Interpersonal Influences on the Self-Management Skills of the Rural Adolescent with Asthma

The need for effective asthma management for the adolescent is evident.  Asthma attacks occur more often in those younger than 18 years, with prevalence rates of 54.6 per 1000 compared to 39.4 per 1000 in those older than 18 years. 38% of children with asthma younger than 18 years old report their current health status as fair or poor.  Using the Theory of Planned Behavior, this study sought to understand how self-management behaviors of rural adolescents with asthma are influenced by the perceived expectations for self-management behaviors from healthcare providers, school nurses, teachers, family and friends. Focus groups were conducted with seven rural adolescents’ ages 13-17 years. Transcripts were recorded, transcribed and analyzed for common themes. The adolescents were unable to identify behaviors needed to perform in order to control their asthma. Except for taking their prescribed medications, no other behaviors were addressed by their health care provider, parents, friends or school nurse. The lack of expectation for other self-management behaviors that are essential for asthma control, such as knowledge of asthma symptoms, trigger avoidance and when to seek help during asthma attack may be a leading contributor for uncontrolled asthma. The results from this study demonstrate the influence of the expectations for asthma self-management by significant people in the adolescents’ life, including nurses and health care providers. Including the adolescent in their asthma treatment and emphasizing what behaviors are needed for asthma control can lead to improved outcomes with fewer school days missed, fewer emergency room visits and hospitalizations.