• Internal Code :
  • Subject Code : SNUG202
  • University : University of Wollongong
  • Subject Name : Nursing

Practice in The Self-Management of Asthma


This study will go on to critique the below researches. The findings of the two studies will be subjected to see how self-management has been procured. It can be seen that both the studies have tried to confer self-management in terms of Asthma but there were certain limitations to it. However, throughout the studies, it has been conferred that Australians are at a higher risk for poor health and self-management.

Table of Contents

1. First study

2. Second Study



1. First study: Paasche-Orlow MK, Riekert KA, Bilderback A, et al. Tailored education may reduce health literacy disparities in asthma self-management. Am J Respir Crit Care Med. 2005; 172: 980-6. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2718412/

Background/ Literature Review

In the context of the research by Paasche-Orlow et al. (2005), it can be very well stated that the topic goes well with the study. It can be comprehended from the very beginning that literacy of health is the adequacy through which individuals acquire, develop, and comprehend the necessary health data and services required to determineappropriate decision on health, and in many cases, it is considered by reading health information.The rationale is well justified. It has been understood that poor health literacy is connected with poor information on asthma medicine and poor MDI technology, but there is a relationship between health literacy and health efficiency. Learning the self-management skill related to asthma is unknown in accordance to the research study.

Aim, Objectives, Purpose of The Study

In this potential study, adults admitted to two hospitals in the inner city for severe asthma, was examined. The relationship between short-term drug deficiencies and learning and maintenance difficulties, output, and guidelines for appropriate MDI strategies were looked at.

From the research, it can be comprehended that the purpose of the study is well-wrought out. It states that this research is to inspect the correlationbetweeninsufficient health literacy and difficulties in learning and maintaining guidelines regarding drug withdrawal and appropriate MDI strategies. From the proposed hypothesis of the study, it can be conferred that inadequate health literacy led to unknown comprehension of asthma medications, unnecessary usage of the MDI technique, along with continued learning and instruction of output and appropriate MDI techniques. These hypotheses present a secondary objective of the study that demonstrates adherence to corticosteroid therapy after release from the hospital. Few of the results of this survey have already been reported in abstract form (Paasche-Orlow et al. 2005).

Methodology/ Participants

The most interesting and valuable part of the research study was that in context discharge from the hospital, participants received 30 minutes of individual, written, and oral instruction based on guidelines regarding appropriate MDI strategies as an asthma exit procedure.

In context to the measurement of the main results, it can be stated that the results were quite similar. The registered healthcare users for this study was 73. Insufficientliteracy on health was recognized among 16 (22%) participants. Previous to prescription, poor health literacy was connected with low awareness of asthma (5.2 / 10 vs. 7.2 / 10, p <0.001) and poor MDI strategies (3.2 / 6 3.9 /, p = 0.03) but insufficient health literacy instructions for learning the method of discharge (p = 0.33) or maintenance (p = 0.35) were not involved. Similarly, insufficient difficulty in health education was not connected with learning (p = 0.26) or maintaining the correct MDI strategy (p = 0.97) in which the consequences were comparable in multiple models to be adjusted in context to demographic characteristics and asthma severity indicators.

Besides, the study assessed healthcare users'understanding of asthma medications. There is no valid measure before assessing healthcare users' understanding of asthma medications (respiratory corticosteroids, short-acting bronchodilators, and oral corticosteroids). However, the study has created ten items subjected to the Asthma Knowledge Scale, professional opinions, and a desire to relate every item directly to drug use. Participants received 1 point for each item answered correctly. In context to a total of 10 possible scores, the researchers calculated the total knowledge score for asthma medications (total score / 10) with adequate internal continuity reliability (Cronbach α =0.62) and equivalent to other published knowledge scales related to asthma.


These results prove that insufficient health literacy is the last obstruction to learning and memorizing the main self-management skills of asthma. From the research, it has been conferred that self-management skills for asthma and the use of intensive care services have been linked to various socio-economic organizations. In particular, smoking, the worst MDI strategy, and the highest rate of emergency room visits have been concerned as a significant risk factor for hospitalization and mortality for asthma healthcare users over the years.

In this study, the patient's education level was not autonomous knowledge of understanding asthma medications, MDI techniques, or menstrual procedures. Instead, it has been found that health-related literacy is extrapolative of asthma medicine knowledge and MDI strategies. Also, the research suggests that knowledge of asthma medicine subjects an important role in the path from inadequate health literacy to inadequate MDI technology (Stanzel et al. 2019).

2. Second Study: Adams RJ, Appleton SL, Hill CL, et al. Risks associated with low functional health literacy in an Australian population. Med J Aust. 2009; 191: 530-4. Available from: https://www.mja.com.au/journal/2009/191/10/risks-associated-low-functional-health-literacy-australian-population

Introduction, Background/ Literature Review

The topic is well justified with the study which has been undertaken by Adams et al. (2009). The research confers that everyone understands the term health literacy which is something that enables healthcare users to understand and work for their benefit, has been subjected as the ultimate path to health care, high quality. Effective health literacy (FHL), addedincomplete concept, subjects the capability to read, compute, and edit oral and written data in healthcare. Studies in context to the US have subjected that limited FHL causes premature death, adverse outcomes of health, higher health costs. It also has less frequent preventive measures associated with behaviors of health and less active self-management in context to chronic diseases (Adams et al. 2009).

