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Ulutas Deniz E, Gülakar AN, Eren R. A qualitative study on asthma management experiences of Turkish community pharmacists. J Asthma 2024; 61:632-642. [PMID: 38108630 DOI: 10.1080/02770903.2023.2297373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/16/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Asthma is seen in more than 4 million people in Turkey. Numerous studies have shown the beneficial effects of pharmacist interventions on medication adherence and therapeutic outcomes. The aim of this study was to gain insight into the current situation by examining the experiences of Turkish community pharmacists in relation to the counseling and referral of asthma patients, the responsibilities of pharmacists and the recommendations made by pharmacists to improve asthma management. METHODS In this qualitative study, the constructivist-interpretivist paradigm was adopted. To conduct qualitative interviews, a semi-structured interview guide was devised to gather insights from the pharmacists. The interviews were coded verbatim. Subsequently, various themes and sub-themes were developed based on the aim and objectives of the study. RESULTS A total of 14 pharmacists engaged in semi-structured interviews conducted between June and August 2023. The wealth of information gathered during these interviews facilitated a meticulous thematic analysis, yielding four overarching themes: 1) Patient-related difficulties, 2) Communication with physicians, 3) Desired traits and responsibilities of pharmacists, 4) Pharmacists' expectations. Pharmacists placed significant emphasis on their challenges in allocating time to patients, primarily due to high workloads and limited collaboration with physicians. CONCLUSION Considering the workload and time limitations faced by pharmacists, a collaborative model involving pharmacists and physicians is seen as essential. Enhancing the collaboration between pharmacists and physicians, especially for chronic diseases, holds the potential to enhance public health outcomes while alleviating the workload of pharmacists.
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Affiliation(s)
- Elif Ulutas Deniz
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
| | | | - Rumeysa Eren
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey
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Qeadan F, McCunn A, Tingey B, Price R, Bobay KL, Saeed AI. Investigating the association between asthma and opioid use disorder with interactions of anxiety and depression among a national sample of the US population. J Asthma 2024; 61:594-607. [PMID: 38088813 DOI: 10.1080/02770903.2023.2294911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/10/2023] [Indexed: 12/22/2023]
Abstract
INTRODUCTION Previous studies have not examined the association between asthma and opioid use disorder (OUD) in a comprehensive national sample of the U.S. population. This study aims to investigate such an association. METHODS This is a matched retrospective cohort study, with a follow-up period of two years, utilizing longitudinal electronic medical records of a comprehensive national healthcare database in the U.S.-Cerner-Real World DataTM. Patients selected for analysis were ≥12 years old with a hospital encounter between January 2000 and June 2020. Adjusted risk ratios (aRRs) of incident OUD for those with asthma compared to those without asthma were calculated using a modified Poisson regressions with robust standard errors via the Huber-White sandwich estimator, and results were stratified by comorbid mental illnesses. RESULTS Individuals with asthma had a greater risk of OUD compared to those without asthma (aRR = 2.12; 95% CI 2.03-2.23). When stratified by anxiety and depression status, individuals with asthma and no anxiety or depression had a greater risk of incident OUD compared to individuals with asthma and either anxiety, depression, or both. Additionally, individuals with asthma medication had 1.29 (95% CI: 1.24, 1.35) greater overall risk for incident OUD compared to those without medication. Independent of comorbid mental illnesses, individuals with asthma medication had greater risk for incident OUD compared to those without medication among individuals without severe/obstructive asthma. CONCLUSIONS Individuals with asthma face a higher OUD risk compared to those without asthma. Comorbid mental illnesses modulate this risk. Caution is advised in opioid prescribing for asthma patients.
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Affiliation(s)
- Fares Qeadan
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
| | - Ashlie McCunn
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
| | - Benjamin Tingey
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
| | - Ron Price
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
| | - Kathleen L Bobay
- Department of Public Health Sciences, Loyola University Chicago, Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
| | - Ali Imran Saeed
- Interventional Pulmonary and Advanced Diagnostics, Dignity Health Norton Thoracic Institute, Phoenix, AZ, USA
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Hall AL, Movva P, Dailey R, Gibson-Scipio W, Baptist AP, MacDonell KK. COVID-19 vaccine intentions and attitudes in Black American emerging adults with asthma. BMC Public Health 2024; 24:1356. [PMID: 38769561 DOI: 10.1186/s12889-024-18843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Emerging adults (aged 18-29) are less likely to receive the COVID-19 vaccine than any other adult age group. Black Americans are less likely than non-Hispanic white Americans to be fully vaccinated against COVID-19. This study explored factors which affect vaccine intention and attitudes in Black American emerging adults with asthma. METHODS Participants were recruited from an NHLBI-funded clinical trial to improve asthma control. Fifty-nine Black American emerging adults completed a Qualtrics survey that assessed asthma control, intention to vaccinate, and factors which may affect the decision to vaccinate. Twenty-five participants also completed a semi-structured interview via Zoom. Bivariate correlations and descriptive statistics, including Chi Square analyses, were run using SPSS. Interview thematic analyses were conducted via QDA Miner. RESULTS Of the 59 Black American emerging adults with asthma who completed surveys, 32.2% responded that they were highly unlikely to receive the COVID-19 vaccine, while 50.8% responded that they were highly likely to receive it. Increased asthma control was significantly correlated with a higher likelihood to discuss the COVID-19 vaccine with their healthcare provider (ρ = 0.339, α = 0.011). Concerns about immediate (ρ= -0.261, α = 0.050) and long-term (ρ= -0.280, α = 0.035) side effects were inversely correlated with intention to vaccinate. Only 17% of the participants who were unemployed stated that they were highly likely to receive the vaccines compared to 65% of the participants who were employed; however, interview participants who were unemployed stated not needing the vaccine because they were protecting themselves by social distancing. When deciding whether to receive the vaccine, safety, efficacy, and immediate side effects were the top three factors for 91%, 54%, and 49% of the participants, respectively. Beliefs about the vaccines' safety and efficacy, information gathering, personal factors, and societal factors emerged as important themes from the interviews. CONCLUSION Only half of the surveyed Black American emerging adults with asthma were highly likely to receive the COVID-19 vaccine. Safety and efficacy were important for the majority of the participants, regardless of vaccine intention. Greater asthma control, but not access to asthma-related healthcare, was correlated with intention to discuss the vaccine with their healthcare provider.
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Affiliation(s)
- Amy Lee Hall
- College of Nursing, Wayne State University, Detroit, MI, USA.
