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1.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000648

RESUMO

INTRODUCTION: The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown. OBJECTIVE: To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia. METHODS: A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk. RESULTS: 148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress. CONCLUSIONS: Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.


Assuntos
Asma , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Asma/epidemiologia , Asma/psicologia , Betacoronavirus , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Angústia Psicológica , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pesquisa Qualitativa , Autoimagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
2.
Niger J Clin Pract ; 23(8): 1033-1038, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788477

RESUMO

Background: Inhaler corticosteroids (ICS) are the most commonly used antiinflammatory drugs in the treatment of asthma. Although systemic adverse effects are minimal, patients hesitate to use ICS for a long time because of corticophobia. There is no study evaluating corticophobia via Likert-type appendix among the asthmatic patients. Aim: In this study, it was aimed to evaluate the fears and beliefs about ICS in asthmatic patients. Subjects and Methods: Between December 2017 and January 2018, 150 stable asthmatic patients were included in the study. Demographic data (age, education, smoking history, etc.) and asthma-related data (pulmonary function test, drug use) were recorded. The appendix of TOPICOP study applied to the patients with asthma which was composed of 10 questions (five questions about fear of ICS and five questions about beliefs of ICS). Results: The rate of ICS maintain in stable asthmatic patients was found to be 66.6%. According to the survey results, 68% of the patients believed that ICS may lead to weight gain, 52% believed that ICS may lead to infection, 73% believed that ICS may pass into bloodstream, and 67.3% believed that ICS may damage the lungs. It was also found that 90.7% needed to be informed about ICS and 67.3% wanted to cut the ICS drug as soon as possible. Conclusion: We found that treatment adherence may increase, if physicians allocate more time to asthma patients to inform about ICS beneficial effects at the initiating of ICS treatment and control visits.


Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Medo , Conhecimentos, Atitudes e Prática em Saúde , Adesão à Medicação/psicologia , Transtornos Fóbicos/psicologia , Administração por Inalação , Corticosteroides/efeitos adversos , Adulto , Antiasmáticos/efeitos adversos , Asma/psicologia , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/etiologia , Inquéritos e Questionários
3.
PLoS One ; 15(8): e0237296, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760127

RESUMO

BACKGROUND: To avoid a surge of demand on the healthcare system due to the COVID-19 pandemic, we must reduce transmission to individuals with chronic conditions who are at risk of severe illness with COVID-19. We aimed at understanding the perceptions, context and attitudes of individuals with chronic conditions during the COVID-19 pandemic to clarify their potential risk of infection. METHODS: A cross-sectional survey was nested in ComPaRe, an e-cohort of adults with chronic conditions, in France. It assessed participants' perception of their risk of severe illness with COVID-19; their context (i.e., work, household, contacts with external people); and their attitudes in situations involving frequent or occasional contacts with symptomatic or asymptomatic people. Data were collected from March 23 to April 2, 2020, during the lockdown in France. Analyses were weighted to represent the demographic characteristics of French patients with chronic conditions. The subgroup of participants at high risk according to the recommendations of the French High Council for Public Health was examined. RESULTS: Among the 7169 recruited participants, 63% patients felt at risk because of severe illness. About one quarter (23.7%) were at risk of infection because they worked outside home, had a household member working outside home or had regular visits from external contacts. Less than 20% participants refused contact with symptomatic people and <20% used masks when in contact with asymptomatic people. Among patients considered at high risk according to the recommendations of the French High Council for Public Health, 20% did not feel at risk, which led to incautious attitudes. CONCLUSION: Individuals with chronic conditions have distorted perceptions of their risk of severe illness with COVID-19. In addition, they are exposed to COVID-19 due to their context or attitudes.


