ABSTRACT
ABSTRACT Objective: To evaluate the impact of pediatric asthma on patients of a specialized outpatient clinic in Southern Brazil. Methods: The study included children aged 8 to 17 years old with asthma diagnosis (mild, moderate and severe) under treatment at the asthma clinic of Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil. Measurements of spirometry, quality of life, disease control and atopy tests were applied. Results: A total of 66 children were included in the study and divided into groups, according to the severity of the disease: mild, moderate or severe asthma. The results showed similarities in both the treatment and the impact of asthma between groups, except for adherence to treatment: the group with mild asthma showed least adherence to treatment, and the group with severe asthma, greater adherence (p=0.011). As to school absenteeism, the group with severe asthma showed higher frequency (p=0.012), with over 10 days per year (p=0.043). Spirometry showed lower volume/capacity for the group with moderate asthma, followed by the groups with severe and mild asthma. All groups had a high prevalence of allergic asthma, with mites as the main allergens. For quality of life (QOL), and health-related quality of life (HRQOL) levels, there were no differences between groups. In addition, the values were close to the acceptable levels for the total score and for each one of the six domains. The same occurred for the HRQOL-asthma module. Conclusions: QOL and HRQOL present acceptable levels regardless of the severity of the disease.
RESUMO Objetivo: Avaliar o impacto da asma pediátrica de pacientes em acompanhamento ambulatorial em um centro de referência em pneumopediatria do Sul do Brasil. Métodos: Participaram do estudo crianças com idade entre oito e 17 anos, com diagnóstico de asma (leve, moderada e grave), em acompanhamento no ambulatório de asma do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Foram verificadas medidas de espirometria, avaliação dos níveis de qualidade de vida, controle da doença e teste de atopia. Resultados: Sessenta e seis crianças participaram do estudo, divididas em três grupos (asma leve, moderada e grave). Evidenciaram-se semelhanças tanto no tratamento quanto no impacto da asma, exceto para a adesão ao tratamento (p=0,011), em que o grupo de asma leve é o que menos adere e o grupo de asma grave o que mais adere ao tratamento. Em relação ao absenteísmo escolar, o grupo de asma grave apresentou o maior valor (p=0,012), com mais de dez dias/ano (p=0,043). As espirometrias demonstram menor volume/capacidade para o grupo de asma moderada, seguido do grupo de asma grave e asma leve. Os grupos possuem alta prevalência de asma alérgica, tendo os ácaros como os principais alérgenos. Quanto à qualidade de vida (QV) e à qualidade de vida relacionada à saúde (QVRS), não houve diferença entre os grupos. Além disso, os valores apresentados estão próximos aos níveis aceitáveis, tanto para o escore total quanto para os seis domínios analisados. O mesmo ocorre para o módulo QVRS-asma. Conclusões: Os níveis de QV e de QVRS demonstram-se aceitáveis, independentemente da gravidade da doença.
Subject(s)
Humans , Animals , Male , Female , Child , Adolescent , Outpatients/statistics & numerical data , Asthma/drug therapy , Treatment Adherence and Compliance/statistics & numerical data , Quality of Life , Asthma/immunology , Asthma/psychology , Asthma/epidemiology , Spirometry/methods , Severity of Illness Index , Brazil/epidemiology , Allergens/adverse effects , Prevalence , Cross-Sectional Studies , Sickness Impact Profile , Absenteeism , Hypersensitivity, Immediate/immunology , Mites/immunologyABSTRACT
Abstract Objective: To perform a systematic review with meta-analysis and meta-regression to correlate the total scores of asthma control with the increase in the total scores of health-related quality of life levels of parents of asthmatic children. Sources: The search was carried out in the following databases: PubMed (MEDLINE); Embase and ScienceDirect (Elsevier); SciELO and LILACs (Bireme) in June 2017. The included studies assessed asthma control through the Asthma Control Questionnaire (ACQ), Asthma Control Test (C-ACT/ACT), and Global Initiative for Asthma (GINA) questionnaires, whereas the Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) was applied to assess the HRQoL of parents and family members. Summary of the findings: 294 articles were evaluated in the selected databases, of which (n = 38) were excluded for duplicity; (n = 239) after the reading of the titles and abstracts and (n = 5) after reading the studies in full, totaling 12 studies eligible for the meta-analysis. Of the 12 eligible articles, 11 (92%) were published in the last five years, and evaluated children and adolescents aged 1 -20 years, totaling 2804 samples. In the evaluation of the correlation between the disease control scores by ACQ and C-ACT/ACT, the results were satisfactory for both ACQ analyses [R 2: −0.88; p < 0.001], and for C-ACT/ACT [R 2: 0.82; p < 0.001]. Conclusions: The results show that asthma control levels can influence the total HRQoL scores of parents or relatives of children and adolescents with asthma.
Resumo Objetivo: Realizar uma revisão sistemática, com meta-análise e meta-regressão para relacionar os escores totais do controle da asma com o aumento dos escores totais dos níveis de qualidade de vida relacionada à saúde de pais de crianças asmáticas. Fontes: As buscas foram aplicadas nas bases de dados: PubMed (Medline); Embase e ScienceDirect (Elsevier); SciELO e LILACs (Bireme). A busca foi realizada nas bases de dados em saúde em junho de 2017. Os estudos incluídos precisavam ter avaliados o controle da asma pelos questionários Asthma Control Questionnaire (ACQ), Asthma Control Test (C-ACT/ACT) e Global Initiative for Asthma (GINA) e para a QVRS dos pais e familiares o Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ). Resumo dos achados: Foram avaliados 294 artigos nas bases de dados escolhidas, quanto aos níveis de duplicidade nas bases de dados (n = 38), excluídos por falta de enquadramento na leitura dos títulos e resumos (n = 239) e após leitura integral dos estudos (n = 05), restaram 12 estudos elegíveis à meta-análise. Dos 12 artigos elegíveis, 11 (92%) foram publicados nos últimos cinco anos, avaliaram crianças e adolescentes de 1 a 20 anos, total de 2.804 amostras. Na avaliação da correlação entre a pontuação dos escores de controle da doença por ACQ e C-ACT/ACT, os resultados se mostraram satisfatórios tanto para as análises de ACQ [R2: −0.88; p < 0,001], quanto para C-ACT/ACT [R2: 0,82; p < 0,001]. Conclusões: Os resultados demonstram que os níveis de controle da asma podem influenciar nos escores totais da QVRS de pais ou familiares de crianças e adolescentes com asma.
Subject(s)
Humans , Child , Adolescent , Parents/psychology , Quality of Life/psychology , Asthma/prevention & control , Caregivers/psychology , Asthma/physiopathology , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
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 ï¡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 ï¡ 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.