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL, USA.
| | - Pranati Movva
- Michigan State University College of Osteopathic Medicine, Lansing, MI, USA
| | - Rhonda Dailey
- School of Medicine, Wayne State University, Detroit, MI, United States of America
| | | | - Alan P Baptist
- Henry Ford Health, Division of Allergy and Immunology, Detroit, MI, USA
| | - Karen Kolmodin MacDonell
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL, USA
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Lingam R, Hu N, Cecil E, Forman J, Newham J, Satherley RM, Bori MS, Cousens S, Fox-Rushby J, Wolfe I. Changing contexts of child health: an assessment of unmet physical, psychological and social needs of children with common chronic childhood illness. Arch Dis Child 2024; 109:488-496. [PMID: 38383134 DOI: 10.1136/archdischild-2023-326766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. METHODS Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. RESULTS Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. CONCLUSIONS There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care.
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Affiliation(s)
- Raghu Lingam
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Women & Children's Health, King's College London, London, UK
| | - Nan Hu
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Elizabeth Cecil
- Department of Women & Children's Health, King's College London, London, UK
| | - Julia Forman
- Department of Women & Children's Health, King's College London, London, UK
| | - James Newham
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | | | - Marina Soley Bori
- Department of Population Health Sciences, King's College London, London, UK
| | | | - Julia Fox-Rushby
- Department of Population Health Sciences, King's College London, London, UK
| | - Ingrid Wolfe
- Department of Women & Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Al-Zayadneh E, Al-Darraji G, Momani A, Sa'ed RA, Abu Qutaish AF, Algallab N, Alzayadneh EM, Alrowwad KA, Alhalaki MM, Al-Iede M. Parental knowledge and attitudes toward asthma in Jordanian children with asthma, a multi-center cross-sectional study. J Asthma 2024; 61:501-510. [PMID: 38047590 DOI: 10.1080/02770903.2023.2289165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE We explored Jordanian caregivers' knowledge, attitudes, and practices (KAP) toward asthma in their children. METHODS This cross-sectional investigation was conducted on caregivers visiting the pediatrics clinic at the Jordan University Hospital and King Abdullah University Hospital between December 2021 and January 2023. KAP were measured using a literature-validated questionnaire. Differences in KAP scores across participants' characteristics were examined using the student-t test and ANOVA. RESULTS A total of 108 caregivers were included in the final analysis. Caregivers were aged 30 to 40 years (54.6%) and had at least secondary education (90.7%). The majority of participants displayed appropriate knowledge with respect to asthma's clinical course. Furthermore, the greater portion of caregivers were knowledgeable about preventing asthma attacks and treating their children during said attacks. Factors affecting knowledge of asthma included age of mothers (p < .05). On the other hand, attitude scores were affected by occupation, type of medication, and family history of asthma (all p < .05). Moreover, employee mothers, children well controlled on both Asthma Control Test and Global Initiative for Asthma scores, and having no pediatric intensive care unit admissions were associated with higher practice treatment scores (all p < .05). Overall practice score was weakly, yet positively correlated with knowledge scores (r = 0.195, p = .043). Similarly, negative attitudes were weakly correlated with higher knowledge scores (r = 0.199, p = .039). CONCLUSION While the knowledge and practice scores were satisfactory, the clinical status of children with asthma was unsatisfactory. Future studies should examine factors associated with caregiver insecurity and measure their extent of applying asthma prevention guidelines.
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Affiliation(s)
- Enas Al-Zayadneh
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Ameera Momani
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | | | - Eba M Alzayadneh
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | - Montaha Al-Iede
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
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Yang F, Chen C, Deng X, Hu T, Bi D, Li H. Perspectives and experiences of mothers of school-age children with asthma: a qualitative study. J Asthma 2024; 61:444-452. [PMID: 38009785 DOI: 10.1080/02770903.2023.2288322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/19/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION AND AIMS This study aimed to explore the perspectives and experiences of mothers of school-age children with asthma in care. METHODS A phenomenological study was conducted using qualitative research methods from August 2021 to November 2021. Mothers (from Sichuan, China) of school-aged children with asthma who sought outpatient care at the pediatric asthma clinic were purposively sampled based on their occupation, education level, and duration of their child's illness. Semi-structured face-to-face interviews were conducted in consultation room A07 of the pediatric asthma clinic. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. RESULTS 23 mothers expressed interest, but data saturation was reached after recruiting 15 mothers.Four main themes encompassing ten sub-themes emerged from the analysis: (1) Negative psychological burden, with sub-themes including anxiety shock, fear of death, guilt, and stigma. (2) Family dysfunction, with sub-themes including impaired quality of life, family emotional crisis, and heavy economic burden. (3) Difficulty in seeking medical treatment. (4) Active response, with sub-themes including emotional adjustment, family empowerment, and social support. CONCLUSIONS In this sample, the caregiving experience of mothers of school-age children with asthma is diverse and complex, reflected not only in personal psychological aspects but also in family functioning and social support. Taking into account various factors, such as addressing psychological well-being, emphasizing family and social support, and promoting the sharing of positive experiences, may result in more effective alleviation of caregiving stress for mothers of school-age children with asthma.