Assuntos
Infecções por Coronavirus/patologia , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/patologia , Adulto , Idoso , Asma/complicações , Asma/patologia , Asma/psicologia , Betacoronavirus/isolamento & purificação , Doença Crônica , Infecções por Coronavirus/virologia , Estudos Transversais , Complicações do Diabetes/patologia , Complicações do Diabetes/psicologia , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/psicologia , Pandemias , Pneumonia Viral/virologia , Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
6.
Arch Dis Child ; 105(9): 819-824, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32620567

RESUMO

OBJECTIVE: We aimed to explore the views of Malaysian children with asthma and their parents to enhance understanding of early influences on development of self-management skills. DESIGN: This is a qualitative study conducted among children with asthma and their parents. We used purposive sampling and conducted focus groups and interviews using a semi-structured topic guide in the participants' preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo and analysed using a grounded theory approach. SETTINGS: We identified children aged 7-12 years with parent-reported, physician-diagnosed asthma from seven suburban primary schools in Malaysia. Focus groups and interviews were conducted either at schools or a health centre. RESULTS: Ninety-nine participants (46 caregivers, 53 children) contributed to 24 focus groups and 6 individual interviews. Children mirrored their parents' management of asthma but, in parallel, learnt and gained confidence to independently self-manage asthma from their own experiences and self-experimentation. Increasing independence was more apparent in children aged 10 years and above. Cultural norms and beliefs influenced children's independence to self-manage asthma either directly or indirectly through their social network. External influences, for example, support from school and healthcare, also played a role in the transition. CONCLUSION: Children learnt the skills to self-manage asthma as early as 7 years old with growing independence from the age of 10 years. Healthcare professionals should use child-centred approach and involve schools to facilitate asthma self-management and support a smooth transition to independent self-management. TRIAL REGISTRATION NUMBER: Malaysian National Medical Research Register (NMRR-15-1242-26898).


Assuntos
Asma/terapia , Autogestão/educação , Adulto , Idoso , Asma/psicologia , Criança , Cultura , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Malásia , Masculino , Pessoa de Meia-Idade , Pais/educação , Pais/psicologia , Pesquisa Qualitativa , Autogestão/psicologia
7.
Ann Allergy Asthma Immunol ; 125(4): 393-398, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32653405

RESUMO

OBJECTIVE: First, to review and critically discuss published evidence on psychosocial stressors, stress, and asthma in adolescents and, then, discuss potential future directions in this field. DATA SOURCES: The data source is the National Library of Medicine (PubMed database). STUDY SELECTIONS: A literature search was conducted for human studies on stressors or stress and asthma between 2000 and 2020. Studies that were published in English, contained a full text, and included adolescents were considered for inclusion in this review. RESULTS: Compared with the available body of evidence in children and adults, relatively few studies have been published in adolescents. Current evidence suggests that exposure to stressors (at the individual, family, and community levels) or stress (acute and chronic) is associated with asthma and worse asthma outcomes, but such evidence must be cautiously interpreted owing to limitations in the design or the analytical approach of the published studies. CONCLUSION: Future large studies with a prospective design should determine whether and how stressors or stress causes or worsens asthma in adolescents. At present, clinicians should assess exposure to stressors (eg, violence or abuse) and screen for anxiety and depressive disorders when caring for adolescents with asthma in addition to providing referrals to social workers or mental health professionals when appropriate. Public health policies are needed to reduce psychosocial stressors, such as gun violence and racism, in adolescents.


Assuntos
Asma/psicologia , Estresse Psicológico/imunologia , Adolescente , Humanos
9.
J Bras Pneumol ; 46(3): e20190095, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321034

