Volume 27, Issue 5 (3-2019)                   Avicenna J Nurs Midwifery Care 2019, 27(5): 306-314 | Back to browse issues page


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Sadeghi A, Kokabi S, oshvandi K, Tapak L. The Effect of Self-care Education on knowledge and Attitude in Patients with Asthma: A Randomized Clinical Trial. Avicenna J Nurs Midwifery Care 2019; 27 (5) :306-314
URL: http://nmj.umsha.ac.ir/article-1-2005-en.html
1- Department of Pediatric Nursing and Mental Health, Faculty of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
2- MSc, Faculty of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran , kokabiam.s@gmail.com
3- Maternal and Child Care Research Center, Faculty of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
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 The results of this study showed that self-care education is effective on knowledge and attitude in asthmatic patients. Therefore, considering the high prevalence of this disease and its economic and social burden, self-care education is recommended to improve the knowledge and attitude of asthmatic patients.


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Introduction

More than 1.5 billion people worldwide have chronic respiratory illnesses, and more than 4 million deaths occur worldwide each year from this group of diseases [1]. With the onset of symptoms, the disease has a profound effect on the patients' life course and affects their health, family life, group activity, social and work performance. [6] Thus, this group of patients is unaware of their disease [7]. Education plays an important role in improving the quality of life of patients with asthma [8]. Raising patients' awareness of self-care is one of the most important ways to control this disease. Self-care education, instead of relying on patient disabilities, can emphasize potential and reduce subtle costs, improve quality of life, and improve daily living activities [9]. Studies show that educational programs, despite their great variety in form, environment, target group, goals, teaching style, and outcomes evaluation, significantly improve knowledge, develop a positive attitude to asthma and increase its control skills, reduce school absenteeism, increase physical activity, increase sense of control over the disease and decrease the use of health care services [23].

 

Materials and Methods

The present study is a clinical trial. The samples of this study included 104 patients with asthma who referred to Lung Clinic of Shahid Beheshti Hospital in Hamadan. They were selected by convenience sampling and randomly divided into two groups of experimental and control (groups of 52 individuals).
Inclusion criteria included having an asthma approved by a physician, lack of experience in formal training such as workshops and research on asthma, having other chronic illnesses, age 20-65 years, no communication problems like deafness and literacy. Exclusion criteria were exclusion for any reason during the study such as death, relocation and unwillingness to continue in the study, patients with severe asthma who were admitted to the ward.
Three questionnaires used in this study were: a) demographic variables questionnaire; b) self-knowledge questionnaire about asthma; c) attitude questionnaire for asthma.
The demographic questionnaire included age, gender, occupation, education level, marital status, years of asthma and smoking. The Asthma Knowledge Questionnaire was developed by Mazloumi et al. and its reliability based on Cronbach's alpha coefficient was reported 0.71 [28]. The validity of the questionnaire has been confirmed by experts based on content method [28]. The questionnaire consists of 3 subscales and 32 questions. A total of 8 items for disease recognition subscale, 8 items for Drug Recognition subscale, and 16 items for asthma-inducing agents subscale were scored; the final score was measured as 0–32. The higher the score, the greater patient awareness. The manner of answering the questions was also determined by the choice of three options: yes, no and I don’t know. For each correct answer, a score of one was assigned and a score of zero for the answer I don't know or false. The reliability of this questionnaire in the present study was 0.88.
The Asthma Attitude Questionnaire was also developed by Mazloumi et al. and its reliability was 0.71 based on Cronbach's alpha coefficient [28]. The validity of the questionnaire based on content method has been confirmed by experts [28]. This is a seven-question questionnaire. Questions are asked in which the patients state their agreement or disagreement with the terms specified. The answers are on a Likert scale, from (1) strongly disagree to (5) strongly agree. The score obtainable in this construct is in the range of 7-35. A score of 5 was completely acceptable and a score of 1 was completely opposite. The reliability of this questionnaire was 0.87 in Cronbach's alpha.
After providing necessary explanations about the research, written consent was obtained from patients and demographic information of both groups was recorded through interview. Then the knowledge and attitude of the patients were measured using the questionnaires. Patients in the experimental group were divided into 2 to 5 groups. PowerPoint software and lecture were given to the experimental group in four sessions of one session per week. The duration of each session was 60 minutes. Coordination was done to hold meetings by phone or SMS. Training sessions were held in the clinic class of Shahid Beheshti Hospital.


