Interpersonal Influences on the Self-management Skills of the Rural Asthmatic Adolescent


PURPOSE: The purpose of this study is to understand how self-management behaviors of the adolescent with asthma are influenced by the perceived expectations (normative beliefs/subjective norms) for self-management behaviors from healthcare providers, school nurses, teachers, family and friends. 

SAMPLE: Seven rural adolescents (five males and two females with an age range of 13-17 years)

METHOD: Focus groups were conducted with analysis for common themes influencing management behaviors.

RESULTS: The majority of participants perceived provider and parental expectations for asthma management as only consisting of medication compliance. The students did not report any perceived expectations from the school nurse except independent inhaler use. There was no expectation to report use to the school nurse. The participants felt that their teachers were not aware of their asthma diagnosis; therefore, no expectations were noted. Expectations from peers had no influence on self-management behaviors.

CONCLUSION:  The results from this study demonstrate the influence of the expectations for asthma self-management by significant people in the adolescents’ life. The adolescents in this study were unable to identify what behaviors they needed to perform in order to control their asthma. Except for taking their prescribed medications, no other behaviors were addressed by their health care provider, parents, friends or school nurse. The lack of expectation for other self-management behaviors that are essential for asthma control, such as knowledge of asthma symptoms, trigger avoidance and when to seek help during an asthma attack may be a leading contributor for uncontrolled asthma. Asthma action plans, if consistently used by health care providers, parents and schools, can reinforce the expectation for behaviors that will result in good asthma outcomes.

KEYWORDS:  Asthma, Adolescent, Self-management, Theory of Planned Behavior, Policy


Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).