RESUMO

OBJECTIVE: To evaluate the health-related quality of life (HRQoL) of children/adolescents with asthma and that of their caregivers, comparing the two. METHODS: This was a systematic review and meta-analysis based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, with a strategy of searching five health-related databases (MEDLINE/PubMed, EMBASE, ScienceDirect, SciELO, and LILACS). We included studies that evaluated the HRQoL of children/adolescents with asthma and that of their caregivers with the Pediatric Asthma Quality of Life Questionnaire and the Pediatric Asthma Caregiver's Quality of Life Questionnaire, respectively, using the total scores and the scores on the domains activity limitation, symptoms (children/adolescents only), and emotional function. RESULTS: We identified 291 articles, and we evaluated 133 of those. A total of 33 articles, collectively including 4,101 subjects, were included in the meta-analysis. An analysis stratified by study design showed no differences between the HRQoL of the caregivers and that of the children/adolescents in the activity limitation domain and in the total score. However, the mean emotional function domain scores were significantly higher (better) among children/adolescents with asthma than among their caregivers in longitudinal studies-Δ = 0.82 (0.21-1.44)-and randomized clinical trials-Δ = 0.52 (0.29-0.79)-although not in cross-sectional studies-Δ = -0.20 (-0.03 to 0.43). CONCLUSIONS: The total HRQoL scores proved to be similar between children/adolescents with asthma and their caregivers. However, the two groups differed in their perception of their emotional function, the caregivers scoring significantly lower than the children/adolescents in that domain.


Assuntos
Asma/psicologia , Cuidadores/psicologia , Qualidade de Vida , Adolescente , Asma/fisiopatologia , Criança , Estudos Transversais , Nível de Saúde , Humanos
11.
Ter. psicol ; 38(1): 119-129, abr. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1115944

RESUMO

Resumen El objetivo fue identificar las asociaciones entre apoyo social percibido, riesgo suicida y presencia de enfermedad crónica no transmisible en estudiantes universitarios. Utilizando un diseño de casos y controles, con 41 estudiantes universitarios por grupo. La mediana de edad fue de 22 años (R = 9), un 81,8% eran mujeres, el 26,8% de los sujetos tenía Asma y el 26,8% Hipotiroidismo, y el 63,6% pertenecía a la Facultad de Educación. No se comprobó la asociación entre enfermedad crónica, apoyo social, ni tampoco con riesgo suicida. Hay asociación indirecta entre riesgo suicida y apoyo social, no así cuando se evalúa el intento de suicidio previo. El nivel de riesgo suicida y apoyo social se asocian independiente de la presencia de enfermedad crónica. Esperamos que nuestros resultados permitan fomentar el apoyo social como una herramienta fundamental para la prevención de la suicidabilidad, especialmente en sujetos con enfermedad crónica.


Abstract The objective was to identify associations between perceived social support, suicidal risk and the presence of chronic or communicable disease in university students. Using a case-control design, consisting of 41 subjects in each group. The median age was 22 years (R = 9), 81,8% were women, 26,8% of the subjects had asthma and 26,8% had hypothyroidism, 63,6% were students of the faculties of Education. The association between chronic disease and social support was not proven, nor was there a suicidal risk. There is an indirect association between suicide risk and social support, not so when assessing the previous suicide attempt. The levels of suicide risk and social support are associated, independent of an existing chronic disease. We are hopeful that our results will be effective in promoting social support as a basic tool for suicide prevention, especially in subjects with chronic disease.


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Apoio Social , Estudantes/psicologia , Suicídio/psicologia , Doença Crônica/psicologia , Asma/psicologia , Tentativa de Suicídio/psicologia , Universidades , Estudos de Casos e Controles , Chile , Inquéritos e Questionários , Medição de Risco , Autorrelato , Doenças não Transmissíveis/psicologia , Hipotireoidismo/psicologia
12.
J Glob Health ; 10(1): 010801, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32257166