 

Results

Of the 104 asthmatic patients included in the study, 52 were in the experimental group and 52 in the control group. The distribution of patients in the two groups was not significantly different in all demographic characteristics. There was a statistically significant difference between the mean score of knowledge and the dimensions of this questionnaire in the pre- and post-intervention groups, while in the control group, in relation to the recognition of the triggers and the general awareness of the asthma, there was a significant difference before intervention, but no significant difference was found in disease and drug cognition (P<0.05). The results of independent t-test showed that there was no significant difference between the mean of pre-intervention knowledge between the experimental and control groups (P=0.98). Whereas the same test showed a significant difference between the two groups after the intervention (P<0.001). There was no significant difference between the mean scores of attitude before intervention between the experimental and control groups (P=0.96), while the mean of attitude scores after the intervention was significant (P<0.001) (Table 1).
 

Table 1. Comparison of mean knowledge and dimensions of knowledge and attitude between experimental and control groups before and after intervention


 

Discussion

Self-care education has increased the awareness and attitude of patients with asthma. The present study showed that although there was no significant difference in the mean score of asthma patients in the experimental and control groups at the beginning of the study, eight weeks after the intervention there was a significant increase in the mean score of asthma patients in the experimental group. The results of the present study are in line with the results of a study conducted by Zigheymat et al. which investigated the effect of education on self-care knowledge and behaviors [29]; they showed that training patients undergoing coronary artery bypass surgery increased their self-awareness and self-care behaviors. [29]. The results of a study by Baba Beigi et al. (2014) in Shiraz showed that educational programs are effective in raising awareness, improving self-care and controlling harmful habits in patients with hypertension [30]. The results of Goodarzi et al.'s study, as well as Baghiani Moghadam et al.'s, showed that education significantly improved the mean score of awareness in patients with type 2 diabetes [32, 31]. While the results of Bidi et al.'s study showed that educational program did not have a significant effect on the mean knowledge of test subjects [26]. One of the most important reasons for the differences between these two studies can be related to the type of intervention and their volume. In the Bidy et al. study, the sample size was very small, only 20 patients in each group, and given the large size of the questionnaire, this sample size as a confounding factor could easily disrupt the results. Therefore, sufficient sample size should be determined in future studies that are planned. Also, this study shows that patients receive 2 and a half hours of training, which is a very short time.

 

Conclusion

According to the results of this study, it can be said that self-care education increases the knowledge and attitude of patients regarding proper use of drugs, sprays, and avoidance of stimulant factors. The care and treatment team in our country should pay more attention to education about patients with chronic diseases such as patients with asthma.

 

Acknowledgements

This study was approved by the Ethics Committee of Hamadan University of Medical Sciences and Health Services under license no. 5195/4/73/16 and IR.UMSHA.REC.1396.725 and registered by Iranian Registry for Clinical Trial center with the code: IRCT2016.110025929N
We would like to thank the Honorable Research Assistant of Hamadan University of Medical Sciences as well as the staff of Shahid Beheshti Hospital and all the participating patients and those who helped with this study for their sincere cooperation.


 

Conflicts of Interest

The authors declared no conflict of interest.

 

Type of Study: Original Research | Subject: Nursing
Received: 2019/02/3 | Accepted: 2019/08/17 | Published: 2019/08/28

