A Longitudinal Study of Knowledge, Attitudes and Self-Efficacy in Pregnant Asthmatics
Affiliation(s)
Governors State University, University Park, USA. University of Illinois at Chicago, Chicago, USA. Maternal-Fetal Medicine, University of Chicago, Chicago, USA.
Governors State University, University Park, USA. University of Illinois at Chicago, Chicago, USA. Maternal-Fetal Medicine, University of Chicago, Chicago, USA.
ABSTRACT
The objectives of this study of pregnant women with asthma are 1) to describe their knowledge and attitudes of asthma in pregnancy and their self-efficacy in carrying out their self-management plan during pregnancy, 2) to determine if their knowledge, attitudes, and self-efficacy changed as their pregnancy progressed, and 3) to ascertain the relationship between knowledge, attitudes, and self-esteem and age, education, trimester of pregnancy, weeks of pregnancy, the number of times pregnant and live births. Sixty-eight pregnant women who had an asthma diagnosis were given knowledge, attitudes and self-efficacy questionnaires initially during the point of first contact (first or second) trimester (Time I) and subsequently during the latter part of their pregnancy (third trimester) (Time II). A demographic data form was also administered at Times I and II. Data were collected in an urban academic medical clinic and analyzed using SPSS 17. Data analysis utilized frequencies, paired samples t tests, and linear regression. There were no significant differences between Time I and Time II in attitudes and self-efficacy. Significant differences were limited to the knowledge questionnaire (t = 4.370, p = 0.05). There was a significant relationship between education and knowledge. Pregnant women with asthma had gaps in their knowledge of asthma in pregnancy, although their knowledge increased as their pregnancy progressed from Time I to Time II. Also, the more education the women had, the better they understood asthma. Education for pregnant women with asthma is tailored to their needs and modified as necessary. Nurses are prepared to address this challenge.
Cite this paper
MacMullen, N. , Telleen, S. , Ismail, M. , Samson, L. and Jones, P. (2013) A Longitudinal Study of Knowledge, Attitudes and Self-Efficacy in Pregnant Asthmatics. Open Journal of Nursing, 3, 524-531. doi: 10.4236/ojn.2013.38071.
MacMullen, N. , Telleen, S. , Ismail, M. , Samson, L. and Jones, P. (2013) A Longitudinal Study of Knowledge, Attitudes and Self-Efficacy in Pregnant Asthmatics. Open Journal of Nursing, 3, 524-531. doi: 10.4236/ojn.2013.38071.
References
[1] American Lung Association Epidemiology and Statistics Unit, Research and Program Services Division (2011) Trends in asthma morbidity and mortality.
http://www.lung.org/finding-cures/our-research/epidemiology-and-statistics-rpts.html [2] Guthrie, C.M. and Tingen, M.S. (2002) Asthma—A case study review of pathophysiology and management strategies. Journal of the American Academy of Nurse Practitioners, 14, 457-461.
http://dx.doi.org/10.1111/j.1745-7599.2002.tb00076.x [3] National Heart, Lung, and Blood Institute (2007) Guidelines for the diagnosis and treatment of asthma. National Asthma Education and Prevention Program Expert Panel Report 3, US Department of Health and Human Services, NIH Publication Number 08-5846. [4] Herman, E.J., Garbe, P.L. and McGeehan, M.A. (2010) Assessing community-based approaches to asthma control: The controlling asthma in American cities project. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88, 1-6. [5] Northridge, M.E., Meyer, I.H. and Dunn, L. (2002) Overlooked and under served in Harlem: A population based survey of adults with asthma. Environmental Health Perspectives Supplements, 110, 217, 220.
http://web16epnet.com [6] Whitman, S., Williams, C. and Shah, A.M. (2004) Improving community health survey, report.
http://www.sinai.org/urban/originalresearch/rwj/index.asp [7] Moorman, J.E., Rudd, R.A., Johnson, C.A., King, M., Minor, P., Bailey, C., Scalia, M.R. and Akinbam, L.J. (2007) Surveillance summaries. MMWR/CDC, 56, 1-46. [8] Kwon, H.L., Triche, E.W., Belanger, K. and Bracken, M.B. (2006) The epidemiology of asthma during pregnancy: Prevalence, diagnosis and symptoms. Immunology and Allergy Clinics of North America, 26, 29-32.
