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Cited by 158Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchOccupational exposure and asthma

Self-efficacy, depressive symptoms, and patients' expectations predict outcomes in asthma

Mancuso, Carol A., Rincon, Melina, McCulloch, Charles E., Charlson, Mary E.·2001·Medical Care
DOI 10.1097/00005650-200112000-00008
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Abstract

BACKGROUND: Certain psychosocial variables are relatively unexplored as possible predictors of asthma outcomes. OBJECTIVE: To determine if asthma self-efficacy, depressive symptoms, and unrealistic expectations predict urgent care use and change in health-related quality of life measured by the Asthma Quality of Life Questionnaire and the SF-36 during 2 years. RESEARCH DESIGN: Prospective cohort study in a primary care internal medicine practice at a tertiary care center in New York City. PATIENTS: Adults with moderate asthma who were fluent in either English or Spanish. MEASUREMENTS: At enrollment patients were interviewed in-person and completed a series of questionnaires including the Asthma Quality of Life Questionnaire (AQLQ), the SF-36, the Asthma Self-efficacy Scale, the Geriatric Depression Scale, and open-ended questions regarding their expectations of treatment. Patients also completed the AQLQ and SF-36 at various time intervals throughout the study and were interviewed by telephone every 3 months to record recent hospitalizations, emergency department visits and nonroutine office visits for asthma. RESULTS: A total of 224 patients were followed for a mean of 23.8 months. In hierarchical analysis, independent predictors of lower AQLQ scores were less self-efficacy, more depressive symptoms, expecting to be cured of asthma, requiring methylxanthines, being Hispanic or black, and having difficult or very difficult access to asthma care (all at P <0.05). Similar predictors were found for lower SF-36 scores. Another outcome, use of urgent care, was required by 60% of patients during the study period. Predictors of using urgent care were having more depressive symptoms, expecting a cure, being female, requiring oral beta-agonists, and having a history of prior hospitalizations for asthma (all at P <0.05). CONCLUSIONS: Less asthma self-efficacy, more depressive symptoms, and unrealistic expectations predict worse asthma outcomes. These relatively unexplored patient-centered variables in asthma are potentially modifiable and may offer new ways to intervene to improve asthma outcomes.

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  • Comorbid depression is often associated with a worse course of physical disorders, partly because depression is often associated with non-adherence to treatment regimens.

    “comorbid depression is often associated with a worse course of the physical disorder.114–116 A number of reasons could be involved here, but one of the most consistently documented is that depression is often associated with non-adherence to treatment regimens.112, 117, 118”

    From The Costs of Depression (2012) · cites this paper as [114]

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Authors
Mancuso, C. A., Rincon, M., McCulloch, C. E., & Charlson, M. E.
Affiliations
  • Hospital for Special Surgery (US)
  • University of California, San Francisco (US)
  • NewYork–Presbyterian Hospital (US)
Corresponding author
  • Mancuso, Carol A.
  • Charlson, Mary E.
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-12
Volume
39
Issue
12
Pages
1326-1338
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/00005650-200112000-00008
OpenAlex
W2072744554
Cited by
158
References
63
Citations by year
2026: 3 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 5 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 9 · 2015: 8 · 2014: 3 · 2013: 6 · 2012: 13
FWCI
3.54
Type
journal article
Language
en
Open access
closed
Locations
  • Medical Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords
asthma, asthma self-efficacy, depressive symptoms, patient expectations, health-related quality of life, asthma outcomes, Hispanic patients, methylxanthines, asthma hospitalization
MeSH terms
Adolescent, Adult, Asthma, Depression, Emergency Treatment, Female, Humans, Male, Middle Aged, New York City, Prospective Studies, Quality of Life, Surveys and Questionnaires, Cohort Studies, Treatment Outcome, Sickness Impact Profile, Self Efficacy

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