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Affiliation(s)
- Fang Yang
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Cheng Chen
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Xuexue Deng
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Tingting Hu
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Dan Bi
- Pediatric Department, Deyang People's Hospital, Deyang, China
| | - Huawei Li
- Nephrology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Nebati E. Do psychological interventions improve outcomes for asthma in children and young people? Clin Exp Allergy 2024; 54:311-313. [PMID: 38576214 DOI: 10.1111/cea.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024]
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Adgent MA, Buth E, Noroña-Zhou A, Szpiro AA, Loftus CT, Moore PE, Wright RJ, Barrett ES, LeWinn KZ, Zhao Q, Nguyen R, Karr CJ, Bush NR, Carroll KN. Maternal stressful life events during pregnancy and childhood asthma and wheeze. Ann Allergy Asthma Immunol 2024; 132:594-601.e3. [PMID: 38122928 PMCID: PMC11069451 DOI: 10.1016/j.anai.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Studies have linked prenatal maternal psychosocial stress to childhood wheeze/asthma but have rarely investigated factors that may mitigate risks. OBJECTIVE To investigate associations between prenatal stress and childhood wheeze/asthma, evaluating factors that may modify stress effects. METHODS Participants included 2056 mother-child dyads from Environmental influences on Child Health Outcomes (ECHO)-PATHWAYS, a consortium of 3 prospective pregnancy cohorts (the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study, The Infant Development and Environment Study, and a subset of the Global Alliance to Prevent Prematurity and Stillbirth study) from 6 cities. Maternal stressful life events experienced during pregnancy (PSLEs) were reported using the Pregnancy Risk Assessment Monitoring System Stressful Life Events questionnaire. Parents reported child wheeze/asthma outcomes at age 4 to 6 years using standardized questionnaires. We defined outcomes as ever asthma, current wheeze, current asthma, and strict asthma. We used modified Poisson regression with robust standard errors (SEs) to estimate risk ratios (RRs) and 95% CI per 1-unit increase in PSLE, adjusting for confounders. We evaluated effect modification by child sex, maternal history of asthma, maternal childhood traumatic life events, neighborhood-level resources, and breastfeeding. RESULTS Overall, we observed significantly elevated risk for current wheeze with increasing PSLE (RR, 1.09 [95% CI, 1.03-1.14]), but not for other outcomes. We observed significant effect modification by child sex for strict asthma (P interaction = .03), in which risks were elevated in boys (RR, 1.10 [95% CI, 1.02-1.19]) but not in girls. For all other outcomes, risks were significantly elevated in boys and not in girls, although there was no statistically significant evidence of effect modification. We observed no evidence of effect modification by other factors (P interactions > .05). CONCLUSION Risk of adverse childhood respiratory outcomes is higher with increasing maternal PSLEs, particularly in boys.
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Affiliation(s)
| | - Erin Buth
- University of Washington, Seattle WA
| | | | | | | | | | | | - Emily S. Barrett
- Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute; Piscataway NJ
| | - Kaja Z. LeWinn
- University of California San Francisco, San Francisco CA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis TN
| | | | | | - Nicole R. Bush
- University of California San Francisco, San Francisco CA
| | - Kecia N. Carroll
- Vanderbilt University Medical Center, Nashville TN
- Icahn School of Medicine at Mount Sinai, New York NY
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Özmen T, Kadiroğlu T. Psychometric test of the Turkish version of the Family Management Scale for Children with Asthma (FMSCA). J Asthma 2024; 61:463-471. [PMID: 37999987 DOI: 10.1080/02770903.2023.2288325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Asthma is the most common chronic disease among children. The management of asthma in children requires ongoing effort and is heavily dependent on the effectiveness of family management. This study aimed to evaluate the validity and reliability of the Family Management Scale for Children with Asthma (FMSCA) by adapting it to Turkish. METHODS This methodological research comprised 293 parents between December 2020 and May 2021. Inclusion criteria were having a child with a diagnosis of asthma for more than six months, being literate, and not having problems in communication. FMSCA was examined for language, content and construct validity. Internal consistency was calculated using Cronbach's α coefficient, item-total correlation, and test-retest equivalence. Ethical principles were adhered to. RESULTS The content validity index scores of the items in the FMSCA ranged from 0.90 to 1.0. The Kaiser-Meyer-Olkin value was determined to be 0.965 and the Bartlett's Test of Sphericity value was χ2 = 18,296.335 (p ≤ .001). Many indices were used to examine the fit of the FMSCA model. Of these, the χ2/SD value was determined to be 1.61. The total FMSCA Cronbach α coefficient was 0.981. The relationship between the test-retest results was statistically significant, high, and positive (p < .05). CONCLUSION FMSCA is a valid and reliable tool that can be used to objectively evaluate family management in families with children with asthma and to determine the effectiveness of interventions.
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Affiliation(s)
- Tubanur Özmen
- Department of Child Health and Diseases Nursing, Ataturk University, Erzurum, Turkey
| | - Türkan Kadiroğlu
- Department of Child Health and Diseases Nursing, Ataturk University, Erzurum, Turkey
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Alyami MA, Alyami MM, Alasimi AH, Alqahtani JS, Alqarni AA, Aldhahir AM. The utility of the necessity-concerns framework (NCF) in explaining adherence and parental beliefs about controller medication in Saudi Arabian children with asthma. J Asthma 2024; 61:436-443. [PMID: 37997759 DOI: 10.1080/02770903.2023.2288320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE This study aims to assess beliefs about asthma controller medications among parents of Saudi Arabian children with asthma and the association between these beliefs and medication adherence using the Necessity-Concerns Framework. METHODS A cross-sectional survey was provided to parents of children with asthma when they brought their children to routine appointments at local public clinics between May 16 and July 10, 2018. Participants electronically filled out validated Arabic versions of the Medication Adherence Reported Scale (MARS) and Beliefs About Medications Questionnaire (BMQ). Descriptive statistics were used to characterize the study participants, while hierarchical linear regression analysis assessed associations between parental beliefs about controller medications and medication adherence. RESULTS A total of 381 parents of children with asthma completed the study survey. The vast majority (89%) of study participants were non-adherent to their children's prescribed medications while only 11% were adherent. Additionally, our study revealed a significantly positive association between adherence and parents' beliefs in the necessity of the medication (p < .001), with concerns about the adverse effects of medication being negatively associated with parental adherence. A higher mean score for medication adherence was reported among the ambivalent groups compared to the accepting, indifferent, and skeptical groups. CONCLUSIONS Medication adherence among parents of children with asthma was relatively low. In addition, necessity beliefs were significantly associated with parental adherence to controller medications for their children with asthma. Further studies are warranted to investigate potential factors contributing to poor parental adherence and develop tailored interventions that support parental medication adherence for their asthmatic children.
