Response: Educational self-help approaches in childhood asthma

Abstract

Asthma self-management programs are most effective if they succeed in increasing individual control over the symptoms, thereby reducing the unpredictability and variability of asthma. Before any attempt at self-care as defined by Levin et al. l can be implemented, certain barriers need to be resolved. As workers in this field have come to realize, the intrinsic interand intrasubject variability of the asthmatic syndrome creates certain limitations, demands, and different emphases when developing self-management strategies, as noted in several studies. ‘-I7 Most of the comments that follow apply to moderate-to-severe asthma since mild episodic asthma is rarely a problem. First of all, the limitations deal with the process of seeking the correct diagnosis; this often requires the self-care initiative discussed by Levin et al.’ and is often stifled by the medical care maze some individuals are made to face. One often receives calls from confused parents and patients regarding the diagnosis, the treatment, and which specialist to see-the allergist or the pulmonologist. The diagnosis of asthma remains a problem for many whose disease is misdiagnosed and mismanaged, thus delaying the initiation of appropriate care. lx The next point that may create confusion for the person with asthma is the variety of treatment modalities presently available. lgPzl This, coupled with the individuality of the asthmatic syndrome, adds to the complexity of the situation in the layperson’s view, a situation somewhat similar to the diabetic’s situation.22 Once the correct diagnosis of asthma has been made and the person linked with a competent physician, the appropriate individualized care is initiated and Bandura’s self-efficacy theory23 can be implemented. Special emphases should deal with a disease histor-