RESUMO

Background: In China, childhood asthma prevalence showed a remarkable increase in the past decades. An updated epidemiological assessment of childhood asthma in China with a focus on prevalence and time trends is required. Methods: We systematically searched three main Chinese databases and one English database to identify epidemiological studies of the prevalence of childhood asthma in China. Asthma cases were defined according to one of the five sets of Chinese diagnostic criteria which were established by the Children Respiratory Disease Group. We estimated age- and sex-specific prevalence of asthma using a multilevel mixed-effects logistic regression. We presented the time trends of asthma prevalence between 1990 and 2020 by age, sex and setting (urban vs rural), and also estimated the number of children affected by asthma in 2010. Results: In 1990, the prevalence of asthma ranged from 0.13% (95% confidence interval (CI) = 0.10-0.20) in rural girls aged 14 years to 1.34% (95% CI = 1.11-1.67) in urban boys aged five years. In 2010, the overall prevalence of asthma in Chinese children aged 0-14 years was 2.12% (95% CI = 1.83-2.51), corresponding to 5.16 million children living with asthma. Children aged 5-9 years were with the highest prevalence estimate of 2.65% (95% CI = 2.31-3.12) and those aged 10-14 years were with the lowest (1.48%, 95% CI = 1.26-1.78). In 2020, it is expected that this disparity will continue, with the prevalence of asthma being at the lowest level among rural girls aged 14 years (1.11%, 95% CI = 0.82-1.54) and at the highest level among urban boys aged four years (10.27%, 95% CI = 8.61-12.18). Over the 30 years (1990-2020), the prevalence of asthma in children aged 0-14 years has increased in both sexes and settings, which was consistently the lowest in rural girls and the highest in urban boys. Conclusions: This study shows that childhood asthma has been increasingly prevalent in China. Asthma is more frequent in boys and in rural areas. The detailed and systematic estimates of asthma prevalence in this study constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources related to the burden of childhood asthma in China.


Assuntos
Asma/epidemiologia , Efeitos Psicossociais da Doença , Asma/psicologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Qualidade de Vida , População Rural , Distribuição por Sexo , População Urbana
13.
Int Arch Allergy Immunol ; 181(6): 434-445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32146467

RESUMO

BACKGROUND: Influenza viral infection is a major public health problem with significant morbidity and mortality.Asthma is a risk factor for developing serious complications related to influenza infection. OBJECTIVE: We explored factors associated with influenza vaccination coverage among adolescents with asthma. METHODS: Data were obtained from 62,276 participants in the 13th Korean Youth Risk Behavior Web-Based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. We used multiple logistic regression analyses to identify variables potentially related to influenza vaccination in adolescents with asthma. RESULTS: The proportion of asthma was 8.8%, and the influenza vaccination rate overall was 37.9%. It was 41.8% in the asthma group and 37.5% in the nonasthma group (p < 0.001). After regression, male sex (odds ratio (OR) = 1.45; 95% CI 1.35-1.55), a high socioeconomic status (OR = 1.12; 95% CI 1.05-1.19), residence at an orphanage (OR = 1.93; 95% CI 1.38-2.29), regular breakfast consumption (OR = 1.09; 95% CI 1.02-1.17), and subjective good health (OR = 2.39; 95% CI 1.69-3.39) were associated with increased influenza vaccination, whereas current smoking (OR = 0.87; 95% CI 0.67-0.96) and a depressive mood (OR = 0.77; 95% CI 0.64-0.95) were inversely associated in adolescents with asthma. CONCLUSION: It is important to improve influenza vaccination in adolescents with asthma, especially females, those with a low socioeconomic status, independent residents, breakfast skippers, current smokers, and those who consider themselves unhealthy and have depressive moods.


Assuntos
Asma/complicações , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Asma/psicologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Influenza Humana/complicações , Modelos Logísticos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , República da Coreia
14.
Int Arch Allergy Immunol ; 181(6): 462-466, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203959

RESUMO

BACKGROUND: The possible gender impact on asthma arouses current and outstanding interest, but few studies addressed this issue in the real-world setting. OBJECTIVE: This cross-sectional study tested the hypothesis of a potential difference between asthmatic males and females in a real-life setting, such as a third-level asthma clinic. METHODS: A total of 499 asthmatic outpatients (301 females and 198 males, mean age 58.25 years) were consecutively visited. The visit included history, asthma control, and severity grade, physical examination, lung function, fractional exhaled nitric oxide assessment, and blood sample for biomarkers. RESULTS: There were more females than males (about 3 of 5). Asthmatic females smoked less (p < 0.0001) than males and had higher FEV1 (p = 0.0022) and FVC (p = 0.0004) values than asthmatic males. CONCLUSIONS: Gender difference was associated with smoking and lung function impairment; thus, this issue should be carefully considered in asthmatic patients in daily clinical practice.


