| Popis: |
Introduction Although generalised anxiety (GA) has a substantial influence on asthma outcomes, the underlying mechanisms remain unclear. This study examined individuals’ ‘Self-efficacy’ (SE) or their own belief in their ability to manage their asthma and ‘Experiential Avoidance’ (EA), the tendency to avoid unpleasant internal states as potential mechanisms that mediate the relationship between GA and asthma outcomes. Methods Four NHS Scotland Outpatient Respiratory clinics included adults with asthma aged 16 to 75 years. 65 participants completed cross-sectional questionnaires: The Generalised Anxiety Disorder Questionnaire, Brief Experiential Avoidance Questionnaire, Perceived Control of Asthma Questionnaire, Mini Asthma Quality of Life Questionnaire and Asthma Control Test. Correlations and path analyses were used to explore relationships between variables and mediating effects. Key asthma outcomes included: Asthma Quality of Life (QoL), Asthma Control and Short-Acting Beta Agonist (SABA) use. Results Higher levels of GA were significantly correlated with poorer asthma control (r=-0.428**), poorer asthma related QoL (r=-0.540**) and higher SABA use (r=0.412*). Higher GA was also significantly correlated with lower SE to manage asthma (r=-0.525**) and higher EA (r=0.565**). Significant indirect effects were found from increased GA to both decreased asthma control and QoL through decreased SE (b=-0.117, SE=0.061, 95%CI=[-0.262,-0.025]) and (b=-0.709, SE=0.239, 95% CI=[-1.21,-0.025]) respectively. The indirect effects from increased GA to both decreased asthma control and QoL through increased EA were also significant (b=-0.110, SE=0.049, 95%CI=[-0.214,-0.021]) and (b=-0.582, SE=0.259, 95%CI=[-1.16,-0.137]) respectively. Indirect effects from GA to SABA through SE and EA were not significant. These findings could not be explained by other covariates such as steroid medication use, SABA use or years living with asthma. P values (*p Conclusions These findings highlight the significance of Self-efficacy and Experiential Avoidance as potential mechanisms through which co-morbid Generalised Anxiety impacts on poorer asthma control and Quality of Life. It provides preliminary support for the use of psychological interventions which focus on these factors such as the Cognitive Behavioural Therapy and Acceptance and Commitment Therapy but will require replication in a longitudinal study. |