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Affiliation(s)
- Marja A Alyami
- Dhahran Long Term Hospital, Eastern Health Cluster, Ministry of Health, Dhahran, Saudi Arabia
| | - Mohammed M Alyami
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Ahmed H Alasimi
- Department of Respiratory Therapy, GA State University, Atlanta, GA, USA
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
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Sheykhi M, Pourvali A, Ghandi Y, Alaghmand A, Zamanian M, Eslambeik T, Tajerian A. Exploring the relationship between asthma, its severity and anxiety symptoms in pediatric patients: a case-control study. J Asthma 2024; 61:491-500. [PMID: 38009701 DOI: 10.1080/02770903.2023.2289158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/25/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Asthma is a global health concern, especially among children, and is associated with various underlying mechanisms. Childhood exposure to early life stress and anxiety can potentially exacerbate asthma symptoms and complicate its management. While some studies have suggested the benefits of psychological therapies as adjuncts to medication in asthma management, evidence remains inconsistent, emphasizing the need for rigorous evaluation. METHOD This case-control study involved 120 children aged 5-15, with 60 children having asthma and 60 healthy controls. Asthma severity was assessed based on EPR3 guidelines, while anxiety symptoms were measured using the Spence Children's Anxiety Scale (SCAS). Demographic data and asthma-related information were collected via questionnaires. Statistical analyses were conducted to explore the relationship between asthma and anxiety. RESULTS Children with asthma exhibited significantly higher anxiety symptoms compared to those without asthma (p < 0.001). Subdomain analysis revealed elevated scores in separation anxiety (SA; p = 0.025), social phobia (SP; p < 0.001), agoraphobia (p = 0.004), and fears of physical injury (p < 0.001) in children with asthma. Furthermore, increased need for SABA, frequency of nocturnal symptoms, and asthma severity were associated with higher anxiety levels in pediatric asthma patients. CONCLUSIONS This study highlights a significant association between asthma and heightened anxiety symptoms in children, particularly in domains, such as SA, SP, agoraphobia, and fears related to physical injury. However, limitations include reliance on self-evaluation questionnaires and the observational nature of the study, emphasizing the need for cautious interpretation.
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Affiliation(s)
- Mahdi Sheykhi
- School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Ali Pourvali
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Yazdan Ghandi
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Anita Alaghmand
- Department of Psychiatry, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Zamanian
- Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
| | - Tina Eslambeik
- School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Amin Tajerian
- School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Nabors L, Merianos AL, Stough CO, Workman B, Adabla S, Bernstein JA. Association among friendship skills, involvement in after-school activities, and flourishing for adolescents with asthma and comorbid emotional and behavioral problems. J Asthma 2024; 61:417-426. [PMID: 37937849 DOI: 10.1080/02770903.2023.2281624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/05/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES Primary objectives were to examine the relations among abilities for making and keeping friends, involvement in after-school activities, and flourishing for adolescents with current asthma, as well as comorbid behavior problems, anxiety, or depression. METHODS Data from the 2021 National Survey of Child Health was analyzed. Parents provided data on one child. Multinomial logistic regression analyses, both unadjusted and adjusted for the sampling weight, were conducted for adolescents with current asthma and comorbid behavior problems, anxiety, or depression. Predictors of flourishing included difficulty in making and keeping friends and involvement in after-school activities. Sex, age, race/ethnic group, and having been bullied were covariates. To examine differences for children with varied comorbid emotional and behavioral problems, relations were tested separately for children with asthma and behavior problems, children with asthma and anxiety, and children with asthma and depression. RESULTS Skills for making and keeping friends were positively related to flourishing of adolescents with current asthma for all three types of mental health concerns. The relationship between involvements in after-school activities was less clear-cut, as this predictor was not always positively related to flourishing. CONCLUSIONS Abilities to make and keep friends were related to flourishing, indicating that peer support is a resilience factor. Conversely, it was not clear that involvement in after-school activities was a resilience factor and more research about factors constituting successful after-school involvement for adolescents with asthma is needed. Future research, illuminating how social support from peers and involvement in activities promote flourishing will extend knowledge.
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Affiliation(s)
- Laura Nabors
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, Human Services, and Information Technology, University of Cincinnati, Cincinnati, OH, USA
| | - Ashley L Merianos
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, Human Services, and Information Technology, University of Cincinnati, Cincinnati, OH, USA
| | - Cathleen Odar Stough
- Department of Psychology, College of Arts and Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Brandon Workman
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, Human Services, and Information Technology, University of Cincinnati, Cincinnati, OH, USA
| | - Samuel Adabla
- Health Promotion and Education, School of Human Services, College of Education, Criminal Justice, Human Services, and Information Technology, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan A Bernstein
- Division of Rheumatology, Allergy and Immunology, University of Cincinnati School of Medicine, University of Cincinnati, Cincinnati, OH, USA
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13
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Fleischer NJ, Gosch E, Roberts MB, Albano AM, Ginsburg G, Piacentini J, Birmaher B, Compton SN, Walkup J, Kendall PC, Carper MM. Asthma and anxiety in children and adolescents: characteristics and treatment outcomes. J Asthma 2024; 61:396-404. [PMID: 37930754 DOI: 10.1080/02770903.2023.2280906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This study (a) examined anxious youth with and without asthma on measures of negative self-talk, parental psychopathology, worry content, physical symptoms, panic symptoms, generalized symptoms, and separation anxiety symptoms, and (b) tested if outpatient CBT or medication were differentially effective in reducing anxiety for youth with asthma and anxiety. METHODS This secondary analysis separated youth with an anxiety disorder into asthma and non-asthma groups. Youth were also compared on response to treatments (i.e. CBT, sertraline, combined, and placebo). RESULTS A total of 488 participants participated in the original study, with an average age of 10 years (SD 2.87). Youth with comorbid asthma and anxiety demonstrated higher rates of negative self-talk. Youth with comorbid asthma and anxiety did not differ from the non-asthma group on measures of physical symptoms, anxiety disorder specific symptoms, parental psychopathology, or worry content. Youth with asthma and anxiety responded similarly to the non-asthma group to treatment across treatment conditions. CONCLUSIONS Treatment was comparably effective for youth with comorbid asthma and anxiety and youth with anxiety. Future research could examine the effects of psychopharmaceuticals on asthma and anxiety comorbidity.