Assuntos
Asma , Adulto , Distribuição por Idade , Asma/diagnóstico , Asma/fisiopatologia , Asma/psicologia , Estudos Transversais , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Índice de Gravidade de Doença , Fatores Sexuais , Fumar
15.
Otolaryngol Head Neck Surg ; 162(4): 566-571, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32122241

RESUMO

OBJECTIVE: To analyze the prevalence of pediatric allergic airway disease (PAA) and recognize its impact on cognitive function, childhood activities, use of early intervention, and missed school days. STUDY DESIGN: Cross-sectional analysis of National Health Interview Survey (NHIS), 2014 to 2017. SETTING: US households. SUBJECTS AND METHODS: An NHIS survey of US children and responding caregivers was analyzed to determine the prevalence of PAA, including allergic rhinitis and allergic asthma. Associations were determined between the presence of PAA and activities limited by difficulty remembering, limitation in the amount of childhood play, use of special education/early intervention, and number of missed school days in the past 12 months. Multivariate analysis was used to adjust for age, sex, race, ethnicity, and income level. RESULTS: An estimated 11.1 million (10.6-11.6 million, 95% confidence interval) children (mean age, 9.9 years; 56.9% male) reported a diagnosis of PAA (15.1% [14.6-15.6%]). Children with PAA missed 4.0 (3.7-4.4) school days per year vs 2.2 (2.1-2.4) days for those without PAA (P < .001, adjusted). PAA was associated with limited daily activities due to difficulty with memory (odds ratio, 1.8 [1.2-2.9]), limitations in childhood play (3.2 [2.2-4.7]), and need for special education/early intervention services (1.6 [1.4-1.8]) after adjusting for age, sex, race, ethnicity, and income level. CONCLUSION: PAA is a common condition and is associated with declines in cognitive function and school attendance as well as increased use of special education/early intervention. Given the significant prevalence and burden of illness of PAA, further attention is needed to ensure timely diagnosis and treatment.


Assuntos
Asma/epidemiologia , Asma/psicologia , Cognição , Qualidade de Vida , Rinite Alérgica/epidemiologia , Rinite Alérgica/psicologia , Criança , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência
16.
PLoS One ; 15(3): e0230194, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203535

RESUMO

The purpose of this study is to assess psychosocial risk across several pediatric medical conditions and test the hypothesis that different severe or chronic pediatric illnesses are characterized by disease specific enhanced psychosocial risk and that risk is driven by disease specific connectivity and interdependencies among various domains of psychosocial function using the Psychosocial Assessment Tool (PAT). In a multicenter prospective cohort study of 195 patients, aged 5-12, 90 diagnosed with acute lymphoblastic leukemia (ALL), 42 with epilepsy and 63 with asthma, parents completed the PAT2.0 or the PAT2.0 generic version. Multivariate analysis was performed with disease as factor and age as covariate. Graph theory and network analysis was employed to study the connectivity and interdependencies among subscales of the PAT while data-driven cluster analysis was used to test whether common patterns of risk exist among the various diseases. Using a network modelling approach analysis, we observed unique patterns of interconnected domains of psychosocial factors. Each pathology was characterized by different interdependencies among the most central and most connected domains. Furthermore, data-driven cluster analysis resulted in two clusters: patients with ALL (89%) mostly belonged to cluster 1, while patients with epilepsy and asthma belonged primarily to cluster 2 (83% and 82% respectively). In sum, implementing a network approach improves our comprehension concerning the character of the problems central to the development of psychosocial difficulties. Therapy directed at problems related to the most central domain(s) constitutes the more rational one because such an approach will inevitably carry over to other domains that depend on the more central function.


