الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 97 |  |  |
| | | from | 97 | | |
Abstract
Asthma is a chronic disease of the air passages of the lungs which inflames and narrows them. Self learning education is currently considered essential for the successful treatment of asthma patients. Self efficacy is a key factor in asthma management. It appears to have a strong influence on decision making, on the amount of effort made, and the persistence applied to performing behavior. Adherence is defined as the extent to which patient’s behavior change in term of taking medications, following diets and other life style changes. Adherence is an essential component in the success of preventive and the therapeutic management (Choudhry, et al, 2009& WHO, 2013).
Aim of the study:
The present study was conducted to fulfill the following aim:
To evaluate the effect of self learning module on self efficacy and adherence to therapeutic regimen for patients with bronchial asthma through:
1. Assessment patient’s self efficacy and adherence to therapeutic regimen for bronchial asthma pre self learning module intervention.
2. Planning and implementing of self learning module regarding therapeutic regimen for patients with bronchial asthma based on needs assessment.
3. Evaluation of the effect of self learning module on patients’ self efficacy and adherence to therapeutic regimen.
Research hypothesis:
This study hypothesized that;
1- Self learning module will improve and affect positively on performance (knowledge and practice) of patients with bronchial asthma than patients who will not use self learning module.
2-Self learning module will improve and affect positively on self efficacy of patients with bronchial asthma than patients who will not use self learning module.
3- Self learning module will improve and affect positively on adherence to therapeutic regimen for patients with bronchial asthma than patients who will not use self learning module.
Research Design:
A quasi-experimental design was utilized to accomplish the aim of this study.
Research Setting:
This study was conducted at the Out-patient Chest Clinic in Ain Shams University Hospitals.
Subjects:
A purposive sample of 70 patients complaining of bronchial asthma selected according to certain criteria. The study subjects divided into two groups 35patients for each group, study group who had the self learning module and routine care, and control group who had only routine care with different educational level.
Tools used to accomplish the aim of this study:
Five Tools were used in the current study as follows:
1. Socio-demographic and clinical data sheet
This sheet was designed by the researcher it included 2 parts as the following:
Part (1): It was concerned with socio-demographic characteristics of the patients under study as regards; age, sex, level of education, social status, occupation, residence.
Part (2): It was designed by the researcher based on literature review to gather information related to patient’s history of present disease, effect of current illness on patient’s work, medications prescription, drug allergy, food allergy and patient’s habits as smoking.
2- Asthma interview questionnaire sheet: It was designed by the researcher based on literature review to assess patients’ knowledge about bronchial asthma and the associated therapeutic regimen.
3- Observational checklists: It was developed by the researcher based on literature review to assess the patients’ practice as regards using inhaler, nebulizer, and breathing exercise and cough exercise.
4- Perceived control asthma questionnaire: It was used to assess patients’ self efficacy. It was developed and designed in English language by Katz, Yelin, Smith and Blanc, 1997 and translated into Arabic language and back translation was done.
5- Adherence questionnaire sheet for patients with bronchial asthma: It was developed by the researcher based on literature review it was used to assess patient’s adherence to therapeutic regimen
-Self learning module for patients with bronchial asthma:: The module was written in Arabic language and it consisted of a pre test, an introduction, and general objectives and the content, which is composed of two parts:
Part I: contained 2 units: (knowledge related to anatomy and physiology about respiratory system. Knowledge related to knowledge related to bronchial asthma disease).
Part II: contained 6 units: (Asthma triggers, Medication regimen, Cough and breathing exercise, diet, Sexual relation, Anxiety and insomnia and Follow up).
Results:
The results of the study showed that:
The mean age of the patients in the study group was 40.91±12.552, while that of the patients in the control group was 45.20±10.726, while in relation to gender, the result showed that 71.4% & 57.1% were females in the study and control groups respectively.
Also more than one third (34.3%) of patients in study group and less than half (45.7%) of patients in control group had Previous hospitalization.
The more learning needs of knowledge for both study and control group (100%) were related to activity, diet and medication regimen, prevention of complication, sexual relation and follow up. While, the more learning needs of practice were concerned to cough and breathing exercise both study and control group.
There were highly statistically significant differences among pre- post and follow up -implementation of self learning module regarding total knowledge between study and control group.
There were highly statistically significant differences among pre- post and follow up -implementation of self learning module of patient practice regarding inhaler, nebulizer, and cough and breathing exercise between study and control group.
There were highly statistically significant differences among pre- post and follow up -implementation of self learning module of patient self efficacy between study and control group.
There were highly statistically significant differences among pre- post and follow up -implementation of self learning module of patients’ total adherence between study and control group.
there was no significant correlation between total adherence and total knowledge and total practice in the study group pre implementation of self learning module, while, there was a highly statistically significant correlation in study group post and a statistically significant correlation in follow up of implementation of self learning module only.
there was no significant correlation between total self efficacy and total knowledge and total practice in the study group pre implementation of self learning module, while, there was a highly statistically significant correlation in study group post and a statistically significant correlation in follow up of implementation of self learning module only.
There was no statistically significant correlation between total self efficacy and total adherence pre implementation of self learning module, but, there was highly statistically significant correlation post implementation and follow up of implementation of self learning module.
Conclusion:
Based on the findings of the present study, it can be concluded that:
The results of the current study supported all hypotheses. There was a statistical significant difference between study and control group in relation to knowledge, practice, self efficacy and adherence to therapeutic regimen. Self learning module affect positively on patients’ knowledge, practice, self efficacy and adherence to therapeutic regimen.
Recommendations:
Based on the results of the present study, the following recommendations are suggested:
Education programs for patients with bronchial asthma for improving the patients’ adherence with therapeutic regimen should be started from the first day of their admission to the hospital or follow at out-patient chest clinic by a community health nurse should be done periodically.
Further studies have to be carried out in order to assess the effectiveness of self learning strategies on patients’ adherence with therapeutic regimen.
Design a systematically continuous self learning module for patients with bronchial asthma in hospitals in addition to media such as: newspapers, television, and radio to help in improving the health status of these patients.
An Arabic guided images booklet about bronchial asthma should be distributed for each newly admitted patient diagnosed with bronchial asthma.
Replication of the study on a large probability sample is recommended to obtain more generalized findings in relation to this problem.