Predictors of adherence in children with asthma using the Health Belief Model and Social Learning Theory.

摘要

Asthma is a chronic and potentially life-threatening disease often diagnosed in children. When treated appropriately, however, asthma can be well controlled, and presents few lifestyle limitations. Unfortunately, adherence to the medical regimens required for the effective treatment of asthma is far below ideal. At least 50% of children with asthma fail to adhere to their treatment recommendations, often resulting in disease exacerbation. This study employed the Health Belief Model and Social Learning Theory in an attempt to better understand the factors that contribute to nonadherence in asthmatic children. Fifty-seven children with asthma and their parents completed measures of asthma self-efficacy, treatment outcome expectancies, and perceived barriers. In addition, an observer rated the level of skill the child exhibited in the use of their asthma inhaler. Adherence was electronically monitored over a 2-week period. Data were analyzed using regression and structural equation modeling procedures. Results suggest that child self-efficacy, as it relates directly to asthma management behaviors, may be the best predictor of adherence. Future interventions should focus on increasing children's self-efficacy in coping with asthma and their medical regimen.