http://dx.doi.org/10.1016/j.iac.2005.11.002 [9] Dombrowski, M.P. and Schatz, M. (2010) Asthma in pregnancy. Clinical Obstetrics and Gynecology, 33, 301-310. http://dx.doi.org/10.1097/GRF.0b013e3181de8906 [10] Kallen, B., Rydhstroem, H. and Aberg, A. (2000). Asthma during pregnancy: A population based study. European Journal of Epidemiology, 16, 167-171.
http://dx.doi.org/10.1023/A:1007678404911 [11] Liu, S., Wen, S.W., DeMissie, K., Marcoux, S. and Kramer, M.S. (2001) Maternal asthma and pregnancy outcomes: A retrospective cohort study. American Journal of Obstetrics and Gynecology, 184, 90-96.
http://dx.doi.org/10.1067/mob.2001.108073 [12] Wen, S.W., DeMissie, K. and Liu, S. (2001) Adverse outcomes in pregnancies of asthmatic women: Results from a Canadian population. Annals of Epidemiology, 11, 7-12. http://dx.doi.org/10.1016/S1047-2797(00)00077-6 [13] Stach, S.L. (2000) Improving self-care in adults with asthma using peak expiratory flow rate home monitoring. Journal of the American Academy of Nurse Practitioners, 12, 69-70.
http://dx.doi.org/10.1111/j.1745-7599.2000.tb00285.x [14] Scherer, Y.K. and Bruce, S. (2001) Knowledge, attitudes and self-efficacy and compliance with medical regimen, number of emergency department visits, and hospitalizations in adults with asthma. Heart and Lung, 30, 250-257.
http://dx.doi.org/10.1067/mhl.2001.116013 [15] Stelmach, W., Majak, P., Jerzynska, J. and Stelmach, I. (2005) Early effects of asthma prevention program on asthma diagnosis and hospitalization in an urban population of Poland. Allergy, 60, 606-610.
http://dx.doi.org/10.1111/j.1398-9995.2005.00773.x [16] Butz, A.M., Syron, L., Johnson, B., Spaulding, J., Walker, M. and Bollinger, M.E. (2005) Home based asthma self-management education for inner-city children. Public Health Nursing, 22, 189-199.
http://dx.doi.org/10.1111/j.0737-1209.2005.220302.x [17] Murphy, V.E., Gibson, P.G., Talbot, P.I., Kessell, C.G. and Clifton, V.L. (2005) Asthma self-management skills and the use of asthma education during pregnancy. European Respiratory Journal, 26, 435-441.
http://dx.doi.org/10.1183/09031936.05.00135604 [18] Wigal, J.K., Stout, C. Brandon, M. Winder, J., McConnaughy, K., Creer, T. and Kostes, H. (1993) The knowledge, attitude and self-efficacy asthma questionnaire. Chest, 104, 1144-1148.
http://dx.doi.org/10.1378/chest.104.4.1144 [19] Benninger, C. and McCallister, J. (2010) Asthma in pregnancy reading between the lines. The Nurse Practitioner, 35, 10-19.
http://dx.doi.org/10.1097/01.NPR.0000369937.32234.05 [20] Stone, J.S. and Nelson-Piercy, C. (2009) Respiratory disease in pregnancy. Obstetrics, Gynecology and Reproductive Medicine, 20, 14-21.
http://dx.doi.org/10.1016/j.ogrm.2009.10.003 [21] Tamasi, L., Horvath, I., Bohacs, A., Muller, V., Losonczy, G. and Schatz, M. (2011) Asthma in pregnancy-Immunological changes and clinical management. Respiratory Medicine, 105, 159-164.
http://dx.doi.org/10.1016/j.rmed.2010.11.006 [22] Schatz, M. and Dombrowski, M.P. (2009) Asthma in pregnancy. The New England Journal of Medicine, 360, 1862-1869. http://dx.doi.org/10.1056/NEJMcp0809942 [23] Weis, K.L. (2003) Asthma management across the life span: The childbearing woman with asthma. The Nursing Clinics of North America, 38, 665-674.
http://dx.doi.org/10.1016/S0029-6465(03)00105-1 [24] Murphy, V.E. and Gibson, P.G. (2010) Asthma and rhinitis in pregnancy. Allergy Frontiers: Therapy and Prevention, 5, 485-497. [25] Powrie, E.O., Larson, L. and Miller, M. (2006) Managing asthma in expectant mothers. Treatments in Respiratory Medicine, 5, 1-10.