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Affiliation(s)
- Nicole J Fleischer
- Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Elizabeth Gosch
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Michael B Roberts
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | - Golda Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - John Piacentini
- Department of Psychiatry, UCLA School of Medicine, Los Angeles, CA, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - John Walkup
- Department of Psychiatry, Lurie Children's Hospital, Chicago, IL, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Matthew M Carper
- Department of Clinical Psychology, William James College, Newton, MA, USA
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14
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Alqarni AA, Aldhahir AM, Siraj RA, Alqahtani JS, Alghamdi DA, Alghamdi SK, Alamoudi AA, Mohtaseb MA, Majrshi M, AlGarni AA, Badr OI, Alwafi H. Asthma medication adherence, control, and psychological symptoms: a cross-sectional study. BMC Pulm Med 2024; 24:189. [PMID: 38641584 PMCID: PMC11031990 DOI: 10.1186/s12890-024-02995-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/03/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Nonadherence to therapies and psychological disorders are associated with poor asthma control. This study aims to assess the prevalence of anxiety and depressive symptoms, asthma control, and adherence to inhalers and to investigate whether there is an association of anxiety and depressive symptoms with adherence to inhalers and asthma control. METHODS We measured anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale in patients with asthma. Asthma Control Test and the 10-Item Test of Adherence to Inhalers Scale were used to assess levels of asthma control adherence to inhalers, respectively. Univariate and multivariate regression models assessed the associations of anxiety and depressive symptoms with adherence to inhalers and asthma control. RESULTS A total of 287 patients completed the study, of whom 72% were female. The mean ± SD age and body mass index of our study population were 44 ± 13 years and 29 ± 7.2 kg/m2, respectively. Poor adherence to inhaler use was highly prevalent (49.8%; 95% CI: 43.8 to 55.7). The prevalence of anxiety, depression and poor asthma control was 27.2% (95% CI: 22.1 to 32.7), 20.9% (95% CI: 16.3 to 26.1), and 22.7% (95% CI: 17.9 to 27.9), respectively. We found a negative relationship between asthma control and anxiety, and depressive symptoms (adjusted β: -0.25; 95% CI: -0.36 to -0.14; p < 0.001 and adjusted β: -0.29; 95% CI: -0.40 to -0.18; p < 0.001, respectively). A negative relationship was also observed between adherence to inhalers and anxiety and depressive symptoms (adjusted β: -0.34; 95% CI: -0.46 to -0.22; p < 0.001 and adjusted β: -0.36; 95% CI: - 0.48 to - 0.24; p < 0.001, respectively). CONCLUSIONS The high prevalence of uncontrolled asthma symptoms and poor adherence to inhalers and their impact on anxiety and depression levels among patients with asthma point to the need for early screening for psychological symptoms and recognition of nonadherence as part of asthma assessment and management plan in primary care in Saudi Arabia to avoid further worsening of asthma symptoms. Further studies are needed to explore the effectiveness of specific psychoeducational interventions and investigate the long-term impact of early psychological symptom detection on asthma outcomes.
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Affiliation(s)
- Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
- Respiratory Therapy Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Rayan A Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Dana A Alghamdi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah K Alghamdi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer A Alamoudi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majduleen A Mohtaseb
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mansour Majrshi
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Abdulkareem A AlGarni
- King Abdulaziz Hospital, The Ministry of National Guard Health Affairs, Al Ahsa, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, College of Applied Medical Sciences, Al Ahsa, Saudi Arabia
| | - Omaima I Badr
- Department of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Pulmonary Medicine, Al Noor Specialist Hospital, Mecca, Saudi Arabia
| | - Hassan Alwafi
- Department of Clinical Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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15
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Lima KF, Lima RBS, Ruiz VMT, Mendes ERR, Rocha DMA, Brito LCS, Santos MBL, Ferreira LCC, Gaspar MWG, Melo RCO, Dalcin CB, Barbosa LP. Booklet and Motivational Interviewing to Promote Self-efficacy in Parents/Caregivers of Children with Asthma: A Clinical Trial. Int J Community Based Nurs Midwifery 2024; 12:76-85. [PMID: 38650954 PMCID: PMC11032423 DOI: 10.30476/ijcbnm.2024.99428.2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/15/2024] [Accepted: 02/24/2024] [Indexed: 04/25/2024]
Abstract
Background Asthma is the most common chronic disease in childhood which accounts for numerous annual hospitalizations due to a lack of management and proper management of the disease. Thus, this study aimed to evaluate the effect of using an educational booklet with or without combination with motivational interviewing (MI) on the self-efficacy of parents/caregivers in the control and management of childhood asthma. Methods A clinical trial was carried out with 86 parents/caregivers of children with asthma aged between 2 and 12 years who were followed up in primary health care units from March 2019 to December 2020. Participants were randomly assigned to two groups: one of the groups read the booklet and the other read the booklet combined with the MI. The Brazilian version of the Self-Efficacy and Their Child's Level of Asthma Control scale was applied before and 30 days after the intervention for assessment of self-efficacy. Data were analyzed using SPSS version 20.0 and R 3.6.3 software. P values<0.05 were considered significant. Results There were 46 participants in the booklet group and 40 in the booklet and MI group. Both groups were effective in increasing total self-efficacy scores after the intervention (P<0.001). No statistically significant difference was found between the scores of the two groups (P=0.257). Conclusion The educational booklet with or without combination with MI can increase the self-efficacy of parents/caregivers of children with asthma. The findings could be considered by healthcare providers for the empowerment of caregivers of children with asthma in the control and management of their children's asthma.Trial Registration Number: U1111-1254-7256.
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Affiliation(s)
- Kamila F Lima
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Rayanne B S Lima
- Department of Nursing, School of Nursing, Amazon Adventist College, Pará, Brazil
| | - Victor M T Ruiz
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
- Veracruzana University, Faculty of Nursing, Minatitlán, Veracruz, Mexico
| | - Elizamar R R Mendes
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Deyse M A Rocha
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Leandro C S Brito
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Monyka B L Santos
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Luzia C C Ferreira
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Maria W G Gaspar
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Regina C O Melo
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | | | - Lorena P Barbosa
- Department of Nursing, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
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16
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Morawska A, Etel E, Mitchell AE. Effects of comorbid asthma and eczema on child and family quality of life. J Child Health Care 2024; 28:69-85. [PMID: 35570795 DOI: 10.1177/13674935221097213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Paediatric chronic health conditions are associated with poorer psychological wellbeing and quality of life for children and families. This study investigated differences in child and parent/family quality of life between families of children with asthma only, eczema only, or both asthma and eczema, and tested predictors of child and parent/family quality of life. A convenience sample of 106 families completed parent-report measures of child and parent/family quality of life, child emotional and behavioural difficulties, parent adjustment and parenting practices. Between-groups ANOVAs indicated no differences for child quality of life, whereas parent/family quality of life was worse for those with eczema only compared to asthma only. Multiple linear regression revealed that child emotional difficulties predicted worse child quality of life, whereas worse parent adjustment, child emotional difficulties and eczema only (compared to both asthma and eczema) predicted worse parent quality of life. Results suggest that families of children with eczema may be at particular risk for impaired parent/family quality of life. Interventions that take a family-centred approach to improving child and parent adjustment should be investigated as an adjunct to medical treatment to reduce the impact of chronic health conditions on quality of life for children and families.