Assuntos
Asma/psicologia , Cuidadores/psicologia , Epilepsia/psicologia , Família/psicologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/psicologia , Criança , Pré-Escolar , Empatia/fisiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais/psicologia , Estudos Prospectivos , Testes Psicológicos , Psicometria/métodos
17.
Rev Paul Pediatr ; 38: e2018172, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31939508

RESUMO

OBJECTIVE: To evaluate the quality of life and its association with disease control, severity, allergic comorbidities and adherence to treatment in children and adolescents with asthma. METHODS: A cross-sectional study that included children and adolescents aged seven to 17. The Paediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to assess their quality of life. Sociodemographic and clinical data were obtained from the chart and from a questionnaire. Descriptive statistics were performed and chi-square or Fisher's exact tests were used to verify the existence of associations between quality of life and disease control, severity, comorbidities and adherence to treatment. The level of statistical significance was set at p<0.05. RESULTS: 101 children/adolescents were evaluated (62.4% boys), with a mean age of 10.1 years. On average, the PAQLQ score was ≤5.9 points, indicating moderate / severe quality of life impairment. Higher levels of control, as well as higher disease severity, were associated with higher quality of life impairment, both in total PAQLQ score and domains (p<0.05). The presence of comorbidities was also associated with higher quality of life impairment (p=0.01), except in the emotional function domain. Adherence to treatment showed no association with quality of life. CONCLUSIONS: Children and adolescents with asthma present impairment in their quality of life, and this is related to poorer control and severity of the disease, as well as to the presence of allergic comorbidities.


Assuntos
Asma/tratamento farmacológico , Asma/psicologia , Hipersensibilidade/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adolescente , Instituições de Assistência Ambulatorial/organização & administração , Asma/diagnóstico , Brasil/epidemiologia , Broncodilatadores/uso terapêutico , Criança , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
18.
Health Psychol ; 39(3): 172-178, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31789561

RESUMO

OBJECTIVE: Asthma prevalence and morbidity are disproportionately higher among youth with lower socioeconomic status (SES). Examination of subjective social status (SSS) may improve understanding of associations between SES and health outcomes in pediatric asthma. METHOD: Fifty adolescents with asthma (Mage = 13.2 years, SD = 1.23; 54% male; 55.1% African American) completed the MacArthur Scale of Subjective Social Status-Youth Version, Daily Life Stressors Scale, Children's Depression Inventory-Short Form, Adolescent Sleep-Wake Scale-short version, and Asthma Control Test during the baseline visit of a study of health behaviors. Body mass index z scores (BMIz) were calculated using height and weight obtained during the visits. Hierarchical linear regressions examined associations between SSS and psychosocial and physical health outcomes, controlling for caregiver-reported objective SES. RESULTS: Caregiver-reported objective SES was not associated with adolescent SSS. SSS-society was associated with daily stress (b = -3.14), t(47) = -2.13, p = .033; asthma control (ß = .34, p = .045); BMIz (ß = .38, p = .013); and sleep quality (ß = .49, p = .001). SSS-community was associated with daily stress (b = -3.76), t(46) = -3.07, p = .002, and sleep quality (ß = .36, p = .010). SSS was not associated with depressive symptoms. CONCLUSIONS: Adolescents' SSS may not always reflect caregiver's objective SES. Perceived social status may play a role in the experience of daily stress, asthma control, BMIz, and sleep quality among adolescents with asthma. SSS may offer a novel means of assessing health disparities in pediatric asthma. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Asma/psicologia , Nível de Saúde , Psicologia/métodos , Adolescente , Asma/patologia , Feminino , Humanos , Masculino
19.
BMC Pulm Med ; 19(1): 187, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660922

