In this study, asthma diaries were used as a research tool
for data collection. Nonetheless, findings from this study
shed important light on clinical implications based on
uncovered multidimensional experience of self-regulation
in uncontrolled asthma including symptoms, emotional
responses, activity levels and medication use in adolescents.
Because adolescents tend to attribute a variety of symptoms
to their uncontrolled asthma, it is important for nurses to be
diligent and open-minded in exploring unconventional
symptoms beyond coughing and wheezing. Also, the impressive
accuracy of self-reported symptoms highlights the
value of daily self-monitoring using asthma diaries instead of
relying on potentially flawed symptom recollections from
several weeks previous. Predominantly negative emotions
may indicate that those adolescents' quality of life is compromised,
which in turn could have negative impact on their
coping with uncontrolled asthma, such as limiting activities
and poor adherence to treatment as suggested in this study. In
addition, high congruency between self-reports and medical
records in short-term relief medications possibly indicates
adolescents' reliance on this type of medication in managing
uncontrolled asthma instead of controller therapy for which
we found a considerably lesser degree of agreement. Prescribed
control medications that are unreported in the diaries
are unlikely to be taken, thus raising a concern of suboptimal
treatment adherence. Particularly, of those who had ICS
prescriptions merely 50% reported the use of the medication,
which is worrisome considering the uncontrolled nature of
their asthma. Nurses' vigilant follow-ups with adolescents
can be beneficial to ensure the adequate treatment adherence
in this population.