Influences of health literacy, judgment skills, and empowerment on asthma self-management practices

Patient Educ Couns. 2015 Jul;98(7):908-17. doi: 10.1016/j.pec.2015.03.003. Epub 2015 Apr 3.


Asthma self-management has been recognized as an essential factor for the improvement of asthma outcomes and patients' quality of life (WHO, 2013). Likewise, empowerment and health literacy have been noted as important elements for the management of chronic diseases.

Objective: To study the influence of health literacy and empowerment on asthma self-management.

Methods: This cross-sectional study used a self-reported questionnaire assessing health literacy, judgment skills, empowerment, and asthma self-management; 236 patients were recruited from medical offices in Switzerland and Italy.

Results: Judgment skills (B=2.28, p<0.001) and empowerment (B=0.19, p<0.05) have a significant and positive influence on several asthma self-management practices such as use of medicines, timely medical consultation, and asthma triggers control whereas health literacy (B=-0.15, p<0.175) appeared to have a negative effect on self-management practices. However, this was not significant.

Conclusions: These findings suggest that empowered patients with adequate judgment skills carry out key self-management tasks more appropriately, which in turn will potentially result in better asthma control.

Practice implications: This study recommends that both empowerment and judgment skills should be addressed in patient education as they serve as essential motivators to engage patients in these behaviors.

Keywords: Asthma self-management; Empowerment; Health empowerment model; Health literacy; Judgment skills.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / psychology*
  • Chronic Disease
  • Decision Making
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Health Literacy / methods*
  • Humans
  • Italy
  • Judgment*
  • Male
  • Middle Aged
  • Models, Theoretical
  • Outcome Assessment, Health Care
  • Power, Psychological*
  • Quality of Life
  • Self Care / methods
  • Self Care / psychology*
  • Surveys and Questionnaires
  • Switzerland


  • Anti-Asthmatic Agents