Aim/ Objective/purpose of The Study

The Objective of the study is wrought out in a true sense and goes well with the topic of the study. It can be understood that the objective is to determine the point of FHL in the Australian populace and to investigate the point of risk connected with the level of FHL.

The study was constituted in a cross-sectional method with a random sampling of the population which is quite fruitful for this kind of research. Data were analyzed through SPSS version 15.0. Several logistical regression models were subjected to variables with insufficient FHL results compared to those receiving adequate FHL and for sufficient FHL with risky or insufficient FHL (NVS score, 0-3).

Methodoloogy/ Data Analysis/ Data Collection/ Participants

It can be studied from the research that limited FHL in adults in SA is connected with low health conditions. According to other reports, individuals with important chronic circumstances like diabetes, stroke, and heart disease had a higher risk of developing limited FHL. Young individualsare at risk of FHL limitation are less probable to see a choice of healthcare providers, as well as general practitioners, in less socioeconomic groups. Each group showed the highest income and limited risk of FHL growth compared to the education department. On the other hand, even among individuals with a bachelor's higher or degree, about 20% were at risk of having a limited FHL (Barber et al. 2009).

In the context of the results, it can be seen that twenty-four percent of participants were at risk of limited FHL, and twenty-one percent were more likely to have inadequate FHL; it has increased with age. In multiple logistic regression models, with low education, the high probability of inadequate FHLs with low annual income is significantly higher; who took birth in thenations other than New Zealand, Australia, UK,and Ireland; and including poor health. Inadequate FHL is significantly less common in women. Individuals with inadequate or high-risk FHL were notably more likely to have diabetes, stroke along with heart diseases, and they were less likely to see a doctor in recent times. It was found that respondents over the age of 65, with inadequate FHL, were more likely to be hospitalized.

The risk of having low FHL for certain groups of foreign origin may be related to fluency in English but it may also be pretentious by more than a few other cultural or economic problems and the only reason to focus on the language may be premature. These groups may deserve further study (Adams et al. 2009).


From the first study of Paasche-Orlow et al. (2005), it has been conferred that this study demonstrates that inadequate self-management skills for asthma are worse than general and inadequate health knowledge, knowledge of asthma actions, and MDI techniques. However, it was not difficult to maintain or manage the guidelines for inadequate health literacy and how to get out of the appropriate MDI strategy. The results propose the need for regular evaluation of healthcare user discharge instructions and assays during release from the hospital. Deficienties in context to the medicinal knowledge of asthma, MDI technique and the regimen of discharge was very common in the adults that were hospitalized and later discharged.

In this particular study the dificiencies in regard to asthma self management were not held by sociodemographic charecteristics like education, sex, age and ethnicity or past asthma care usage. Insufficient literacy in conext to health was connected hospitalization for exacerbations in asthma, with improper use of medicines and less knowledge of MDI technique. In this context it will be very well to mention that healthcare users with insuffient literacy in terms of health were likely to have less medication knowlge about asthma and improper technique of MDI.

From this research of Adams et al. (2009), it can be very well conferred that certain elements were limited. What we do not know from our study is that the risk of limited FHL is connected with lessdata about the chronic disease or unhealthy lifestyle behaviors. The person will understand the problem better than the difference between the treatment and the results of the relevant information and health literacy test. Nevertheless, it is obvious from the data and other studies that FHL test results reflect the risk of chronic disease and the outcome of this condition.From the research study, it has been evident that many Australians are at risk for poor health and this poses a risk to the effectual delivery of health care and improving the health of the population. However, this particular study clearly wrought out that FHL in context to the adults of Sa were vvery much limited. Lower status of ealth were also very much prudcent in the adults of SA.

The risk in context to FHL was very much prevalent foor the individual;s who has chronic conditions like hear disease, diabetes and storke. It alos had been evident from the findings that the adults were less likely to go to the healthcare experts or practisioners. However, in comparison with the highest category of education and income, every group subjected an upliftnent in the risk of FHL. It has been analuysed that by the use of level of education the study will misclassilfy the respondents with limited FHL. The only improvement in this context has been through communication. Communication has only been the medium thrpugh whoch poor hea;th literacy can besubjected in effective terms. It has also improved the healthcare users havinf chronic conditions like diabetes.


Adams, R. J., Appleton, S. L., Hill, C. L., Dodd, M., Findlay, C., & Wilson, D. H. (2009). Risks associated with low functional health literacy in an Australian population. Medical Journal of Australia, 191(10), 530-534, Available from: https://staging.mja.com.au/system/files/issues/191_10_161109/ada10529_fm.pdf

Barber, M. N., Staples, M., Osborne, R. H., Clerehan, R., Elder, C., &Buchbinder, R. (2009). Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool: results from a population-based survey. Health promotion international, 24(3), 252-261, Available from: https://academic.oup.com/heapro/article/33/5/901/3091768

Paasche-Orlow, M. K., Riekert, K. A., Bilderback, A., Chanmugam, A., Hill, P., Rand, C. S., ...& Krishnan, J. A. (2005). Tailored education may reduce health literacy disparities in asthma self-management. American journal of respiratory and critical care medicine, 172(8), 980-986, Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2718412/

Stanzel, K., Hammarberg, K., Nguyen, T. T., & Fisher, J. (2019). Menopause-related health literacy: a qualitative study of experiences and perceptions of menopause-related health care among Vietnamese-born women in Melbourne, Australia, Available from: https://assets.researchsquare.com/files/rs-2697/v1/manuscript.pdf

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