The findings yielded a direct correlation between poor inhaler use and poor literacy: Poor inhaler technique was found in 89% of patients reading at less than the third-grade level compared with 48% of patients reading at the high-school level (Nowlan, Williams, Baker, Honig, Lee 1991). This study's result would have a direct impact upon traditional patient educational efforts, as health education still tends to rely heavily on printed materials. These materials might also be written at too high a level. Making use of pictorial materials and personal demonstrations, the authors concluded, might be more effective than using traditional verbally-based media. The study suggests that different approaches are needed, and more personalized intervention may be required for asthmatics, at least during early stages of treatment. However, there is an issue of correlation vs. causation -- individuals with low levels of literacy may have difficulty learning in general, regardless of the medium, because of less comfort with the concepts of the healthcare system. Also, English literacy, versus literacy in general, was not specifically examined -- cultural incomprehension about the seriousness of the illness amongst ESL speakers who are new immigrants might be an additional problem. Lower-level literacy subjects might also have the very poorest job prospects, and be more apt to be in housing or jobs that exacerbate asthma, even though the study was controlled for such factors as income.

Search items: "adult asthmatics education" in Medline

When I typed in "adult asthmatics" only a broad range of 235 entries in total were received through Medline, including information on asthma in general. I next chose the search teams "adult asthma education." The first page of results yielded a summary of a 2009 study: "Internet-based self-management plus education compared with usual care in asthma. A randomized trial" from the Annals of Internal Medicine. Meer et al. (2009) engaged in a cross-comparative research study of 200 individuals with asthma to see if Internet-based asthma programs in addition to regular care by a doctor could be a helpful,...

After 12 months, although patients in the Internet group reported improvements in asthma control and lung function compared with patients in the usual care group, the improvements in the respondent's quality of life were minimal and the number of asthma attacks was not reduced.
Conclusion

Further research is required to see why use of the computer was more effective in the 200 Medline study vs. The earlier CINAL study. Both combined computer use with real-life, hands on educational efforts by physicians, yet a better success rate was reported in one, while the improvement in the second study was not considered medically significant. The quality of the online materials and the degree to which they reinforced 'real world' and personalized education would have to be compared in future research, as would the overall quality of the education received by the different groups of patients from the physicians. How 'quality of life' was measured in both studies, and improvement of symptoms might have differed in terms of both studies, which could have affected their results.

Works Cited

Huss K., M. Salerno, & R.W. Huss. (1991, August). Computer-assisted reinforcement of instruction: Effects on adherence in adult atopic asthmatics. Research in Nursing & Health, 14 (4): 259-67. ISSN: 0160-6891 PMID: 1891611 CINAHL an: 1991128860.

Database: CINAHL Plus

Meer, V. van der, M.J. Bakker, W.B. van den Hout, K.F. Rabe, P.J. Sterk, J. Kievit, W.J.J.

Assendelft, & J.K. Sont. (2009, July 21). Internet-based self-management plus education compared with usual care in asthma. A randomized trial. Annals of Internal Medicine. 151 (2): 110-120.

Nowlan, Adam, Mark V. Williams, David W. Baker, Eric G. Honig, & Theodore M. Lee.

Inadequate Literacy Is a Barrier to asthma knowledge and self-care. (1998, October).

Chest: Official publication of American College of Chest Physicians. Retrieved through Google Scholar August 17, 2009 at http://www.chestjournal.org/content/114/4/1008.full.pdf