References
1. Becker AB, Abrams EM. Asthma guidelines: the Global Initiative for Asthma in relation to national guidelines. Current Opinion in Allergy and Clinical Immunology. 2017; 17(2):99-103. [DOI:10.1097/ACI.0000000000000346] [PMID]
2. Luyster FS, Teodorescu M, Bleecker E, Busse W, Calhoun W, Castro M, et al. Sleep quality and asthma control and quality of life in non-severe and severe asthma. Sleep and Breathing. 2012; 16(4):1129-37. [DOI:10.1007/s11325-011-0616-8] [PMID] [PMCID]
3. Uchmanowicz B, Panaszek B, Uchmanowicz I, Rosinczuk J. Clinical factors affecting quality of life of patients with Asthma. Patient Preference and Adherence. 2016; 10:579-89. [DOI:10.2147/PPA.S103043] [PMID] [PMCID]
4. Mohajjel Aghdam A, Hasankhani H, Gharemohammadlu R, Esmaeily M. Relation of patients self-efficacy with control-4 of asthma symptoms. Journal of Gorgan University of Medical Sciences. 2013; 15(2):70-6.
5. Oni O, Efosa Erhabor G, Oluboyo P. Does Health Related Quality of life in asthma patients correlate with the clinical indices? Journal of South African Family Practice. 2014; 56(2):134-8. [DOI:10.1080/20786204.2014.10855351]
6. Naveed S, Hameed A, Sharif N, Qamar F, Abbas S. Health-related quality of life in patients with asthma, survey based study in Karachi. Journal of Bioequivalence & Bioavailability. 2016; 8(4):179-84. [DOI:10.4172/jbb.1000290]
7. Urek MC, Tudorić N, Plavec D, Urek R, Koprivc-Milenović T, Stojić M. Effect of educational programs on asthma control and quality of life in adult asthma patients. Patient Education and Counseling. 2005; 58(1):47-54. [DOI:10.1016/j.pec.2004.06.010] [PMID]
8. Gibson PG, Powell H, Wilson A, Abramson MJ, Haywood P, Bauman A, et al. Self-management education and regular practitioner review for adults with asthma. The Cochrane Database of Systematic Reviews. 2009; (1):CD001117. [DOI:10.1002/14651858.CD001117]
9. Shames RS, Sharek P, Mayer M, Robinson TN, Hoyte EG, Gonzalez-Hensley F, et al. Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma. Annals of Allergy, Asthma & Immunology. 2004; 92(6):611-8. [DOI:10.1016/S1081-1206(10)61426-3]
10. Lee JE, Han HR, Song H, Kim J, Kim KB, Ryu JP, et al. Correlates of self-care behaviors for managing hypertension among Korean Americans: a questionnaire survey. International Journal of Nursing Studies. 2010; 47(4):411-7. [DOI:10.1016/j.ijnurstu.2009.09.011] [PMID]
11. Eftekhar H, Mirkamali SK, Tavafian SS, Mohammad K, Shahnazi H, Sharifirad G. Exploring self care in Tehran, Iran: A population based study. Journal of Research in Medical Sciences. 2012; 17(12):1144-9.
12. Mousing C, Lomborg K. Self care 3 months after attending chronic qbstrvctive pulmonary diease education. Patient Preference and Adherence. 2012; 6:19-25. [DOI:10.2147/PPA.S28466] [PMID] [PMCID]
13. Rider SH, Dietrich MS, kidd N. Breast cancer treatment-related lymphedema self- care: Education, practice, symptons, and quality of life. Support Care Cancer. 2011; 19(5):631-7. [DOI:10.1007/s00520-010-0870-5] [PMID]
14. Godarzi M, Ahmadvand M, Farajollahi M. Study of Patient Teaching Importance from Point of Views in Azad University Nursing Students in Karaj in 1382. The Journal of Urmia Nursing and Midwifery Faculty. 2004; 2(2):68-77. [In Persian]
15. Goudarzi M, Ebrahimzadeh A, Rabie A, Saidipour B, Asghri Jafar Abadi M. The relationship between knowledge, attitude and self-efficacy in patients with type II diabetes in Karaj. Iranian Journal of Diabetes and Metabolism. 2011; 11(3):269-81. [In Persian]
16. Kadda O, Marvaki C, Panagiotakos D. The role of nursing education after a cardiac event. Health Science Journal. 2012; 6(4):634-46.
17. Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe HJ, Carta MG, et al. Evolution ofpublic-17 attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica. 2012; 125(6):440-52. [DOI:10.1111/j.1600-0447.2012.01826.x] [PMID]
