Elsevier

Heart & Lung

Volume 30, Issue 4, July–August 2001, Pages 250-257
Heart & Lung

Issues in Pulmonary Care
Knowledge, attitudes, and self-efficacy and compliance with medical regimen, number of emergency department visits, and hospitalizations in adults with asthma*,**

https://doi.org/10.1067/mhl.2001.116013Get rights and content

Abstract

Purpose: The purpose of this study was to examine the relationship between knowledge, attitudes, and self-efficacy and compliance with prescribed medical regimen, number of emergency department (ED) visits, and hospitalizations in adults with asthma. Method: The sample consisted of 29 adults with a diagnosis of asthma. The relationship among knowledge, attitudes, self-efficacy, and compliance with medical regimen was explored through use of a survey design. The Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire and the Asthma Management Questionnaire that measured compliance were mailed to subjects’ homes. Once completed, questionnaires were returned, and demographic data and number of ED visits and hospitalizations were obtained through a retrospective chart review. Results: There was a significant correlation between knowledge and attitudes and knowledge and self-efficacy. The more positive persons’ attitudes toward their asthma, the higher their knowledge and self-efficacy scores. There were significant correlations between select demographic variables and knowledge, attitude, and self-efficacy. Women scored higher on attitudes, persons with a college education scored higher on knowledge and attitudes, and persons with mild asthma scored highest on the self-efficacy scale. Compliance with use of peak-flow meters correlated with higher scores on the attitude and self-efficacy scales. The higher total compliance score group had significantly higher self-efficacy scores. In addition, higher self-efficacy scores correlated with lower numbers of hospitalizations. Conclusion: Attitudes and self-efficacy rather than knowledge had the most significant impact on compliance and number of ED visits and hospitalizations. The Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire provides a means for nurses to assess patients’ knowledge, attitudes, and self-efficacy regarding their asthma. Patients with low scores could be channeled into programs that would help them improve their ability to manage their asthma. (Heart Lung® 2001;30:250-7.)

Section snippets

Literature review

Many definitions have been given for compliance. The most widely accepted is by Haynes et al,5 who state that compliance is the extent to which a person’s behavior, such as taking medications, coincides with medical or health advice. Compliance can be seen as an attitude and as a behavior. Compliance as an attitude is willingness or intention to follow health prescriptions. Compliance as a behavior is related to the actual carrying out of the medical regimen.6 The term compliance, to many

Research questions

Specifically the study sought to answer the following questions:

  • 1.

    What is the relationship between demographic characteristics and scores on the knowledge, attitudes, and self-efficacy scales?

  • 2.

    Is there a relationship between knowledge, attitudes, and self-efficacy in adults with asthma?

  • 3.

    What is the relationship between knowledge, attitudes, and self-efficacy and compliance with prescribed medical regimen?

  • 4.

    What is the relationship between demographic variables and compliance with prescribed medical

Sample

The sample consisted of 29 adults with a diagnosis of asthma. Subjects were obtained from the office files of a private-practice primary care provider. All adult patients at the practice site with a diagnosis of asthma (N = 51) were included in the study. Twenty-nine subjects returned the questionnaires, resulting in a response rate of 59%.

Setting

The private practice setting, from which the sample was obtained, is managed by a primary care physician and an adult nurse practitioner. Management of

Results

In computing the score of the KASE-AQ, consideration had to be given to managing missing values. Missing values for items measuring self-efficacy and attitudes were substituted with the item mean before the scores were summed. Missing items on the knowledge scale were coded as equivalent to incorrect answers. The KASE-AQ scores for the total sample are listed in Table II.

. Knowledge, attitude, and self-efficacy scores (N = 29)

ScaleMeanSDScale range
Knowledge12.233.710-20
Attitude86.478.3120-100

Discussion

The results revealed that only slightly more than half of the questions on the knowledge scale were answered correctly (mean, 12.23). The mean scores on the attitude (86.47) and the self-efficacy (83.06) scales were high. Compliance with prescribed medical regimen scores was highest regarding the correct use of prescribed medications (0.82) and correct use of metered-dose inhalers (0.90). They were lowest regarding the correct use of peak-flow meters (0.61) and management of asthma symptoms

Acknowledgements

We acknowledge Janice Grzankowski, doctoral candidate, for her data entry and analysis and Yow-Wu Bill Wu, PhD, for his statistical consultation.

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    *

    Supported by the Governor’s Office of Employee Relations and United University Professions Individual Development Awards Program.

    **

    Reprint requests: Yvonne Krall Scherer, RN, EdD, School of Nursing, State University of New York at Buffalo, 924 Stockton Kimball Tower, 3435 Main St, Buffalo, NY 14214.

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