Among the limitations of this study is the reliance on the use of a self-reported tool, with neither objective measures of lung functioning to assess the level of asthma control, nor objective health behaviour measurements that indicate that patients behave as reported.33 The advantages of self-administered tools are that discomfort or embarrassment are avoided. Although the scenarios describe common situations for asthma patients, the amount of reading might pose a burden on people with poor reading skills, discouraging participants to participate in the study and imposing a risk for random responses. To lessen those risks participants were given the time to fill in the questionnaire at home. Furthermore, this study acknowledges the possible loss of measurement information due to dichotomization of the variables using the median
split. However, this partition was necessary due to skewness of the composite score of judgment skills, with a high tendency of selecting the best options. However, for this particular case the median split has been accepted by other authors,34 and the data itself showed a difference between the split groups. Since the tool is context-bound it would require more effort to translate it into another context. To the best of our knowledge, health information use, expressed as judgment skills, within the asthma context has not been explored before. Our findings contribute to the health literacy field by providing an assessment tool that goes beyond the functional skills shedding light on how limited health information use leads to adverse self-management behaviours.