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Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Evren Etel
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
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17
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Clark HL, Dixon LJ, Ramachandran S, Leukel PJ, Lee AA. Psychometric Properties of the Short Scale Anxiety Sensitivity Index Among Adults with Chronic Respiratory Disease. J Clin Psychol Med Settings 2024; 31:186-196. [PMID: 37770802 DOI: 10.1007/s10880-023-09976-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
Approximately one-third of adults with chronic respiratory disease (CRD) have comorbid depressive and anxiety disorders; yet these disorders are often unrecognized in this patient population. Transdiagnostic processes such as anxiety sensitivity (AS) are useful for identifying mechanisms underlying psychological and heath conditions. The Short-Scale AS Index (SSASI) is a brief self-report measure of AS which has potential clinical utility among CRD populations to evaluate psychological distress and inform comprehensive care. The present study investigated the psychometric properties of the SSASI among adults with CRDs. Participants were recruited from a web-based panel of adults with CRDs (n = 768; 49.3% female; 57.8% White) including adults with asthma only (n = 230), COPD only (n = 321), or co-occurring asthma and COPD (n = 217). Participants completed a battery of self-report questionnaires assessing psychological and medical symptoms. Analyses were conducted to examine the factor structure and measurement invariance across CRD groups. Convergent validity and criterion validity of the SSASI were assessed within each group. Results supported partial measurement invariance across CRD groups. The SSASI demonstrated high reliability, convergent validity, and criterion validity with each CRD group. Findings from this study and existing work indicate that the SSASI is an effective and economical assessment tool for identifying patients CRD who may benefit from psychological interventions to reduce AS.
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Affiliation(s)
- Heather L Clark
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Sujith Ramachandran
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Patric J Leukel
- Department of Pharmacy Administration, University of Mississippi, University, MS, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
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18
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Dong R, Sun S, Sun Y, Wang Y, Zhang X. The association of depressive symptoms and medication adherence in asthma patients: The mediation effect of medication beliefs. Res Social Adm Pharm 2024; 20:335-344. [PMID: 38110324 DOI: 10.1016/j.sapharm.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The significant role of depression in influencing medication beliefs, which are pivotal cognitive factors that strongly influence medication adherence, has been established. Poor adherence to asthma-controlled medication poses an significant barrier to achieving optimal asthma management. OBJECTIVE To explore the potential mediating effects of medication beliefs on the relationship between depressive symptoms and medication adherence in patients with asthma. METHODS Demographic and clinical characteristics, depressive symptoms, medication adherence, and medication beliefs were collected using questionnaires. Structural equation modeling, was utilized to model medication beliefs as mediators in the relationship between depressive symptoms and medication adherence. Bootstrapping was performed to analyze the mediation- and contrast-specific indirect effects of the two medication beliefs. RESULTS Among the patients who participated in the study, 29.6 % with depressive symptoms were more prone to poor adherence and exhibited skepticism toward asthma medications. Depression had a direct effect (direct effect = -0.275, 95%CI: -0.369 to -0.190) and an indirect effect on adherence mediated by medication beliefs (indirect effect = -0.168, 95%CI: -0.224 to -0.121). The specific mediation effect of concern belief was stronger than that of necessity belief (difference = -0.076, 95%CI: -0.132 to -0.029). CONCLUSION Depressive symptoms have a direct impact on medication adherence as well as an indirect effect mediated by beliefs about medication, particularly concerns belief.
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Affiliation(s)
- Ruiying Dong
- The First Affiliated Hospital of China Medical University, China
| | - Shanwen Sun
- The First Affiliated Hospital of China Medical University, China
| | - Yajun Sun
- The First Affiliated Hospital of China Medical University, China
| | - Yali Wang
- The First Affiliated Hospital of China Medical University, China
| | - Xiaochun Zhang
- The First Affiliated Hospital of China Medical University, China.
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19
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Hashem E, Kandil F, Alsharif F, Sharif L, Khaled A. Assessment of lifestyle and coping strategies among asthmatic patients during the Covid-19 crisis. J Asthma 2024; 61:58-68. [PMID: 37869898 DOI: 10.1080/02770903.2023.2272790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/15/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND COVID-19 can cause an asthma attack by triggering asthma symptoms, such as wheezing, chest tightness, and difficulty breathing, which are distressing for patients and can cause anxiety. Additionally, it can progress to pneumonia or other severe lung diseases. OBJECTIVES Therefore, this study aimed to assess the coping strategies and lifestyle modifications among patients with asthma during the COVID-19 crisis. METHODS A descriptive comparative design was conducted on 300 adult patients with bronchial asthma at the Alexandria Main University Hospital's chest disease outpatient clinic. Three tools were used for data (including biosocio-demographic characteristics of patients with asthma, the effect of the COVID-19 crisis on the lifestyle of patients with asthma, and how patients with asthma cope with COVID-19) collection. RESULTS This study revealed that more than two-thirds of patients with asthma did not have COVID-19, while more than one-quarter had COVID-19. More than two-thirds had reasonable asthma control, and more than half had neutral coping with their asthma and the COVID-19 crisis. Half of the studied patients had coped neutrally with their asthma during the COVID-19 crisis, and more than half coped neutrally with the COVID-19 crisis. CONCLUSION These findings indicate that all stressors faced by patients with respiratory diseases during the COVID-19 crisis and psychological, social, and health support that should be provided to these patients during the pandemic require further investigation.
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Affiliation(s)
- Eshrak Hashem
- Medical Surgical Nursing Department, Faculty of Nursing, University of Alexandria, Alexandria, Egypt
| | - Faten Kandil
- Medical Surgical Nursing, Nursing Department, Faculty of Applied Medical Sciences, University of Jeddah, Jeddah, Saudi Arabia
| | - Fatmah Alsharif
- Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Loujain Sharif
- Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Asmaa Khaled
- Community Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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20
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Waters EA, Pachur T, Pogge G, Hunleth J, Webster GD, Shepperd JA. Linking cognitive and affective heuristic cues to interpersonal risk perceptions and behavior. Risk Anal 2023; 43:2610-2630. [PMID: 36781299 PMCID: PMC10423305 DOI: 10.1111/risa.14101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
People often use cognitive and affective heuristics when judging the likelihood of a health outcome and making health decisions. However, little research has examined how heuristics shape risk perceptions and behavior among people who make decisions on behalf of another person. We examined associations between heuristic cues and caregivers' perceptions of their child's asthma risk, the frequency of caregivers' asthma management behaviors, and child health outcomes. We used Ipsos KnowledgePanel to recruit 814 U.S. adult caregivers of children with asthma of the age <18 years. Participants completed a survey at baseline (T1) and 3 months later (T2). Caregivers who, at T1, reported greater negative affect about their child's asthma (affect heuristic cue), greater ease of imagining their child experiencing asthma symptoms (availability heuristic cue), and greater perceived similarity between their child and a child who has ever experienced asthma symptoms (representativeness heuristic cue) reported statistically significantly (p < 0.05) higher interpersonal perceived risk of their child having an exacerbation or uncontrolled asthma at T1. They also indicated at T2 that their child had poorer asthma control and more frequent exacerbations. Greater T1 negative affect was associated with more frequent T2 actions to reduce inflammation, manage triggers, and manage symptoms, and with poorer T2 child health outcomes. Heuristic cues are likely important for interpersonal-not just personal-risk perceptions. However, the interrelationship between caregivers' ratings of heuristic cues (in particular, negative affect) and risk judgments may signify a struggle with managing their child's asthma and need for extra support from health care providers or systems.
