More precautions needed for adult asthma

Meredith Somers

Dry throat, tight chest and permanent shortness of breath.

All three are signs of an asthma attack, something that is not limited to overexcited eighth grade basketball players.

On Wednesday, Feb. 23, Professor of Nursing and Department Chair Elizabeth McGann spoke to students and faculty about her research findings concerning adults with asthma.

With the help of co-investigators Christine Fitzgerald, Carmen Adams, and Geoffrey Chupp, McGann set out to “explore the relationship among lab severity, self-reported severity, control, and self-management behaviors in adults with asthma.”

Using information received from the Yale-New Haven Hospital databases and written surveys sent by mail, McGann spent the fall of 2004 studying Pulmonary Function Tests (PFT). She then mailed responses to learn about adults afflicted with the breathing condition.

“The research project was quantitative, descriptive, correlative, exploratory, and retrospective. We looked not only at lab tests, but how [the patients felt],” McGann said.

McCann sent out 213 surveys with questions concerning each person’s demographics, their personal affliction of asthma, and two open-ended questions that asked about changes in self-management and their views after being hospitalized. Thirty-seven people replied.

“We wanted to see if these people had a wake-up call after going into the hospital,” McGann said.

The results produced helpful information; however, they were limited due to the sample size, combination of data sources and lack of face-to-face contact.

“It was found that a majority of the patients who responded were married females, who were white, married, and living in urban areas,” McGann reported. “The average time spent in the hospital for these people with asthma was five days, and the average was three years since the discharge. For most patients, they had lived with their asthmatic condition for over 20 years.”

Along with demographics came results on relationships between severity of asthma and prevention and treatment variables.

The study found that a greater portion of participants who labeled themselves as having a high level of severity also had poorer control over their condition.

Fifty-four percent of the respondents said they had good control over their asthma, while 46 percent felt the opposite reaction.

People did not change their views on asthma after being hospitalized, but 56 percent of the respondents made self-management changes such as weight loss and avoiding asthma triggers.

McGann also learned that 84 percent of the respondents made decisions about their asthma with their doctor but only 32 percent had written instructions from their doctor concerning their lifestyles when not encountering an attack.

From the facts and feedback, McGann and her colleagues came to a conclusion: specialty care is needed.

“Even though a majority of participants make self-management changes after their hospitalization, they still need more information and support in their efforts towards treating asthma,” McGann said. “A lack of written plans by a majority of participants suggests a knowledge deficit.”

Supporting her claims, McGann explained why there is a need for greater understanding of asthma. “Even though asthma is not as prevalent as cancer, 20 million people are afflicted with it in the United States, 12 million being adults. In 2002, there were over 4,000 deaths related to asthma,” McGann said. “People view it as ‘if it doesn’t affect me, I don’t care.’ But I’m concerned with the hospitalization. I don’t want a trip to the emergency room to be the wake-up call for these people to start changing their lives. What about those who don’t go to the ER?”

There are now efforts being to help learn more about adult asthma. Yale-New Haven Hospital has a list of questions for anyone admitted due to asthma related problems. The list includes questions about control of the asthmatic condition, whether or not the person has missed work due to asthma and how frequently a quick relief medication (inhaler) is used.

For McGann, the next step is another study. She hopes to explore the effects of self-efficacy, or the “belief in [yourself]” theory, to study asthma and its relation to human behaviors.