18. Moore Z, Price P. Nurses' attitudes behaviours and towards pressure ulcer prevention. Journal of Clinical Nursing. 2004; 13(8):942-51. [DOI:10.1111/j.1365-2702.2004.00972.x] [PMID]
19. Wang WL, Herting JR, Tung YY. Adolescents' avoidance of secondhand smoke exposure: model testing. Western Journal of Nursing Research. 2008; 30(7):836-51. [DOI:10.1177/0193945908319251] [PMID]
20. Bourbonnais FF, Tousignant KF. The pain experience of patients on maintenance hemodialysis. Nephrology Nursing Journal. 2012; 39(1):13-9.
21. Zografos K, Marshak HH, Dyjack DT, Neis C. The effects of an adolescent asthma education intervention on knowledge, intention, behavior, self-efficacy and self-consciousness. Californian Journal of Health Promotion. 2010; 8(1):60-71. [DOI:10.32398/cjhp.v8i1.2031]
22. Kurtz ME, Kurtz J, Johnson SM, Beverly EE. Exposure to environmental tobacco smoke perceptions of African American children and adolescents. Preventive Medicine. 1996; 25(3):286-92. [DOI:10.1006/pmed.1996.0058] [PMID]
23. McCarthy MJ, Herbert R, Brimacombe M, Hansen J. Empowering parents through asthma education. Pediatric Nursing. 2002; 28(5):465-73.
24. Brito GM, Gois CF, Zanetti ML, Resende GG, Silva JR. Quality of life, knowledge and attitude after educational program for Diabetes. Acta Paul Enferm. 2016; 29(3):298-306. [DOI:10.1590/1982-0194201600042]
25. Rajanandh M, Nageswari A, Ilango K. Impact of pharmacist provided education on konwledge, attitude, practice and quality of life in asthma patient in a south hospital. Journal of Medical Sciences. 2014; 14(5):254-60. [DOI:10.3923/jms.2014.254.260]
26. Bidi F, Hassanpour K, Ranjbarzadeh A, Arab KA. Effectiveness of educational program on knowledge, attitude, self care and life style in patients with type II diabetes. 2013
27. Muchiri Jw, Gericke GJ, Rheeder P. Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial. Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2016; 21(2):26-34. [DOI:10.1080/16089677.2016.1200324]
28. Mazloomi S, Fallahzadeh H. The relation of knowledge, attitude and self-management behaviors in asthmatic patients with controlling asthma. Zahedan Journal of Research in Medical Sciences. 2012; 14(1):49-55.
29. Zigheymat F, Ebadi A, Motahedian Tabrizi E, Alaf Javadi M, Hamedanizadeh F. Effect of training according to Health Belief Model (HBM) on health believing, knowledge and behavior of patients under CABG. Kowsar Medical Journal. 2009; 13(4):309-13.
30. Baba Beigi MA, Zibaeenzhad MJ, Aghasadeghi K, Jokar A, Shekar Foroush S, Khazraei H. The effecet of Education program on Hypertension management. International Cardio Vascular Research Journal. 2014; 8(3):94-8. [In Persian]
31. Goodarzi M, Javadi Bora MA, Farajollahi M. Impact of education via mobile phone on knowledge, attitude, practice and HbA1C of patients with type 2 diabetes mellitus in Karaj-Iran. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2015; 6(3):8-19.
32. Baghiani Moghadam MH, Taheri G, Fallahzadeh H, Parsa M. The effect of instructional designed SMS based on Health Belief Model (HBM) on adoption of self-care behavior of patients with type II diabetes. Modern Care Journal. 2014; 11(1):10-8.
33. Abbaszadeha A, Borhanib F, Asadi N. Effects of Face-to-face health-belief oriented education about risk factors on knowledge and attitude of myocardial infarction patients after discharge. Iranian Journal of Medical Education. 2012; 12(9):638-46.
34. Borji M, Azami M, Amirkhani M, Bastami E, Salimi K, Sayehmiri A, et al. The effect of education about the risk factors of myocardial infarction based on Health Belief Model on knowledge and attitudes of patients with myocardial infarction in Shahid Mustafa Hospital in Ilam. Nursing Journal of the Vunerable. 2016; 3(6):37-47. [In Persian]

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