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Affiliation(s)
- Erika A. Waters
- Washington University in St. Louis, Saint Louis, Missouri, USA
| | | | | | - Jean Hunleth
- Washington University in St. Louis, Saint Louis, Missouri, USA
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21
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Jenkins CR, Singh D, Ducharme FM, Raherison C, Lavoie KL. Asthma and Rhinitis Through the Lifespan of Nonpregnant Women. J Allergy Clin Immunol Pract 2023; 11:3578-3584. [PMID: 37802256 DOI: 10.1016/j.jaip.2023.09.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
Increasingly, clinical practice guidelines advocate a precision medicine-based approach to care for asthma. This focus requires knowledge of not only different asthma phenotypes and their associated biomarkers but also sex and gender differences through the lifespan. Evidence continues to build in favor of different lifetime prevalence, clinical presentations, responses to management, and long-term prognosis of asthma. Women transition through many biological and psychosocial phases in their lives, all of which may interact with, and influence, their health and well-being. Historically, explanations have focused on hormonal effects on asthma in reproductive life, but a greater understanding of mechanisms starting before birth and changing over a lifetime is now possible, with immunologic, inflammatory, and hormonal factors playing a role. This article describes the evidence for the differences in asthma and rhinitis between men and women at different stages of life, the potential underlying mechanisms that contribute to this, and the implications for management and research. Future research studies should systematically report sex differences in asthma so that this knowledge can be used to develop a personalized approach to care, to achieve best possible outcomes for all.
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Affiliation(s)
| | - Dave Singh
- Medicines Evaluation Unit, Manchester University, Manchester, United Kingdom; NHS Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Francine M Ducharme
- Department of Pediatrics, University of Montréal, Montréal, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, QC, Canada
| | - Chantal Raherison
- Department of Pulmonology, CHU Guadeloupe, French West Indies University, Guadeloupe, French West Indies
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montréal (UQAM), Montréal, QC, Canada; Montréal Behavioural Medicine Centre (MBMC), CIUSSS-NIM, Hopital du Sacre-Coeur de Montreal, Montréal, QC, Canada
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22
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Perelman NL, Kolosov VP. Differences in the health-related quality of life in patients with asthma living in urban and rural areas in the Amur Region of Russian Federation. PLoS One 2023; 18:e0284683. [PMID: 37963175 PMCID: PMC10645338 DOI: 10.1371/journal.pone.0284683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/05/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Asthma usually arises from an interaction between host and environmental factors. Growing attention has been paid to a place of residence as a factor shaping health-related quality of life (QoL). This study investigated the rural-urban disparity in QoL among adult asthma patients in the Amur region of Russian Federation. MATERIALS AND METHODS This cross-sectional study included 351 randomly selected adults with asthma. We analyzed QoL (SF-36 and AQLQ scores), asthma control (ACT), and anxiety and depression (HADS) depending on the place of residence (urban vs. rural). RESULTS The scale "Role Emotional" (RE) of SF-36 was significantly lower in patients from rural areas compared to urban residents (59.3±3.1 vs. 70.4±2.3 points; p = 0.0042). In the urban group, the correlation analysis demonstrated a clear influence of RE on patients' own assessment of their physical functioning (PF, r = 0.53; p<0.0001). Both groups demonstrated low "Social Functioning" (SF). In the group of urban residents, correlation analysis revealed the presence of positive correlations of SF-36 domains reflecting physical (PF, RP, BP) and social functioning (SF, VT) with most scales of both QoL questionnaires. The domains of the emotional sphere (RE and MH) positively correlated with all scales of both QoL questionnaires among urban residents. In the group of rural residents, a comparative analysis showed the absence of significant correlations between more of the QoL scales. Although Asthma Control Test did not differ between groups, we noted a significantly higher need for β2-agonists in rural areas compared to urban areas (4.2±0.6 vs. 2.7±0.3 inh/day, respectively; p = 0.0221). The frequency of urban residents with a clinically significant level of anxiety (56 persons, or 25.2%) turned out to be lower compared to rural residents (45 persons, or 34.8%; χ2 = 34.08; p<0.001). CONCLUSION The burden of asthma introduces a greater imbalance in the health-related QoL of rural residents compared to urban residents in the Amur region of the Russian Federation. The absence of interrelationships of some QoL domains in rural residents suggested a disunity of the physical, psychological and social aspects of life. The rural residents suppress physical discomfort by the more frequent use of short bronchodilators. They often showed emotional instability with a predominance of anxiety, which affected the decrease in QoL in the psycho-emotional sphere.
