The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

Özyiğit, Leyla Pur; Ozcelik, Bahar; Ciloglu, Seda Ozcan; Erkan, Feyza

doi:10.3109/02770903.2013.863331

Cited by 19 publications

(20 citation statements)

References 25 publications

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“…As suggested by other researchers, when patients received proper instructions on how to follow their action plan, they viewed it more favorably and useful. 54,55 Similar findings were reported by other researchers that applied the patients' feedback and suggestions in the development of pictorial or friendly-user action plans. [51][52][53][54] In addition, understanding and evaluation of the information provided on the action plan (which has implications for "use" domain), could also be a major factor of not using the instructions provided by the doctor.…”

Section: Discussionsupporting

confidence: 79%

“…54,55 Similar findings were reported by other researchers that applied the patients' feedback and suggestions in the development of pictorial or friendly-user action plans. [51][52][53][54] In addition, understanding and evaluation of the information provided on the action plan (which has implications for "use" domain), could also be a major factor of not using the instructions provided by the doctor. Therefore, detailed communication of the proper use of an action plan from the providers' side is needed also in addition to providing the patient with the option of calling the provider when there is uncertainty of when it should be used (evaluation).…”

Section: Discussionsupporting

confidence: 79%

“…3,4,51 However, various studies have reported only a minority of asthma patients receive an action plan from their doctor or respiratory educator (access), and for those who do receive an action plan, only approximately 50% use it appropriately. [52][53][54][55][56] Based on our participants' feedback, poor action plan utilization may be mainly due to having difficulty in following the information provided on their action plan. As suggested by other researchers, when patients received proper instructions on how to follow their action plan, they viewed it more favorably and useful.…”

Section: Discussionmentioning

confidence: 99%

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<p>Development and Pretesting of a New Functional-Based Health Literacy Measurement Tool for Chronic Obstructive Pulmonary Disease (COPD) and Asthma Management</p>

Poureslami

Shum

Kopeć

et al. 2020

COPD

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Background: Health literacy (HL) is a person's ability to practically apply a wide range of cognitive and non-cognitive skills in health-related decisions. HL includes five domains: navigate/ access, understand, communicate, evaluate, and use of health information and services. Currently, no tool accurately captures and measures HL in adult patients with asthma and COPD, while utilizing all 5-HL domains. Objective: Develop a comprehensive functional-based measurement tool for adult asthma and/or COPD patients, while assessing HL on routine actions required to manage their chronic respiratory condition(s). Methods: We developed our HL tool based on a conceptualization of the link between HL and asthma and COPD management, during needs assessment stage including; a systematic review, which was followed by patient-oriented focus groups, and key-informant and respirologist interviews. Preliminary face and content validation were obtained by patients' and health professionals' input prior to the pretesting stage. The needs assessment information enabled us to develop passages in scenario-format and corresponding items to assess HL core domains, in addition to numeracy skills, across nine self-management topics: peak flow meters, prednisone use, pulmonary rehabilitation, action plans, flu shots, inhaler technique, lifestyle (nutrition and exercise), trigger control, and map navigation. The tool was pretested with asthma and COPD patients to assess its relevance, clarity, and difficulty. Results: Our systematic review identified the deficiencies of existing HL tools that assessed the HL skills of asthma and COPD patients. The patient-oriented focus groups (n=93) enabled us to identify self-management topics and develop items for our proposed HL tool, which were enriched by input from 45 key informants (eg, policy makers, clinicians, etc.) and 17 respiratory physicians. Preliminary pretesting with a new cohort of participants (36 asthma and COPD patients and 39 key informants) aided in the refinement and finalized our tool. The modified tool included passages and corresponding items related to asthma and COPD management was pretested with 75 asthma/COPD patients who completed the questionnaire and provided their feedback on the clarity, relevance, and difficulty of the tool. The main barrier to self-management pertained to "communication" skills. The flu shot was the most relevant topic (91.2%), while map navigation was the least relevant (63.9%). Action plans were the most difficult topic, where only 55% knew when to utilize their action plans. Numeracy items challenged COPD patients the most. Conclusion: We summarized findings from the development and preliminary testing stages of a new asthma/COPD HL tool. This tool will now be validated with a new cohort of patients.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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<p>Development and Pretesting of a New Functional-Based Health Literacy Measurement Tool for Chronic Obstructive Pulmonary Disease (COPD) and Asthma Management</p>

Poureslami

Shum

Kopeć

et al. 2020

COPD

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“…PAAPs lacking in relevance for professionals and patients was first recognised over a decade ago [ 23 ] so a fresh approach is required to overcome this barrier. For patients, improving PAAP design and accessibility [ 32 – 34 ] should bring some benefits, but our patient participants with asthma of longstanding duration indicated a need for PAAPs better suited to their requirements. In future, Living with Asthma plans addressing a broader range of self-management issues [ 17 ], such as what to do when patients are increasing their exercise levels and/or travelling overseas, may be more relevant and fit-for-purpose for patients.…”