http://dx.doi.org/10.2165/00151829-200605010-00001 [26] Richardson, H.M. (1991) The perceptions of Canadian young adults with asthma of their health teaching/learning needs. Journal of Advanced Nursing, 16, 447-453.
http://dx.doi.org/10.1111/j.1365-2648.1991.tb03435.x [27] Beckmann, C.A. (2002) A descriptive study of women’s perceptions of their asthma during pregnancy. American Journal of Maternal Child Nursing, 27, 98-102.
http://dx.doi.org/10.1097/00005721-200203000-00009 [28] Janson-Bjerklie, S.L. and Pardini, K. (1988) Relationship of panic-fear symptomatology to patterns of asthma self-care in emotionally triggered asthma. American Review of Respiratory Diseases, 137-117. [29] Lehrer, P.M., Isenberg, S. and Hochron, S.M. (1993) Asthma and emotion: A review. Journal of Asthma, 30, 5-21. http://dx.doi.org/10.3109/02770909309066375 [30] Mancuso, C.A., Sayles, W. and Allegrante, J.P. (2010) Knowledge, attitude, and self-efficacy in asthma self-management and quality of life. Journal of Asthma, 47, 883-888.
http://dx.doi.org/10.3109/02770903.2010.492540 [31] Arnold, R., Ranchor, A.V., DeJongste, M.J., Koeter, G.H., Ten Hacken, N.H., Aalbers, R. and Sandeman, R. (2005) The relationship between self-efficacy and self-reported physical functioning in chronic obstructive pulmonary disease and heart failure. Behavioral Medicine, 31, 107-115. http://dx.doi.org/10.3200/BMED.31.3.107-115 [32] Cummings, E., Turner, P., Walters, H., Baker, R.W., Robinson, A. and Courtney-Prat, H. (2006) Pathways home project: Patient self-management and self-efficacy through the deployment of ICS. BLED 2006 Proceedings, Paper 12. http://a/se/.aisnet.org/bled2006/12 [33] Shegogg, R., Bartholomew, K. Parcel, G.S., Sockrider, M.M., Masse, L. and Abramson, S. (2001) Impact of a computer-assisted education program on factors related to asthma self-management behavior. Journal of the American Medical Informatics Association, 8, 49-61.
http://dx.doi.org/10.1136/jamia.2001.0080049 [34] Clark, N.M., Valerio, M.A. and Gong, Z.M. (2008) Self-regulation and women with asthma. Current Opinion in Allergy and Clinical Immunology, 8, 222-227.
http://dx.doi.org/10.1097/ACI.0b013e3282fe9d05 [35] Bodenheimer, T., Lorig, K., Holman, H. and Grumbach, K. (2002) Patient self-management of chronic disease in primary care. Journal of the American Medical Association, 288, 2469-2475.
http://dx.doi.org/10.1001/jama.288.19.2469 [36] Orem, D.E. (2001) Nursing: Concepts of practice. 5th Edition. Mosby-Yearbook, Inc., St. Louis. [37] Fishbein and Ajzen (1975) Attitude and related problems in science education. John Wiley & Sons Inc., Hoboken. [38] Telleen, S. (2007) Asthma management self-efficacy scale.
www.sinai.org [39] Comerford, M.F., Moos, M.K. and Curtis, M. (2006) The history of preconception care: Evolving guidelines and standards. Maternal Child Health Journal, 10, 43-52.
http://dx.doi.org/10.1007/s10995-006-0087-x
[1] American Lung Association Epidemiology and Statistics Unit, Research and Program Services Division (2011) Trends in asthma morbidity and mortality.
http://www.lung.org/finding-cures/our-research/epidemiology-and-statistics-rpts.html [2] Guthrie, C.M. and Tingen, M.S. (2002) Asthma—A case study review of pathophysiology and management strategies. Journal of the American Academy of Nurse Practitioners, 14, 457-461.
http://dx.doi.org/10.1111/j.1745-7599.2002.tb00076.x [3] National Heart, Lung, and Blood Institute (2007) Guidelines for the diagnosis and treatment of asthma. National Asthma Education and Prevention Program Expert Panel Report 3, US Department of Health and Human Services, NIH Publication Number 08-5846. [4] Herman, E.J., Garbe, P.L. and McGeehan, M.A. (2010) Assessing community-based approaches to asthma control: The controlling asthma in American cities project. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88, 1-6. [5] Northridge, M.E., Meyer, I.H. and Dunn, L. (2002) Overlooked and under served in Harlem: A population based survey of adults with asthma. Environmental Health Perspectives Supplements, 110, 217, 220.
