HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Free All Versions of this Article: chest.06-2539v1 132/1/88    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Clark, N. M Articles by Johnson, T. R. Search for Related Content PubMed PubMed Citation Articles by Clark, N. M Articles by Johnson, T. R.

A Randomized Trial of a Self-Regulation Intervention for Women with Asthma

¹Center for Managing Chronic Disease, Schools of Public Health and Medicine, University of Michigan ²Center for Managing Chronic Disease, School of Public Health, University of Michigan ³Department of Biostatistics, School of Public Health, University of Michigan ⁴Department of Biostatistics, School of Public Health, Harvard University ⁵Shriners Hospitals for Children, Tampa, Florida ⁶Department of Obstetrics and Gynecology, University of Michigan School of Medicine

Abstract

BackgroundWomen with asthma have greater mortality and morbidity than men in the United States. To date there has been no rigorous evaluation of an intervention focused on the particular problems in asthma management faced by women. This study was a randomized clinical trial of a self-regulation, telephone counseling intervention emphasizing women's concerns and sex and gender-role factors in their management of asthma. Methods: 808 women with diagnosed asthma were randomly assigned to the intervention or a usual care control group including conventional asthma education. Interviews and medical record data were collected to assess psychosocial, and behavioral factors, functioning, quality of life, symptoms, and health care use at baseline and one year subsequently. Generalized estimating equations, identity link, logit link and log link were employed to analyze data. Results: Compared to controls, treatment women had greater annual reductions in the average number of nights with asthma symptoms (p=.04), days of missed work/school (p=.03), emergency department (ED) visits (p=.04), unscheduled office visits (p=.01), and scheduled office visits (p=.04). They had greater recognition of asthma symptoms during the menstrual cycle (p=.0003), had decreased asthma symptoms with sexual activity (p=.008), and had greater improvement in quality of life (p=.0005), self-regulation (p=.03), and self confidence to manage asthma (p=.001). Conclusion: The intervention improved women's clinical status, functioning, quality of life, and health care use. A program with a focus on asthma management problems particular to women can significantly assist female asthma patients.

Key Words: outcomes • management by patients • chronic conditions • asthma • women's health