Year: 1995
Type: dissertation
Abstract: The Self-Regulation Model (Leventhal, Nerenz & Steele, 1984) \nhighlights the roles of patients' illness representations, coping, emotional \nreactions and appraisal of coping in the progression of chronic disease. This \nthesis incorporates previous literature on adherence, panic-fear and selfmanagement \ninterventions into the model in order to (a) investigate coping \nwith asthma and (b) develop an intervention aimed at improving asthmatic \ncontrol. \nNew measures of asthmatic control and illness representations of the \nconsequences of having asthma were developed in order to operationalise the \nmodel. \nA cross-sectional study investigated factors influencing asthmatic \ncontrol in a sample of 35 adult asthma sufferers recruited through a single \ngeneral practice. Coping was poor, adherence being low and less than 50% of \nparticipants reporting current Peak Flow monitoring or medical contact \nduring the previous 12 months. Good coping appeared to be a response to \npoor asthmatic control, rather than prophylactic. Good asthmatic control was \nassociated with low perceived consequences, recent medical contact, moderate \npanic-fear and low general avoidance coping. These results imply that \nasthmatic control may be improved by encouraging sufferers to maintain \nregular contact with outpatient services and to implement prophylactic \ncoping. \nSince epidemiological and clinical evidence suggested asthmatic \ncontrol to be poor in young adults, an intervention was developed to \nimprove asthmatic control in this group by modifying illness representations, \ncoping and panic-fear. The intervention was evaluated in a randomised \ncontrolled study of 50 student asthma sufferers identified initially through an \nepidemiological screening of 2,979 students. It led to increased Preventer \nmedication use and Peak Flow monitoring and decreased distress over the \ncondition. However, the coping process changed and asthmatic control \nimproved even in the control group, perhaps because self-monitoring of \nasthmatic control for the study constituted a change in coping. This \nunanticipated result was entirely compatible with the Self-Regulation Model. \nThe thesis dearly demonstrates value of the Self-Regulation Model in \nunderstanding asthma self-management and developing clinical \ninterventions.
Author: Julie M. Williams
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: Medical Research Council
OpenAlex ID: W69751160