Evaluation of self-efficacy and its limiting factors among children with asthma aged 8–18 years

BACKGROUND AND OBJECTIVE: Asthma is the most prevalent chronic disease in childhood, and self-efficacy is a key determinant of symptom control, treatment adherence, and prevention of exacerbations. Despite advances in pharmacological management, many children continue to experience barriers that hinder effective self-management. This study aimed to assess the level of self-efficacy and identify its limiting factors among children with asthma aged 8-18 years. METHODS: This descriptive cross-sectional study was conducted in 2025 at a pediatric specialty clinic affiliated with a teaching hospital. A total of 100 children with asthma were recruited using convenience sampling. Data were collected using A demographic questionnaire, the Asthma Self-Efficacy Scale, and the Limiting Factors of Self-Efficacy Questionnaire were used to collect the data. The instruments demonstrated acceptable content validity and internal consistency. Data analysis was done with descriptive statistics, Spearman's correlation, and multiple linear regression in SPSS version 22, with statistical significance set at p < 0.05. RESULTS: The findings indicated a moderate level of self-efficacy among children with asthma, accompanied by a relatively low-to-moderate level of perceived limiting factors. Spearman's correlation showed a significant positive association between the frequency of asthma attacks and limiting factor scores (r = 0.197, p = 0.049), suggesting that increased exacerbations were associated with greater perceived barriers to disease management. Multiple linear regression analysis revealed that longer disease duration significantly predicted higher self-efficacy, whereas lower paternal educational level was associated with reduced self-efficacy. The most commonly reported barriers included insufficient disease-related knowledge, concerns about medication side effects, and challenges in treatment follow-up, while family support emerged as a key facilitator of self-efficacy. CONCLUSION: Children with asthma exhibited moderate self-efficacy in disease management, while cognitive, attitudinal, and family-related barriers undermined sustained self-care behaviors. Strengthening family-centered educational interventions, improving parental health literacy, and implementing targeted nursing programs may contribute to improving self-efficacy and reducing perceived barriers.