Building explanatory model of asthma-specific quality of life - An analysis of patients enrolled in an asthma disease management program

Objectives: The aim of this study was to build an explanatory model in the quality of life (QOL) for patients with asthma by examining children and adults samples. Methods: The study subjects were adults and children who participated in the asthma disease management program conducted by the Bureau of National Health Insurance (BNHI) of Taiwan. The total sample size was 669 with a response rate of 29.4%. We used structural equation modeling to examine the models by LISREL 8.30. Results: Both the children (x²/df=63.8/49, p=0.076, RMSEA=0.037) and the adults (x²/df=78.9/60, p=0.052, RMSEA=0.026) models were supported. Results indicated that both attitude and self-reported severity of illness had direct effects on QOL of asthmatics. Both knowledge and attitude had positive and indirect effects on QOL via self-care behavior and severity of illness. Conclusions: Asthma knowledge might affect QOL of asthma patients through the mediation from attitude, self-care behavior, and severity of asthma. We suggest that for both children and adults we should focus especially on building up a positive attitude, guiding and promoting of self-care behavior with the aim of improving patients' QOL during the intervention of asthma disease management program.