Royal College of Surgeons in Ireland
The Impact of Biofeedback on Self-Efficacy in Adults with Asthma.....pdf (1.74 MB)

The impact of biofeedback on self-efficacy in adults with asthma: a cross-sectional descriptive survey

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journal contribution
posted on 2022-09-30, 15:07 authored by Joanne WalshJoanne Walsh, Zena MooreZena Moore, Elaine MacHale, Garrett Greene, Frank DoyleFrank Doyle, Richard CostelloRichard Costello, Bridget MurrayBridget Murray

Purpose: Educating patients to self-manage chronic diseases such as asthma is a key role for nurses. The success of this education is often limited by low patient self-efficacy. In this study, we hypothesized that the self-efficacy of patients could be enhanced if their education was based on biofeedback of their own self-management, following a nurse led educational intervention.

Patients and methods: Patients with severe and uncontrolled asthma from one centre who participated in an eight-month, nurse-led asthma education and dose adjustment Randomised Control Trial (RCT) were studied (NCT02307669). Inhaler adherence and technique of use were objectively assessed using a validated digital device. The data recorded on this device was used as the basis for the individualised biofeedback. The Asthma Self-efficacy Questionnaire was used to assess self-efficacy.

Results: A total of 88 participants (44 in each group) completed the asthma self-efficacy questionnaire at the end of the study. The mean overall level of self-efficacy was high across both groups; 91 (8.7), with both biofeedback and standard care groups having similarly high levels of self-efficacy, biofeedback group: 89 (10) and standard care group 93 (6). Self-efficacy was not related to objective measures of adherence at either the start of the study, 68 (26), p=0.23, or the end of the study, 58 (32), p=0.62. It was also not related to peak expiratory flow (PEF) at the end of the study in either group (r2= 0.0245, p=0.14). Self-efficacy was related to asthma control test (ACT), 18 (5.5), p=0.0014 and quality-of-life measures; EuroQol (EQ5D3L) 6.4 (1.5) p=0.02.

Conclusion: Repeated nurse-delivered education results in high levels of self-efficacy among patients with severe asthma. A high level of perceived self-efficacy should not be assumed to result in higher inhaler adherence.



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Published Citation

Walsh J. et al. The impact of biofeedback on self-efficacy in adults with asthma: a cross-sectional descriptive survey. Patient Prefer Adherence. 2022 Jun;16:1469-1475.

Publication Date

14 June 2022

PubMed ID



  • Beaumont Hospital
  • Clinical Research Centre
  • Health Psychology
  • Medicine
  • School of Nursing and Midwifery

Research Area

  • Population Health and Health Services
  • Nursing and Midwifery
  • Respiratory Medicine


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  • Published Version (Version of Record)