Health Science Journal

Introduction

Asthma is a long term health problem affects 300 million people worldwide and 15 million people in India. It accounts for 0.5% of national burden and 0.2% of death. It is considered to be a prototype of psychosomatic illness. The various triggers for asthma includes, allergic, infective, climatic and emotional factors.

Background of the Study

The theme for world Asthma day, 2011 is you can control your Asthma' as framed by Global Initiatives for asthma (GINA) in order to create awareness and control asthma. It’s like an iceberg, that only 11% asthma patients are being identified and remaining 89% are either not or wrongly diagnosed. Hence, necessary measures to be taken to cure it before it becomes fatal condition. However, yoga can increase fitness and reduce stress, which may help control asthma. Hence the level of control needs to be identified and measures to be initiated as earlier.

Need for the Study

Education seems to be a positive predictor of physical and mental health among patients with chronic illness. Research suggests that social support and education on control measures by the health care professionals is advantageous for promoting their quality of life.

Objectives

1. To determine the level of asthma control among patients with bronchial asthma.

2. To associate the level of asthma control with the selected demographic variables among patients with bronchial asthma.

Methodology

Research Design : Evaluative approach

Sample : Patients with bronchial asthma

Sample size : 60

Setting : Chest OPD, Sri Ramachandra Hospital

Sampling technique : Random sampling

Tool : Pharmacy Asthma Control Screening Tool (PACS)

Tool description

Ask the patient if he/ she has experienced any of the following in the last month (Tick) (Table 1).

Table 1 Tool description.

Criterion	Never	Once a week or less	More than once a week	Not sure
Symptoms of asthma, cough, wheeze, shortness of breath
Waking at night because of asthma
Chest tightness on walking
Difficulty in performing vigorous activity like running, lifting heavy objects, exercise
Difficulty in performing moderate activities like vacuuming, climbing flights of stairs
Asthma Control	Good	Partial	Poor	Not sure

Note: Well controlled= good or partial, Poorly controlled = poor

Data analysis: Descriptive and Inferential statistics, Results: The major findings of the study are depicted below in tables and graphs.

Table 2 and 3 depicts the frequency and percentage distribution of the demographic variables of patients with bronchial asthma. Among which 23 (38%) belongs to the age group of 20-30 years and 36 (60%) of them are male patients, and majority 33 (55%) had primary education, 27 (18%) are unskilled labors with the income of Rs. 10,001 to 15,000 are 16 (27%), 28 (47%) are living in the semi-urban areas, 35 (58%) are non smokers, 32 (54%) had family history of asthma in their first degree relative, 18 ( 30%) had comorbid illness of hypertension.

Table 2 Frequency and percentage distribution of the demographic variables among patients with bronchial asthma.

Demographic Variables		N=60
		No.	%
1.	Age (in yrs)
a.	20-39	23	38
b.	40-59	22	37
c.	59-60	15	25
d.	>60	-	-
2.	Gender
a.	Male	36	60
b.	Female	24	40
3.	Educational status
a.	No formal education	12	20
b.	Primary school	33	55
c.	High school	15	25
d.	Higher secondary	-	-
e.	Degree	-	-
4.	Marital status
a.	Married	10	17
b.	Unmarried	23	38
c.	Divorced	-	-
d.	Widow	27	45
5.	Occupation
a.	Coolie	10	25
b.	unskilled	27	18
c.	Skilled	12	30
d.	Professional	11	27
6.	Income (inRs) per month
a.	≤ 5000	5	8
b.	5001-10,000	15	25
c.	10,001-15,0000	16	27
d.	15,001-20,000	12	20
e.	>20,001	12	20
7.	Residence
a.	Rural	12	20
b.	Semi-urban	28	47
c.	Urban	20	33
8.	Type of family
a.	Joint	23	38
b.	Nuclear	22	37
c.	Extended	15	25
9.	Smoking habit
a.	Non smoker	35	58
b.	Cigaratte smoker	25	42
10.	Duration of asthma(yrs)
a.	<6 months	23	38
b.	≤ 1	12	20
c.	1-5	25	42
11.	Family history of asthma
a.	First degree relative	32	54
b.	No First degree relative	28	46
12.	Presence of co-morbid medical illness
a.	Diabetes mellitus	16	27
b.	Hypertension	18	30
c.	Cardiac disease	10	17
d.	Bone disease	-	-
e.	Gastro-intestinal disease	16	26

Table 3 Overall mean and standard deviation of level of asthma control among patients with asthma (N=60).

Mean	Standard deviation
10.9	4.38

Figure 1 depicts the percentage distribution of the asthma symptom experienced by the patients in the last month. Overall it showed that 56% of them are in the poor state of asthma control, 20% of them have partial control and 15% are not sure about their asthma control.

Figure 1: Percentage distribution of level of symptom experienced in the last month among patients with bronchial asthma.

Figure 2 depicts that asthma control was classified into two categories which includes well controlled as good or partial experience of symptoms and poorly controlled as poor way of experiencing the symptom control in the last month (PACS). The analysis shows that 71% of them are in the poorly controlled state of their asthma severity.

Figure 2: Percentage distribution of level of control among patients with bronchial asthma.

There was an significant association between asthma control with the age, duration of illness.

Conclusion

Prevention from the complications is an essential key in the asthma management. Collaborative management is essential to improve their quality of life and prevent from deterioration of lung function. Nurses can implement the protocols/policies to motivate patients to improve their adherence with poor disease control.

Holistic Nursing should focus on health care sector in which the care of individuals, families and communities to maintain optimal health and quality of life.

Effective asthma management requires routinely tracking symptoms and measuring how well lungs are functioning.

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