Table 3.
Unadjusted relationship between illness and medication beliefs with self-management behaviors of World Trade Center rescue and recovery workers with asthma.
| Belief | Participants holding belief No. (%) | Medication adherence OR (95% CI) | Correct MDI technique OR (95% CI) | Correct DPI technique OR (95% CI) | Action plan OR use (95% CI) | Trigger avoidance OR (95% CI) |
|---|---|---|---|---|---|---|
| Illness beliefs | ||||||
| Asthma labels | ||||||
| Wheezing due to asthma | 299 (84.0) | 1.08 (0.53–2.17) | 1.29 (0.56–2.94) | 0.97 (0.10–9.57) | 1.21 (0.31–4.79) | 2.07 (1.14,3–75) |
| Tiredness due to asthma | 161 (44.6) | 1.01 (0.63–1.63) | 1.21 (0.69–2.13) | 4.70 (0.52–42.59) | 2.06 (0.76–5.60) | 1.42 (0.93,2.15) |
| WTC-related asthma is different from non-WTC-related asthma | 146 (52.1) | 1.21 (0.76–1.95) | 0.91 (0.52–1.59) | 0.83 (0.16–4.19) | 2.39 (0.89–6.40) | 1.01 (0.67–1.52) |
| Cause | ||||||
| Asthma due to WTC exposure | 348 (95.1) | 1.88 (0.56–6.25) | 0.60 (0.13–2.78) | 1.03 (0.04–23.6) | 5.05 (0.30–84.36) | 3.27 (1.05–10.12) |
| Asthma due to inadequate respiratory protection at WTC site | 265 (95.7) | 1.37 (0.48–3.87) | 0.65 (0.14–3.07) | * | 2.53 (0.43–14.86) | 1.84 (0.73–4.68) |
| Timeline | ||||||
| Have asthma all the time, not just when experiencing symptoms | 133 (36.0) | 2.20 (1.36–3.57) | 1.42 (0.79–2.54) | 1.27 (0.25–6.40) | 2.88 (0.90–9.24) | 1.06 (0.69–1.63) |
| Control | ||||||
| WTC-related asthma is more severe | 182 (49.7) | 1.31 (0.81–2.10) | 0.93 (0.53–1.63) | 0.49 (0.08–2.83) | 1.77 (0.67–4.67) | 1.27 (0.84–1.92) |
| Doctors do not know how to treat WTC-related asthma | 67 (18.6) | 0.83 (0.46–1.49) | 0.74 (0.37–1.48) | 1.24 (0.13–11.93) | 1.51 (0.40–5.69) | 0.88 (0.52–1.50) |
| Consequences | ||||||
| Asthma affects my life | 139 (37.3) | 1.10 (0.69–1.76) | 0.79 (0.45–1.38) | 0.48 (0.27–0.86) | 2.48 (0.88–6.99) | 1.65 (1.08–2.51) |
| Experience lot of asthma symptoms | 93 (24.9) | 0.82 (0.48–1.39) | 1.66 (0.83–3.33) | 1.96 (0.34–11.28) | 1.88 (0.58–6.09) | 0.81 (0.51–1.30) |
| Emotional Responses | ||||||
| Concerned about asthma | 231 (61.9) | 1.08 (0.65–1.79) | 0.74 (0.41–1.33) | 0.94 (0.19–4.78) | 1.33 (0.48–3.67) | 1.63 (1.07–2.49) |
| Asthma affects emotionally | 115 (30.8) | 1.21 (0.74–1.97) | 0.48 (0.27–0.86) | 1.06 (0.21–5.35) | 1.71 (0.61–4.82) | 1.94 (1.24–3.03) |
| Worried asthma may get worse | 103 (28.1) | 1.07 (0.64–1.76) | 0.52 (0.29–0.96) | 1.35 (0.23–7.85) | 1.69 (0.57–5.06) | 1.54 (0.98–2.44) |
| Medication beliefs | ||||||
| Necessity | ||||||
| Important to use medications when not having symptoms | 191 (71.3) | 10.93 (4.97–24.1) | 1.56 (0.80–3.03) | 1.38 (0.23–8.33) | 0.96 (0.24–3.83) | 1.47 (0.86–2.50) |
| Feel effects of inhaled corticosteroids | 228 (64.0) | 1.87 (1.10–3.16) | 1.05 (0.58–1.89) | 1.09 (0.18–6.47) | 0.49 (0.15–1.61) | 1.37 (0.89–2.12) |
| Only need SABA to treat asthma | 196 (59.0) | 0.48 (0.29–0.78) | 1.12 (0.63–1.99) | 0.36 (0.06–2.09) | 0.92 (0.33–2.55) | 0.70 (0.45–1.09) |
| Present health depends on medicine | 147 (55.1) | 2.04 (1.23–3.37) | 1.33 (0.73–2.46) | 2.48 (0.48–12.66) | 3.51 (1.05–11.76) | 1.15 (0.71–1.87) |
| Concerns | ||||||
| Inhaled steroids weaken immunity | 122 (35.1) | 1.28 (0.78–2.12) | 0.68 (0.38–1.22) | 1.09 (0.16–7.31) | 1.65 (0.57–4.76) | 1.57 (1.01–2.44) |
| Medications do not work as well for WTC asthma | 60 (16.6) | 0.72 (0.38–1.34) | 0.77 (0.36–1.65) | 0.61 (0.10–3.71) | 1.21 (0.37–3.98) | 0.91 (0.52–1.59) |
| Self-efficacy | ||||||
| Confident in ability to control asthma | 298 (81.0) | 1.48 (0.83–2.64) | 2.65 (1.37–5.14) | 1.94 (0.31–12.12) | 0.73 (0.22–2.39) | 0.75 (0.44–1.26) |
OR: Odds ratio for adherence to asthma self-management behavior for those with vs. without the belief; CI: confidence interval; MDI: Metered Dose Inhaler; DPI: Dry Powder Inhaler; WTC: World Trade Center; SABA: Short-Acting Beta-Agonist.