Development and testing of the Asthma Self-Management Questionnaire.
Academic Article
Overview
abstract
BACKGROUND: Assessing self-management knowledge can guide physicians in teaching patients necessary skills. OBJECTIVE: To develop and test the Asthma Self-Management Questionnaire (ASMQ). METHODS: The ASMQ was developed from patient interviews. Validity was evaluated by comparison with the established Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire, and test-retest reliability was evaluated with repeated administration (mean, 5 days apart) in 25 patients (mean age, 41 years; 96% women). The ASMQ was further described in additional patients by comparison with cross-sectional self-management practices and longitudinal change in Asthma Quality of Life Questionnaire scores. RESULTS: The 16-item, multiple-choice ASMQ measures knowledge of preventive strategies, inhaler use, and medications and generates a score of 0 to 100, with higher scores indicating more correct responses. The ASMQ was correlated with the Knowledge, Attitude, and Self-Efficacy Questionnaire (r = 0.58) and had a Cronbach alpha of 0.71. The correlation between administrations was 0.78, and the intraclass correlation coefficient was 0.58. When given to another 231 patients (mean age, 41 years; 74% women), the mean (SD) ASMQ score was 60 (20). Patients with better ASMQ scores were more likely to own peak flow meters (P = .04) and to have received flu vaccines (P = .03). For 12 months, these patients received self-management information through workbooks and telephone reinforcement. Patients with higher ASMQ scores after 12 months were more likely to have clinically important improvements in quality of life compared with patients with lower ASMQ scores (65% vs 46%; P = .01). CONCLUSIONS: The ASMQ is valid and reliable and is associated with clinical markers of effective self-management and better asthma outcomes.