http://web16epnet.com [6] Whitman, S., Williams, C. and Shah, A.M. (2004) Improving community health survey, report.
http://www.sinai.org/urban/originalresearch/rwj/index.asp [7] Moorman, J.E., Rudd, R.A., Johnson, C.A., King, M., Minor, P., Bailey, C., Scalia, M.R. and Akinbam, L.J. (2007) Surveillance summaries. MMWR/CDC, 56, 1-46. [8] Kwon, H.L., Triche, E.W., Belanger, K. and Bracken, M.B. (2006) The epidemiology of asthma during pregnancy: Prevalence, diagnosis and symptoms. Immunology and Allergy Clinics of North America, 26, 29-32.
http://dx.doi.org/10.1016/j.iac.2005.11.002 [9] Dombrowski, M.P. and Schatz, M. (2010) Asthma in pregnancy. Clinical Obstetrics and Gynecology, 33, 301-310. http://dx.doi.org/10.1097/GRF.0b013e3181de8906 [10] Kallen, B., Rydhstroem, H. and Aberg, A. (2000). Asthma during pregnancy: A population based study. European Journal of Epidemiology, 16, 167-171.
http://dx.doi.org/10.1023/A:1007678404911 [11] Liu, S., Wen, S.W., DeMissie, K., Marcoux, S. and Kramer, M.S. (2001) Maternal asthma and pregnancy outcomes: A retrospective cohort study. American Journal of Obstetrics and Gynecology, 184, 90-96.
http://dx.doi.org/10.1067/mob.2001.108073 [12] Wen, S.W., DeMissie, K. and Liu, S. (2001) Adverse outcomes in pregnancies of asthmatic women: Results from a Canadian population. Annals of Epidemiology, 11, 7-12. http://dx.doi.org/10.1016/S1047-2797(00)00077-6 [13] Stach, S.L. (2000) Improving self-care in adults with asthma using peak expiratory flow rate home monitoring. Journal of the American Academy of Nurse Practitioners, 12, 69-70.
http://dx.doi.org/10.1111/j.1745-7599.2000.tb00285.x [14] Scherer, Y.K. and Bruce, S. (2001) Knowledge, attitudes and self-efficacy and compliance with medical regimen, number of emergency department visits, and hospitalizations in adults with asthma. Heart and Lung, 30, 250-257.
http://dx.doi.org/10.1067/mhl.2001.116013 [15] Stelmach, W., Majak, P., Jerzynska, J. and Stelmach, I. (2005) Early effects of asthma prevention program on asthma diagnosis and hospitalization in an urban population of Poland. Allergy, 60, 606-610.
http://dx.doi.org/10.1111/j.1398-9995.2005.00773.x [16] Butz, A.M., Syron, L., Johnson, B., Spaulding, J., Walker, M. and Bollinger, M.E. (2005) Home based asthma self-management education for inner-city children. Public Health Nursing, 22, 189-199.
http://dx.doi.org/10.1111/j.0737-1209.2005.220302.x [17] Murphy, V.E., Gibson, P.G., Talbot, P.I., Kessell, C.G. and Clifton, V.L. (2005) Asthma self-management skills and the use of asthma education during pregnancy. European Respiratory Journal, 26, 435-441.
http://dx.doi.org/10.1183/09031936.05.00135604 [18] Wigal, J.K., Stout, C. Brandon, M. Winder, J., McConnaughy, K., Creer, T. and Kostes, H. (1993) The knowledge, attitude and self-efficacy asthma questionnaire. Chest, 104, 1144-1148.
http://dx.doi.org/10.1378/chest.104.4.1144 [19] Benninger, C. and McCallister, J. (2010) Asthma in pregnancy reading between the lines. The Nurse Practitioner, 35, 10-19.
http://dx.doi.org/10.1097/01.NPR.0000369937.32234.05 [20] Stone, J.S. and Nelson-Piercy, C. (2009) Respiratory disease in pregnancy. Obstetrics, Gynecology and Reproductive Medicine, 20, 14-21.
http://dx.doi.org/10.1016/j.ogrm.2009.10.003 [21] Tamasi, L., Horvath, I., Bohacs, A., Muller, V., Losonczy, G. and Schatz, M. (2011) Asthma in pregnancy-Immunological changes and clinical management. Respiratory Medicine, 105, 159-164.
