Asthma ; psychology ; therapy ; Humans ; Integrative Medicine ; Stress, Psychological

A study was conducted to determine the clinical factors that affect the quality of life in adult asthmatics. As part of their routine follow-up visit, 399 patients completed the SF-36 quality of life questionnaire, had peak expiratory flow rate readings (PEFR) taken and were interviewed to determine current symptom severity. The grade of severity of asthma was verified by the consultant physician in-charge. The mean age of the patients was 41.8 years and 31.8% of the patients were men. Most of the patients were Malay (64.7%), 89% had at least secondary level education and the mean duration of asthma was 17.6 years. The majority of patients had moderate or severe disease (43.6% and 55.9% respectively). For asthmatics with moderate or severe symptoms of chest tightness and/or shortness of breath, all domains of SF-36 scored significantly lower than those with mild symptoms, with the exception of the domain bodily pain. Patients with moderate/severe cough recorded significantly lower scores than those with mild cough for all domains except for bodily pain and social functioning. Only the physical functioning, role physical, general health and role emotional scores were significantly worse in those with a consultant grade of severe asthma compared to those with mild/moderate asthma. Patients with PEFR < 80% predicted had lower scores for the domains physical functioning, role physical and general health than those with PEFR > or = 80% predicted, but the scores for the other domains were similar in both groups. Quality of life is significantly impaired in adult asthmatics with current respiratory symptoms. However, consultant grade of severity of asthma and PEFR readings do not affect quality of life scores as much.
Asthma/*physiopathology ; Asthma/psychology ; Malaysia ; *Quality of Life ; Questionnaires ; Regression Analysis ; Severity of Illness Index ; Statistics, Nonparametric

PURPOSE: The purpose of this study was to develop and evaluate a Korean questionnaire to measure resilience in children with chronic illness. METHODS: Item construction was drawn from an extensive review of the literature, existing questionnaires and interviews with parents. Content validity was tested by experts. To further refine the questionnaire and test its reliability and validity, data were collected from the 202 children with asthma, diabetes mellitus or nephrotic syndrome. Corrected items were used to total correlation coefficient and test-retest reliability. Questionnaire testing was conducted using factor analysis, Cronbach's alpha, and correlation coefficients. Validity of the questionnaire was tested using internal consistency, construct validity, and criterion-related validity. RESULTS: Components of the questionnaire were in three domains; interpersonal characteristics, characteristics of coping, and intrapersonal characteristics. Factor analysis is showed five factors; positive self-understanding, self-reliance, resourcefulness, perception of positive family relationships, and intimacy. The questionnaire showed a high internal consistency. A significant positive correlation with the Numerical Rating Score and negative correlation with the Child Depression Inventory support the validity of the questionnaire. CONCLUSION: This instrument demonstrated high reliability and validity. Therefore, this instrument can contribute to the evaluation of resilience of chronically ill children and to any subsequent intervention as well as to develop a theory for resilience.
Adolescent ; Adult ; Asthma/*psychology ; Child ; Chronic Disease ; Depression/psychology ; Diabetes Mellitus/*psychology ; Humans ; Interviews as Topic ; Middle Aged ; Nephrotic Syndrome/*psychology ; Parents/psychology ; Program Evaluation ; *Questionnaires ; *Resilience, Psychological

OBJECTIVEA qualitative research was conducted to investigate the problems on the family management of asthmatic children and the needs for family health services in order to provide basis for family-centered care.

METHODSFifteen caregivers of children with asthma were interviewed with open-ended questions. The collected data were studied using Colaizzi's seven-step method of phenomenological analysis.

RESULTSThe problems of family management and the needs for family health services were shown as follows: insufficient knowledge to prevention and treatment of asthma, poor compliance, ignoring psychological effects of asthma on children, a family's failure to cope with the distress and financial burden.

CONCLUSIONSIt is important to provide asthma education and prevention program for caregivers and encourage them to participate in the design of medical program for asthmatic children. Individual asthma education and guides are also necessary for caregivers.

Adult ; Asthma ; psychology ; therapy ; Caregivers ; education ; psychology ; Female ; Humans ; Male ; Middle Aged ; Needs Assessment ; Patient Education as Topic ; Qualitative Research

