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Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its c hronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process-clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings. Keywords: Australia; Asthma; Self-management model; Community pharmacists; Illness behaviour

Infection control is often cited inappropriately to justify actions, to ban or restrict practices (news August 31). Staff wearing hospital uniforms in public places has generated considerable discussion. The banning [...]

Coronary artery disease patients’ perception of their health and expectations of benefit following coronary artery bypass grafting This prospective descriptive study has analysed 214 patient interviews before and 1 year after coronary artery bypass grafting (CABG). The preoperative interview explored issues related to the impact of coronary artery disease upon health and expectations of benefit from the patients’ perspective. The postoperative interview examined patients’ accounts of the experience of operation and its impact on their health. A thematic analysis of the interview data was undertaken. The main factors relating to health status preoperatively were described in terms of ‘dependency’ on others and medication, and ‘impending doom’ of some major life threatening event. Benefits to health postoperatively were viewed in terms of ‘removal of a death sentence’ and ‘freedom of choice’. Expectations of benefit from operation were varied and included ‘freedom and independence’, ‘hope, chance and uncertainty’ and ‘addition of years to life and life to years’. Undergoing the operation was described by themes of the ‘enormity of the experience’ and ‘the importance of lay support’. These findings provide a greater understanding of the ‘lived experience’ of both coronary artery disease and undergoing coronary artery bypass grafting. Unrealistic expectations of the benefits of CABG highlights the need for improvement in the way patients are informed about risks and benefits of interventions. In addition, the views and insights suggest that CABG operation is regarded as a significant major life event; thus more information, advice and counselling might help support patients before, during and after surgery. [ABSTRACT FROM AUTHOR]