were administered between November 2020 and July 2021. A hypothesized model based on the revised self- and family-management framework was proposed. Data were analyzed using descriptive statistics and path analysis.</p></div><div><h3>Results</h3><p>It was shown that the proposed model was a good fit for the empirical data and accounted for 67.2% of the variance in health-related quality of life. Depression and asthma symptom control directly affected quality of life (<em>β</em> = −0.132, <em>P</em> < 0.05; and <em>β</em> = 0.740, <em>P</em> < 0.05, respectively), while asthma self-management behaviors did not. Both depression and asthma self-management behaviors had indirect effects on the quality of life through asthma symptom control (<em>β</em> = −0.382, <em>P</em> < 0.05; and <em>β</em> = 0.225, <em>P</em> < 0.05, respectively). Health literacy (<em>β</em> = 0.343, <em>P</em> < 0.05), family support (<em>β</em> = 0.167, <em>P</em> < 0.05), peer support (<em>β</em> = 0.163, <em>P</em> < 0.05), and relationships with health care providers (<em>β</em> = 0.181, <em>P</em> < 0.05) also showed direct effects on asthma self-management behaviors.</p></div><div><h3>Conclusion</h3><p>The findings confirmed the causal relationships among asthma symptom control, self-management behaviors, depression and health-related quality of life. Health literacy, support from family and peers, and relationships with health care providers were also found to influence asthma self-management behaviors. To achieve effective asthma control and good quality of life, a nursing intervention promoting asthma self-management for Thai adolescents should be developed. Early detection and intervention of depressive symptoms are also suggested.</p></div>\",\"PeriodicalId\":37848,\"journal\":{\"name\":\"International Journal of Nursing Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401355/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352013223000571\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Sciences","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352013223000571","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Causal relationships among self-management behaviors, symptom control, health-related quality of life and the influencing factors among Thai adolescents with asthma
Objective
To examine causal relationships among asthma self-management behaviors, asthma symptom control, health-related quality of life and the influencing factors among Thai adolescents.
Methods
A cross-sectional study was conducted using convenience sampling. A total of 240 adolescent-caregiver dyads from three tertiary hospitals in Bangkok, Thailand was ultimately included. Interviews and self-administered questionnaires assessing health-related quality of life, asthma symptom control, asthma self-management behaviors, health literacy, depression, comorbidities, family support, peer support, home environmental management, and relationships with health care providers were administered between November 2020 and July 2021. A hypothesized model based on the revised self- and family-management framework was proposed. Data were analyzed using descriptive statistics and path analysis.
Results
It was shown that the proposed model was a good fit for the empirical data and accounted for 67.2% of the variance in health-related quality of life. Depression and asthma symptom control directly affected quality of life (β = −0.132, P < 0.05; and β = 0.740, P < 0.05, respectively), while asthma self-management behaviors did not. Both depression and asthma self-management behaviors had indirect effects on the quality of life through asthma symptom control (β = −0.382, P < 0.05; and β = 0.225, P < 0.05, respectively). Health literacy (β = 0.343, P < 0.05), family support (β = 0.167, P < 0.05), peer support (β = 0.163, P < 0.05), and relationships with health care providers (β = 0.181, P < 0.05) also showed direct effects on asthma self-management behaviors.
Conclusion
The findings confirmed the causal relationships among asthma symptom control, self-management behaviors, depression and health-related quality of life. Health literacy, support from family and peers, and relationships with health care providers were also found to influence asthma self-management behaviors. To achieve effective asthma control and good quality of life, a nursing intervention promoting asthma self-management for Thai adolescents should be developed. Early detection and intervention of depressive symptoms are also suggested.
期刊介绍：
This journal aims to promote excellence in nursing and health care through the dissemination of the latest, evidence-based, peer-reviewed clinical information and original research, providing an international platform for exchanging knowledge, research findings and nursing practice experience. This journal covers a wide range of nursing topics such as advanced nursing practice, bio-psychosocial issues related to health, cultural perspectives, lifestyle change as a component of health promotion, chronic disease, including end-of-life care, family care giving. IJNSS publishes four issues per year in Jan/Apr/Jul/Oct. IJNSS intended readership includes practicing nurses in all spheres and at all levels who are committed to advancing practice and professional development on the basis of new knowledge and evidence; managers and senior members of the nursing; nurse educators and nursing students etc. IJNSS seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Contributions are welcomed from other health professions on issues that have a direct impact on nursing practice.
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