Womens self management of asthma
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This study examined how demographic factors and symptoms are associated with asthma self-management among 652 women with physician-diagnosed asthma. It found that minority women, those with lower income/education, and unemployed women were more likely to have persistent asthma and use management techniques more frequently. Women who experienced premenstrual symptoms or asthma symptoms during sex had significantly more healthcare utilization. Adopting management techniques was associated with more severe asthma, though disease severity was unrelated to beliefs or confidence in management.
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Womens self management of asthma
- 1. Noreen Clark, PhD Molly Gong, MD Melissa Valerio, MPH Sijian Wang, BS Xihong Lin, PhD William Bria, MD Timothy Johnson, MD Women’s Self-Management of Asthma University of Michigan School of Public Health
- 12. Asthma Severity Classified by NAEPP criteria, Guidelines and Diagnosis and Treatment of Asthma, 1997 15% Severe persistent 18% Moderate persistent 15% Mild persistent 52% Mild intermittent Percent of Women
Editor's Notes
- In 2001, 9.1% of US women or 9.6 million had asthma. Increases in deaths from asthma between 1979 to 1996 was attributable to women, primarily those over 65 with Black women having the highest rates. Obesity is now seen as an epidemic in the United States.
- The purpose of this study was to examine factors associated with self-management for women with asthma. Asthma related problems include an awareness of particular issues women with asthma face, health care utilization, self-management and physician/patient communication. Sex and gender related management issues were also studied including menstruation, PMS, sexual activity and household activities.
- The current study reports findings at baseline data collection for 652 women, 18 years and older with an asthma physician diagnosis. Women were recruited from the University of Michigan Asthma & Airways Clinic and the University of Michigan Health System.
- Data is collected via telephone in a 45 minute interview. The questionnaire includes demographics, asthma symptoms – frequency, both daytime and nighttime and trigger identification. Health care utilization – ED visits, hospitalization and physician office visits (both scheduled and unscheduled). Gender related management – including daily activity limitation (HH chores, social activities, day care activities, and sexual activity) Co-Morbidity – as self-reported by women Quality of life - Using the Juniper Adult questionnaire and selected Rosenberg self-esteem questions.
- Findings reported are from logistic regression models.
- About 50% of the participants were between 41 and 60 years of age. Twenty percent were 60 years of age and older and the remaining one fourth were 40 years and younger. .
- Twenty-six% of the participants were high school graduates, 21% reported completion of two-years of college, 30% completed 4-years of college, and 21% reported post graduate education.
- Eleven percent of the women have less than $20,000 annual household income. Eighteen % between 20,000 to 40,000. About 35% of the women reported in a range of 40,000 to 60,000 annual household income. 11% of the women did not report their income.
- 17% of the participants are minorities. 10% African-American and 2% Hispanic. This is representative of the population served by the UM Health System.
- Asthma severity was calculated using NAEPP criteria with 53% of the women were classified as having mild intermittent asthma while 48% had mild persistent to severe persistent asthma. 15% of the women were classified as severe persistent.
- Logistic regression adjusted for age is use. Marriage=1 if married, marriage=0 otherwise. Low income=1 if annual income less than 20,000, low income=0 otherwise. Race =1 if white, race =0 otherwise. Education=1 if education level higher than high school, education=0 otherwise.
- Self-management was associated with persistent asthma, Low education and unemployment in the logistic model.
- Study limitations include: The study sample represents a proportionately higher number of women with high levels of education and income and an average age of 49 years. Data is also self-reported.