Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features.

OBJECTIVE: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. METHODS: The parents or legal guardians of public school students (8-16 years of age) completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127) and healthy controls (n = 124). RESULTS: The study involved 251 parents or legal guardians, of whom 127 (68.5%) were the mothers and 130 (51.8%) were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1%) and 26 (21.0%), respectively, reported being afraid of using asthma medications, whereas 61 (48%) and 56 (45.2%), respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4%) and 17 (13.7%) of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3%) were diagnosed with uncontrolled asthma, only 41 (32.3%) had a prescription or written treatment plan, and 38 (29.9%) used asthma medications regularly. CONCLUSIONS: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems.

Validação linguística e psicométrica do questionário sobre conhecimento em asma Newcastle Asthma Knowledge Questionnaire / Linguistic and psychometric validation of the questionnaire Newcastle Asthma Knowledge Questionnaire on knowledge of asthma

Objective To perform the linguistic and psychometric validation of the Brazilian Portuguese version of the questionnaire Newcastle Asthma Knowledge Questionnaire on knowledge of asthma. Methods Two translations into Brazilian Portuguese of the Newcastle Asthma Knowledge Questionnaire were compared, creating a preliminary version. Seventeen questionnaires were administered to academics and health professionals for possible adjustments of the linguistic translation. Next, internal validation, and analysis of reproducibility and agreement were conducted using Cronbach's coefficient, test and retest, and Kappa analysis. Results Only question number two required linguistic/cultural adaptation. The mean score of the knowledge on asthma of 78 participants was 20.81±3.81 points. The group of physicians got a mean score of 22.94±2.40 points, and other health professionals got a mean score of 19.07±3.88 points. Regarding the internal consistency analysis for the total score, the instrument obtained Cronbach  values of 64.4 for the minimum score, and 70.7 for the maximum score. Conclusion The Brazilian Portuguese version of the questionnaire Newcastle Asthma Knowledge Questionnaire was effective linguistically and psychometrically, presenting good internal consistency and reproducibility.

Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features / Mitos populares e características do tratamento da asma em crianças e adolescentes de zona urbana do sul do Brasil

Objective: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. Methods: The parents or legal guardians of public school students (8-16 years of age) completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127) and healthy controls (n = 124). Results: The study involved 251 parents or legal guardians, of whom 127 (68.5%) were the mothers and 130 (51.8%) were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1%) and 26 (21.0%), respectively, reported being afraid of using asthma medications, whereas 61 (48%) and 56 (45.2%), respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4%) and 17 (13.7%) of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3%) were diagnosed with uncontrolled asthma, only 41 (32.3%) had a prescription or written treatment plan, and 38 (29.9%) used asthma medications regularly. Conclusions: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems.

Objetivo: Descrever a frequência de mitos populares e as características do tratamento em asma em crianças e adolescentes em uma amostra urbana no sul do Brasil. Métodos: Foi aplicado um questionário específico, contendo perguntas sobre entendimento da doença, controle da asma e características do tratamento a pais/responsáveis de escolares da rede pública (8-16 anos de idade) com diagnóstico de asma (n = 127) e de controles saudáveis (n = 124). Resultados: Participaram do estudo 251 pais/responsáveis, com predomínio de mães como acompanhantes dos escolares (n = 127; 68,5%) e de etnia caucasiana (n = 130; 51,8%), com média de idade de 38,47 ± 12,07 anos. Sobre os mitos, 37 (29,1%) dos participantes do grupo asma e 26 (21,0%) dos do grupo controle relataram possuir receio de utilizar medicamentos para asma, e 61 (48%) e 56 (45,2%), respectivamente, acreditam que os inaladores pressurizados podem levar a dependência ao fármaco. No entanto, apenas 17 (13,4%) dos participantes do grupo asma e 17 (13,7%) dos do grupo controle relataram ter receio de utilizar corticoide oral. A ausência de controle da asma foi detectada em 55 (43,3%) dos escolares no grupo asma, apenas 41 (32,3%) possuíam uma receita ou um plano por escrito de como tratar da asma e 38 (29,9%) fazia uso contínuo de medicamentos para a doença. Conclusões: A presença de mitos populares sobre o tratamento da asma, a falta de controle da doença e seu manejo inadequado mostraram ser elevados nesta amostra. Nossos achados apontam para a necessidade de novos estudos nesse campo em países em desenvolvimento e de uma avaliação dos programas de manejo da asma pediátrica na saúde pública.

Burden of asthma among inner-city children from Southern Brazil.

OBJECTIVE: To assess the impact of asthma in a population of inner-city Brazilian children. METHODS: In a cross-sectional study, we selected children with asthma and healthy controls from public schools (8-16 years) from a capital city of Southern Brazil. Divided into three phases, questionnaires were administered, assessing lung function, body mass index and allergic sensitization. RESULTS: From 2500 children initially included in the study (48.4% males; mean age of 11.42 ± 2.32 years), asthma prevalence was detected in 28.6% (715/2500). The disease was not controlled in 42.7% (305/715) of the children, with 7.6% of hospitalization rate. School absenteeism (at least one day of missing school because of asthma) and sedentary behavior were high (57.1 and 67.2%, respectively), with 47.9% of subjects requiring oral steroids in the previous year, and physical well-being significantly lower than controls, directly interfering with quality of life, and therefore in the daily activities of these students. Moreover, 38% of the parents admitted to being non-adherent to treatment with their children and 31.1 and 53.6%, respectively, believed that rescue medication and exercise might be harmful. CONCLUSIONS: The burden of asthma in Brazilian children seems to be substantial. New international guidelines with a special focus in developing countries settings, with more pragmatic approaches, should be a priority for discussion and implementation actions.