Causal relationships among self-management behaviors, symptom control, health-related quality of life and the influencing factors among Thai adolescents with asthma.
Jinnaphat Sangngam, Tassanee Prasopkittikun, Apawan Nookong and 2 others
PMID 37545770WHAT IT FOUND
Asthma self-management did not directly improve quality of life, but it improved symptom control, which then improved quality of life.
Depression and health literacy, family support, peer support, and trust in providers were key drivers of this self-management.
Key findings
01Self-management behaviors improved asthma symptom control, which in turn improved health-related quality of life, but self-management had no direct effect on quality of life.
02Health literacy, family support, peer support, and relationships with health care providers significantly influenced self-management behaviors.
03Depression had a strong negative effect on asthma symptom control and quality of life, but did not significantly affect self-management behaviors after controlling for other factors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data collection occurred during the COVID-19 pandemic, which may have artificially improved asthma symptom control due to increased health protective behaviors like masking and social distancing. Participants were recruited from tertiary hospitals with specialty clinics and had well-educated caregivers, limiting generalizability to the broader Thai adolescent population. The cross-sectional design with a one-month gap cannot definitively prove causality, despite the use of path analysis. Self-management behaviors were measured using a researcher-developed questionnaire with limited validation data.
Declared interests
The authors declare no competing financial interests or personal relationships. The study had no external funding.
The easy way to misread this
Do not conclude that self-management behaviors directly improve quality of life. The study found that self-management works by improving asthma symptom control, which then improves quality of life. Focusing solely on self-management education without ensuring it leads to better symptom control may not improve the patient's lived experience.