Date of Award

Fall 12-18-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Dr. Patricia C. Clark

Second Advisor

Dr. Shih-Yu Lee

Third Advisor

Dr. Lynda T. Goodfellow

Abstract

There are approximately 22.2 million Americans’ who are living with asthma and of those 18.4 million are adults. African Americans’ are more likely to be diagnosed with asthma compared to Caucasians, and experience more asthma attacks. In this study, the Social Cognitive Theory was used to examine the relationships among personal characteristics, environmental factors, asthma self-efficacy, self-management behaviors, and quality of life (QOL) in African American adults with asthma.

A correlational design was used. Data were collected from a non-random sample of adult African Americans’ with asthma (N = 39) using the following self-report questionnaires: the Knowledge, Attitude, and Self-Efficacy of Asthma Questionnaire (KASE), the short form of the Rapid Estimate of Adult Literacy in Medicine (REALM-SF), the Medical Outcomes Study (MOS) for social support, the Asthma Trigger Inventory (ATI), the Morisky Medication Adherence Questionnaire, Asthma Self-Management Questionnaire (ASMQ), the Modified Pittsburgh Sleep Quality Index (PSQI), the Asthma Control Test (ACT), and the Asthma Quality of Life Standardized (AQLQ-S). Data analyses included descriptive statistics, Pearson Product correlations, and hierarchical multiple regression.

On average, participants (N = 39) were middle aged (M = 55.9 ± 7.9) years, female (65%), did not smoke (87%), did not use a peak flow meter (PEFR) to self-manage their asthma (72%), and were obese (M = 34.06, SD = 10.78). Participants reported high confidence in asthma self-management; however, had low medication adherence and scores indicating uncontrolled asthma (M = 16.10, SD = 4.29). More than half (67%) of the participants reported poor sleep quality (PSQI). BMI and sleep quality accounted for significant variance (38%) in asthma QOL (F (2, 38) = 7.08, p = .001). Social support was an independent predictor of asthma self-efficacy (F (2, 38) = 5.65, p = .02).

Better control of weight and asthma symptoms may improve sleep quality. Health care providers need to address the ongoing challenges of asthma self-management and monitor sleep quality. Encouraging the use of peak flow meters, which have been shown to improve self-management and asthma control, may result in better quality of life for African Americans’ with asthma.

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