PURPOSE: The objective of this study was to evaluate skills in handling inhalers and factors associated with these skills among patients with asthma who had undergone treatment at special asthma and allergy clinics in Korea. METHODS: We enrolled 78 subjects who used Turbuhaler and 145 who used Diskus for asthma control at special clinics in 10 university hospitals and visually assessed their skills in handling these inhalers. We also evaluated skills in 137 subjects who had used pressurized metered-dose inhalers (pMDIs) for symptom relief. Age, sex, duration of asthma and inhaler use, smoking status, monthly income, highest grade completed in school and previous instruction for handling inhalers were also measured to evaluate their association with overall inhaler skills. RESULTS: Performance grade was inadequate for 12.8% of participants using Turbuhaler, 6.2% for Diskus, and 23.4% for pMDIs. The success rates for each step in handling the inhalers were relatively high except for the "exhale slowly to residual volume" step, in which success rates ranged from 24.2% to 28.5%. Older age, male sex, lower educational grade, and absence of previous instruction for handling inhalers were associated with inadequate inhaler technique in univariate analysis; however, only older age and absence of previous instruction remained significant independent risk factors in multivariate analysis. CONCLUSIONS: Among Korean asthmatic patients in special asthma and allergy clinics, skills in handling their inhalers were mostly excellent; meanwhile, older age and absence of previous instruction for handling inhalers were associated with inadequate techniques.
Asthma ; Handling (Psychology) ; Hospitals, University ; Humans ; Hypersensitivity ; Male ; Nebulizers and Vaporizers ; Risk Factors ; Smoke ; Smoking

BACKGROUNDS: Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements would be is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and FEV1 in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. METHODS: PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 mg salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second(FEV1). Reversible airflow obstruction was analysed analyzed according to American Thoracic Society(ATS) criteria. RESULTS: When defined as a 12% A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 reversibility was were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%) CONCLUSIONS: Absolute changes in PEF can be used to diagnose reversible airflow obstruction.
Albuterol ; Asthma ; Discrimination (Psychology) ; Forced Expiratory Volume ; General Practice ; Humans ; Inhalation ; Pulmonary Disease, Chronic Obstructive

Adolescent ; Asthma ; psychology ; therapy ; Behavior Therapy ; Child ; Female ; Health Education ; Humans ; Male ; Massage ; Psychotherapy

Anxiety ; etiology ; Asthma ; psychology ; Child ; Child, Preschool ; Depression ; etiology ; Female ; Humans ; Male ; Mental Disorders ; etiology

OBJECTIVEAsthma is considered as a typical psychosomatic disease. This study aimed to investigate the temperament of asthmatic children and risk factors for asthma.

METHODSTemperamental type and dimensionality were investigated by Carry Temperament Scale in 106 children with asthma. Logistic regression analysis was used to study the risk factors for the development of asthma. One hundred and six age and sex-matched normal children served as controls.

RESULTSThere were significant differences in the adaptability, mood value and attention persistence of temperament between asthmatic patients and normal controls. Higher proportion of inter-high difficult temperamental type (17.0% vs 5.7%) and lower proportion of easy temperamental type (16.0% vs 29.2%) were found in children with asthma when compared with controls (P < 0.01). Logistic regression analysis showed that the frequency of cold between 3 and 7 years old, allergic history, idiosyncratic physique, parental history of asthma, house decoration and mood value and attention persistence of temperament were risk factors for the development of asthma.

CONCLUSIONSThere were differences in the temperamental type and dimensionality between asthmatic children and normal controls. Children with inter-high difficult temperament and suffered from the above risk factors showed a higher risk for developing asthma.

Adaptation, Psychological ; Affect ; Asthma ; etiology ; psychology ; Attention ; Child ; Child, Preschool ; Humans ; Logistic Models ; Risk Factors ; Temperament

BACKGROUND/AIMS: Patients with chronic airway lung diseases often experience depression and anxiety, but little information is available regarding Koreans with these conditions. We thus assessed depression and anxiety in Korean patients with chronic airway lung diseases. METHODS: The degree of depression and anxiety in 84 outpatients with chronic obstructive pulmonary disease (COPD), 37 with asthma, 33 with bronchiectasis, and 73 healthy controls were evaluated by the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). RESULTS: The patients with COPD and bronchiectasis had higher BDI scores and were more likely than controls to experience depression ([COPD, 17; range, 0 to 42; prevalence, 55%], [bronchiectasis, 16; range, 3 to 51; prevalence, 55%], [controls, 13; range, 0 to 31; prevalence, 30%], p < 0.05). The state-anxiety scores of the patients were higher than those of the controls, but only the bronchiectasis group demonstrated a higher frequency of state-anxiety compared with the controls (39 vs. 16%, patients vs. controls, p = 0.015). Among all patients, 22% presented with concomitant depression and state-anxiety, and 25% demonstrated depression and trait-anxiety. Depression was positively correlated with both state-anxiety (r = 0.644) and trait-anxiety (r = 0.597, p < 0.0001). Irrespective of individual diagnosis, post-bronchodilator FEV1 (odds ratio [OR], 0.972; p = 0.027) and smoking history (OR, 3.894; p = 0.018) were independent risk factors for depression in patients with chronic airway lung diseases. CONCLUSIONS: Chronic airway lung diseases are associated with depression and/or anxiety, particularly in those with a higher airflow limitation and/or history of smoking.
Aged ; Aged, 80 and over ; Anxiety/*epidemiology ; Asthma/epidemiology/psychology ; Bronchiectasis/epidemiology/psychology ; Chronic Disease ; Depression/*epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive/*epidemiology/*psychology ; Risk Factors ; Smoking/epidemiology/psychology