Section: Discussionmentioning

confidence: 99%

The ‘vicious cycle’ of personalised asthma action plan implementation in primary care: a qualitative study of patients and health professionals’ views

et al. 2015

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BackgroundPersonal asthma action plans (PAAPs) have been guideline recommended for years, but consistently under-issued by health professionals and under-utilised by patients. Previous studies have investigated sub-optimal PAAP implementation but more insight is needed into barriers to their use from the perspective of professionals, patients and primary care teams.MethodsA maximum variation sample of professional and patient participants were recruited from five demographically diverse general practices and another group of primary care professionals in one Scottish region. Interviews were digitally recorded and data thematically analysed using NVivo.ResultsTwenty-nine semi-structured interviews were conducted (11 adults with asthma, seven general practitioners, ten practice nurses, one hospital respiratory nurse). Three over-arching themes emerged: 1) patients generally do not value PAAPs, 2) professionals do not fully value PAAPs and, 3) multiple barriers reduce the value of PAAPs in primary care. Six patients had a PAAP but these were outdated, not reflecting their needs and not used. Patients reported not wanting or needing PAAPs, yet identified circumstances when these could be useful. Fifteen professionals had selectively issued PAAPs with eight having reviewed one. Many professionals did not value PAAPs as they did not see patients using these and lacked awareness of times when patients could have benefited from one. Multi-level compounding barriers emerged. Individual barriers included poor patient awareness and professionals not reinforcing PAAP use. Organisational barriers included professionals having difficulty accessing PAAP templates and fragmented processes including patients not being asked to bring PAAPs to their asthma appointments.ConclusionsPrimary care PAAP implementation is in a vicious cycle. Professionals infrequently review/update PAAPs with patients; patients with out-dated PAAPs do not value or use these; professionals observing patients’ lack of interest in PAAPs do not discuss these. Patients observing this do not refer to their plans and perceive them to be of little value in asthma self-management. Twenty-five years after PAAPs were first recommended, primary care practices are still not ready to support their implementation. Breaking this vicious cycle to create a healthcare context more conducive to PAAP implementation requires a whole systems approach with multi-faceted interventions addressing patient, professional and organisational barriers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0352-4) contains supplementary material, which is available to authorized users.

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“…Po upływie 6 miesięcy zarówno w grupie poddanej dodatkowym działaniom edukacyjnym, jak i w grupie kontrolnej stwierdzono poprawę stopnia kontroli astmy ocenianego przy użyciu testu ACT oraz na podstawie liczby hospitalizacji z powodu zaostrzeń. Poprawę jakości życia, ocenianej przy użyciu kwestionariusza SGRQ, odnotowano jednak wyłącznie w grupie, w której przeprowadzono dodatkowe działania edukacyjne [32]. Podobne wyniki uzyskano w analogicznym badaniu przeprowadzonym wśród 85 chorych z Tajwanu, których jakość życia oceniano przy użyciu kwestionariusza AQLQ [33].…”

Section: Jakość żYcia Związana Ze Stanem Zdrowia Jako Punkt Końcowy Bunclassified

Jakość życia zależna od stanu zdrowia u chorych na astmę oskrzelową

Uchmanowicz¹,

Manulik

Uchmanowicz

et al. 2014

Advances in Respiratory Medicine

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A patient is not, or at least should not be, a passive subject, but the active participant of the process of asthma treatment. This naturally imposes covering patients with bronchial asthma with a holistic model of care. Assessment of health-related quality of life (HRQoL) is one component of this model. HRQoL of asthma patients can be determined with an array of generic instruments, e.g., Medical Outcomes Survey Short Form 36 (SF-36), EuroQoL questionnaire (EQ-5D) or World Health Organization Quality of Life Questionnaire (WHOQOL), as well as with the specific tools, among which Saint George’s Respiratory Questionnaire (SGRO) and Asthma Quality of Life Questionnaire (AQLQ) belong to the most widely used. HRQoL is significantly associated with the degree of asthma control. However, literature data suggest that a determination of HRQoL alone, with either specific or generic instrument, can be insufficient, as the level of health-related quality of life turned out to be modulated by three groups of factors: (1) demographic characteristics of patients, (2) clinical parameters, and (3) personality traits of respondents. Due to particularly strong effect of psychological characteristics on the quality of life of patients with bronchial asthma, also the level of depressiveness should be examined along with the HRQoL determination. Furthermore, complex assessment of the quality of life and its determinants should be conducted longitudinally, either in individual patients or in epidemiological studies.

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The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

Abstract: Education provides a significant improvement in asthma control and HRQoL while managing illiterate asthma patients, additionally the pictorial asthma action plan can be a helpful tool for self-medication.

Cited by 19 publications

References 25 publications

<p>Development and Pretesting of a New Functional-Based Health Literacy Measurement Tool for Chronic Obstructive Pulmonary Disease (COPD) and Asthma Management</p>

<p>Development and Pretesting of a New Functional-Based Health Literacy Measurement Tool for Chronic Obstructive Pulmonary Disease (COPD) and Asthma Management</p>

The ‘vicious cycle’ of personalised asthma action plan implementation in primary care: a qualitative study of patients and health professionals’ views

Jakość życia zależna od stanu zdrowia u chorych na astmę oskrzelową

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