The relationship between symptom management and health-related quality of life in patients with severe asthma

Worawan Khemjan — 2026-06-08

Background: Severe asthma is a difficult-to-control condition that substantially affects patients’ health-related quality of life (HRQoL). Appropriate symptom management is essential for improving symptom control and promoting favorable health outcomes in patients with severe asthma. Objectives: To examine the relationship between symptom management and health-related quality of life in patients with severe asthma. Methods: A cross-sectional correlational study was conducted among 93 patients with severe asthma receiving care at a specialized clinic at the Central Chest Institute of Thailand. Data were collected using standardized instruments, including the Asthma Control Test (ACT), Global Initiative for Asthma (GINA) symptom control criteria, an inhaler technique checklist, the Medication Adherence Report Scale (MARS), the Asthma Self-Management Questionnaire (ASMQ), and the Severe Asthma Questionnaire (SAQ and SAQ-global). Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient. Correlation strength was interpreted according to Cohen’s criteria (1988). Results: Participants demonstrated good asthma control, with a mean ACT score of 22.25 (± 2.68) and a high HRQoL, with a mean SAQ score of 91.33 (± 14.10). SAQ-global scores were substantially higher during asymptomatic conditions than symptomatic conditions. According to Cohen’s criteria, inhaler technique demonstrated a high positive correlation with HRQoL (rₛ = 0.530, p < 0.01), while self-management demonstrated a moderate positive correlation (rₛ = 0.442, p < 0.01). Medication adherence demonstrated a low positive correlation with HRQoL (rₛ = 0.241, p < 0.05). In addition, asthma control assessed by ACT and GINA criteria was significantly associated with overall and symptomatic HRQoL, whereas no significant association was observed during asymptomatic conditions. Conclusions: Symptom management was significantly associated with health-related quality of life in patients with severe asthma. Inhaler technique and self-management demonstrated stronger associations with HRQoL than medication adherence. These findings highlight the importance of promoting effective inhaler technique and self-management skills to improve symptom control and enhance long-term quality of life in patients with severe asthma

Factors Associated with Smoking Cessation Behavior among Patients at the Smoking Cessation Clinic, Central Chest Institute of Thailand

sirata chuenchotekitti — 2026-08-20

Background and Objective: Chronic diseases represent a major public health problem, with smoking being a primary risk factor for disease exacerbation and complications. Smoking cessation among chronic lung and heart disease patients with long-term nicotine dependence is complex and challenging due to chemical addiction and behavioral habituation. Understanding the factors influencing successful cessation is essential for developing effective therapeutic interventions. This study aimed to examine the factors associated with and the predictors of successful smoking cessation among patients with chronic lung and heart diseases at the Smoking Cessation Clinic, Central Chest Institute of Thailand.

Methods: This cross-sectional survey recruited a purposive sample of 158 patients with chronic diseases. Inclusion criteria were patients with chronic lung and heart diseases receiving services at the Smoking Cessation Clinic, Central Chest Institute of Thailand, having a history of smoking with long-term nicotine dependence, and willing to participate in the study. The research instrument was a questionnaire validated for content validity (IOC = 0.96) and reliability (Cronbach’s alpha = 0.71–0.94). Data were analyzed using descriptive statistics, Chi-square tests, and logistic regression analysis.

Results: The study found that all aspects of health belief models and social support were significantly associated with smoking cessation behavior (p < .05). Multivariate analysis revealed two significant predictors of successful cessation (p < .05):

1) Nicotine Dependence Level: Patients with low-to-moderate dependence were 33.30 times more likely to succeed in quitting compared to those with high dependence (OR = 33.30, 95% CI: 2.01-551.40).

2) Perceived Self-Efficacy: Patients with high levels of perceived self-efficacy were 5.63 times more likely to succeed (OR = 5.63, 95% CI: 2.39-13.25).

These findings highlight that even among chronic disease patients with long-term smoking history (mean = 35.09 years), managing biological dependence alongside psychological confidence is a crucial key to success.

Conclusion and Recommendations: Nurses should prioritize in-depth assessment of nicotine dependence in conjunction with emotional barriers. Integrating self-efficacy enhancement programs within a Healing Environment is recommended to improve sustainable smoking cessation rates among patients with chest diseases.

Journal of Central Chest Institute of Thailand

The relationship between symptom management and health-related quality of life in patients with severe asthma

Factors Associated with Smoking Cessation Behavior among Patients at the Smoking Cessation Clinic, Central Chest Institute of Thailand