RESUMO

BACKGROUND: Patient awareness of asthma severity is important for optimal asthma management. However, there is often a discrepancy between physician assessment of asthma control based on guidelines and patient discernment of control. We compared physician and patient perception of asthma control in a clinic population seen at a tertiary hospital in Addis Ababa, Ethiopia. METHODS: In this cross-sectional study, 182 consecutive patients with a physician diagnosis of asthma seen in Chest Clinic at Tikur Anbessa Specialized Hospital (TASH) between July and December 2015 were studied. Demographics, asthma symptoms, medication use in the past month, and self-perception of asthma control in the past 7 days were obtained from the clinic records. Physician assessed asthma control was based on the GINA asthma symptom control assessment tool. Lung function was measured using a Diagnostic EasyOne Plus model 2001 SN spirometer. The institutional review board approved the study protocol. RESULTS: Of the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years, and the mean (SD) duration of asthma was 19.4 ± 12.7 years. Forty-four (24.2%) patients had physician determined well-controlled asthma and 138 (75.8%) patients had physician determined partly controlled/uncontrolled asthma. One hundred and fifty-one (83%) patients thought their asthma control was good. However, the degree of concordance between physician evaluation and patient perception of asthma control was low (kappa index = 0.09). On multivariate analysis, self-perceived poor asthma control was associated with any activity limitation due to asthma and inconsistent inhaled corticosteroid use. CONCLUSION: In our study, the first of its kind in Ethiopia, a high percent of patients with physician determined well-controlled asthma has appropriate perception of their disease state. However, those patients with partly controlled/uncontrolled asthma had poor self-perception of their disease, emphasizing the need for further patient education. These conclusions may be especially useful in the care of asthmatics from other low-income countries.


Assuntos
Asma , Autoavaliação Diagnóstica , Testes de Função Respiratória , Avaliação de Sintomas , Adulto , Asma/diagnóstico , Asma/epidemiologia , Asma/psicologia , Asma/terapia , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Conduta do Tratamento Medicamentoso/estatística & dados numéricos , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Educação de Pacientes como Assunto , Testes de Função Respiratória/métodos , Testes de Função Respiratória/estatística & dados numéricos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/psicologia , Avaliação de Sintomas/estatística & dados numéricos
20.
Korean J Intern Med ; 34(6): 1363-1371, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31610633

RESUMO

BACKGROUND/AIMS: Depression and allergic diseases, including asthma, are frequently reported as comorbid conditions. However, their associations have been rarely examined in community-based elderly populations. METHODS: The analyses were performed using the baseline data set of the Korean Longitudinal Study of Health and Aging, which consists of 1,000 elderly participants (aged > 65 years) randomly recruited from an urban community. Depression was assessed using the Geriatric Depression Scale, Center for Epidemiologic Studies Depression Scale, and Hamilton Rating Scale for Depression. Major and minor depressive disorders were diagnosed by psychiatrists. Allergic conditions were assessed using structured questionnaires, lung function, and skin prick test. Quality of life and comorbidities were assessed using structured questionnaires. RESULTS: Prevalence of asthma and major depressive disorder were 5.4% and 5.3%, respectively. The rate of depression was not significantly different between the non-asthmatic and asthmatic groups. No correlation was observed between the scores obtained using the depression scales and self-reported asthma. However, chronic, frequent, and nocturnal cough were significantly associated with depression and scores obtained using the depression scales, which remained significant in multivariate logistic regression analyses (chronic cough: odds ratio [OR], 3.23; 95% confidence interval [CI], 2.57 to 12.74; p = 0.04). Rhinitis was independently associated with high Mini-Mental State Examination scores (OR, 1.11; 95% CI, 1.05 to 1.17; p < 0.001) and low 36-item short-form (OR, 0.96; 95% CI, 0.80 to 0.98; p = 0.002). CONCLUSION: Depression may not be significantly associated with asthma and allergic diseases in elderly populations, but cough is a significant factor affecting depression.


Assuntos
Asma/epidemiologia , Tosse/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Afeto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Asma/diagnóstico , Asma/psicologia , Doença Crônica , Comorbidade , Tosse/diagnóstico , Tosse/psicologia , Estudos Transversais , Bases de Dados Factuais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Prevalência , Prognóstico , Qualidade de Vida , República da Coreia/epidemiologia , Fatores de Risco
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