http://dx.doi.org/10.1016/j.rmed.2010.11.006 [22] Schatz, M. and Dombrowski, M.P. (2009) Asthma in pregnancy. The New England Journal of Medicine, 360, 1862-1869. http://dx.doi.org/10.1056/NEJMcp0809942 [23] Weis, K.L. (2003) Asthma management across the life span: The childbearing woman with asthma. The Nursing Clinics of North America, 38, 665-674.
http://dx.doi.org/10.1016/S0029-6465(03)00105-1 [24] Murphy, V.E. and Gibson, P.G. (2010) Asthma and rhinitis in pregnancy. Allergy Frontiers: Therapy and Prevention, 5, 485-497. [25] Powrie, E.O., Larson, L. and Miller, M. (2006) Managing asthma in expectant mothers. Treatments in Respiratory Medicine, 5, 1-10.
http://dx.doi.org/10.2165/00151829-200605010-00001 [26] Richardson, H.M. (1991) The perceptions of Canadian young adults with asthma of their health teaching/learning needs. Journal of Advanced Nursing, 16, 447-453.
http://dx.doi.org/10.1111/j.1365-2648.1991.tb03435.x [27] Beckmann, C.A. (2002) A descriptive study of women’s perceptions of their asthma during pregnancy. American Journal of Maternal Child Nursing, 27, 98-102.
http://dx.doi.org/10.1097/00005721-200203000-00009 [28] Janson-Bjerklie, S.L. and Pardini, K. (1988) Relationship of panic-fear symptomatology to patterns of asthma self-care in emotionally triggered asthma. American Review of Respiratory Diseases, 137-117. [29] Lehrer, P.M., Isenberg, S. and Hochron, S.M. (1993) Asthma and emotion: A review. Journal of Asthma, 30, 5-21. http://dx.doi.org/10.3109/02770909309066375 [30] Mancuso, C.A., Sayles, W. and Allegrante, J.P. (2010) Knowledge, attitude, and self-efficacy in asthma self-management and quality of life. Journal of Asthma, 47, 883-888.
http://dx.doi.org/10.3109/02770903.2010.492540 [31] Arnold, R., Ranchor, A.V., DeJongste, M.J., Koeter, G.H., Ten Hacken, N.H., Aalbers, R. and Sandeman, R. (2005) The relationship between self-efficacy and self-reported physical functioning in chronic obstructive pulmonary disease and heart failure. Behavioral Medicine, 31, 107-115. http://dx.doi.org/10.3200/BMED.31.3.107-115 [32] Cummings, E., Turner, P., Walters, H., Baker, R.W., Robinson, A. and Courtney-Prat, H. (2006) Pathways home project: Patient self-management and self-efficacy through the deployment of ICS. BLED 2006 Proceedings, Paper 12. http://a/se/.aisnet.org/bled2006/12 [33] Shegogg, R., Bartholomew, K. Parcel, G.S., Sockrider, M.M., Masse, L. and Abramson, S. (2001) Impact of a computer-assisted education program on factors related to asthma self-management behavior. Journal of the American Medical Informatics Association, 8, 49-61.
http://dx.doi.org/10.1136/jamia.2001.0080049 [34] Clark, N.M., Valerio, M.A. and Gong, Z.M. (2008) Self-regulation and women with asthma. Current Opinion in Allergy and Clinical Immunology, 8, 222-227.
http://dx.doi.org/10.1097/ACI.0b013e3282fe9d05 [35] Bodenheimer, T., Lorig, K., Holman, H. and Grumbach, K. (2002) Patient self-management of chronic disease in primary care. Journal of the American Medical Association, 288, 2469-2475.
http://dx.doi.org/10.1001/jama.288.19.2469 [36] Orem, D.E. (2001) Nursing: Concepts of practice. 5th Edition. Mosby-Yearbook, Inc., St. Louis. [37] Fishbein and Ajzen (1975) Attitude and related problems in science education. John Wiley & Sons Inc., Hoboken. [38] Telleen, S. (2007) Asthma management self-efficacy scale.
www.sinai.org [39] Comerford, M.F., Moos, M.K. and Curtis, M. (2006) The history of preconception care: Evolving guidelines and standards. Maternal Child Health Journal, 10, 43-52.
http://dx.doi.org/10.1007/s10995-006-0087-x