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Affiliation(s)
- Natalia L. Perelman
- Laboratory of Prophylaxis of Nonspecific Pulmonary Diseases, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Blagoveshchensk, Russian Federation
| | - Victor P. Kolosov
- Laboratory of Prophylaxis of Nonspecific Pulmonary Diseases, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Blagoveshchensk, Russian Federation
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Pollack CE, Roberts LC, Peng RD, Cimbolic P, Judy D, Balcer-Whaley S, Grant T, Rule A, Deluca S, Davis MF, Wright RJ, Keet CA, Matsui EC. Association of a Housing Mobility Program With Childhood Asthma Symptoms and Exacerbations. JAMA 2023; 329:1671-1681. [PMID: 37191703 PMCID: PMC10189571 DOI: 10.1001/jama.2023.6488] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/01/2023] [Indexed: 05/17/2023]
Abstract
Importance Structural racism has been implicated in the disproportionally high asthma morbidity experienced by children living in disadvantaged, urban neighborhoods. Current approaches designed to reduce asthma triggers have modest impact. Objective To examine whether participation in a housing mobility program that provided housing vouchers and assistance moving to low-poverty neighborhoods was associated with reduced asthma morbidity among children and to explore potential mediating factors. Design, Setting, and Participants Cohort study of 123 children aged 5 to 17 years with persistent asthma whose families participated in the Baltimore Regional Housing Partnership housing mobility program from 2016 to 2020. Children were matched to 115 children enrolled in the Urban Environment and Childhood Asthma (URECA) birth cohort using propensity scores. Exposure Moving to a low-poverty neighborhood. Main Outcomes Caregiver-reported asthma exacerbations and symptoms. Results Among 123 children enrolled in the program, median age was 8.4 years, 58 (47.2%) were female, and 120 (97.6%) were Black. Prior to moving, 89 of 110 children (81%) lived in a high-poverty census tract (>20% of families below the poverty line); after moving, only 1 of 106 children with after-move data (0.9%) lived in a high-poverty tract. Among this cohort, 15.1% (SD, 35.8) had at least 1 exacerbation per 3-month period prior to moving vs 8.5% (SD, 28.0) after moving, an adjusted difference of -6.8 percentage points (95% CI, -11.9% to -1.7%; P = .009). Maximum symptom days in the past 2 weeks were 5.1 (SD, 5.0) before moving and 2.7 (SD, 3.8) after moving, an adjusted difference of -2.37 days (95% CI, -3.14 to -1.59; P < .001). Results remained significant in propensity score-matched analyses with URECA data. Measures of stress, including social cohesion, neighborhood safety, and urban stress, all improved with moving and were estimated to mediate between 29% and 35% of the association between moving and asthma exacerbations. Conclusions and Relevance Children with asthma whose families participated in a program that helped them move into low-poverty neighborhoods experienced significant improvements in asthma symptom days and exacerbations. This study adds to the limited evidence suggesting that programs to counter housing discrimination can reduce childhood asthma morbidity.
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Affiliation(s)
- Craig Evan Pollack
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- School of Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Laken C Roberts
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Roger D Peng
- Department of Statistics and Data Sciences, University of Texas at Austin
| | - Pete Cimbolic
- Baltimore Regional Housing Partnership, Baltimore, Maryland
| | - David Judy
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Susan Balcer-Whaley
- Department of Population Health, Dell Medical School, University of Texas at Austin
| | - Torie Grant
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stefanie Deluca
- Department of Sociology, Johns Hopkins University, Baltimore, Maryland
| | - Meghan F Davis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rosalind J Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Corinne A Keet
- Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Elizabeth C Matsui
- Department of Population Health, Dell Medical School, University of Texas at Austin
- Department of Pediatrics, Dell Medical School, University of Texas at Austin
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24
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Feldman JM, Serebrisky D, Starr S, Castaño K, Greenfield N, Silverstein G, Fruchter N, Mammen J, McGovern C, Arcoleo K. Reduced asthma morbidity during COVID-19 in minority children: is medication adherence a reason? J Asthma 2023; 60:468-478. [PMID: 35341432 PMCID: PMC9532462 DOI: 10.1080/02770903.2022.2059510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Asthma control improved during the COVID-19 pandemic. This study examined objectively measured medication adherence, asthma morbidity and quality of life (QoL) outcomes in Black and Latinx children by month for January-June 2019 (pre-COVID) compared to January-June 2020 (including first peak of COVID). METHODS Secondary analyses of 94 children with asthma (ages 10-17 years, 64% Latinx, 36% Black) and their caregivers assigned to the comparison group of a longitudinal RCT intervention trial. Outcomes included mean aggregate electronic adherence for controller medications, oral steroid bursts, acute healthcare utilization, caregiver asthma QoL, and the Asthma Control Test. Repeated measures analyses were conducted due to multiple observations. RESULTS Adherence to controller medications declined 48% from 2019 to 2020 (LS Mean = 33.9% vs. 17.6%, p=.0004, f=.92) with levels reaching a low in May 2020. A reduction in steroid bursts was observed over the same timeframe, 1.29 vs. 0.61, p = 0.006, f=.63. Caregiver QoL increased from 2019 to 2020 on total score (5.18 vs. 5.85, p = 0.002, f=.72), activity limitations (5.04 vs. 5.95), and emotional functioning (5.26 vs. 5.80). Although not statistically significant, a clinically meaningful 62% reduction in acute healthcare visits (p = 0.15) was reported in 2020. Children reported better asthma control (OR = 1.47, 95% CI 1.24, 1.73, p < 0.0001) in 2020 versus 2019 driven by improvements from May to June 2020. CONCLUSIONS Decreased asthma morbidity in minority children during COVID was coupled with decreased adherence to controller medications. This observed decrease in morbidity is not explained by improvements in adherence.
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Affiliation(s)
- Jonathan M. Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Bronx, NY
| | | | - Sheena Starr
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Katerina Castaño
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Naomi Greenfield
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | | | - Natalie Fruchter
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | | | - Colleen McGovern
- University Of North Carolina at Greensboro School of Nursing, Greensboro, NC
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25
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Brown ES. The Complex Relationship Between Asthma and Psychiatric Illnesses. J Allergy Clin Immunol Pract 2023; 11:809-810. [PMID: 36894279 DOI: 10.1016/j.jaip.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 03/09/2023]
Affiliation(s)
- E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas; The Altshuler Center for Education & Research, Metrocare Services, Dallas, Texas.
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26
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Liu M, Yang X, Wang Y, Lu Y, Liang L, Zhang H, Huang K. Comparison of health-related quality of life measures in asthma-COPD overlap. Chron Respir Dis 2023; 20:14799731231215093. [PMID: 37949435 PMCID: PMC10640801 DOI: 10.1177/14799731231215093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE The Asthma Quality of Life Questionnaire (AQLQ) and COPD assessment test (CAT) are used to assess the health status of asthma and chronic obstructive pulmonary disease (COPD), respectively. However, whether these questionnaires are appropriate in patients with asthma-COPD overlap (ACO) has not been reported. This study aimed to evaluate the performance of the AQLQ and CAT in subjects with ACO. METHODS Subjects were enrolled from two previously described observational studies in Beijing, China. ACO was defined by a consensus definition from a roundtable discussion. All subjects completed the AQLQ, CAT, St George's Respiratory Questionnaire (SGRQ), pulmonary function tests, and the Asthma Control Questionnaire (ACQ)-5. Cross-sectional construct validity was evaluated by correlating the AQLQ and CAT with SGRQ score and other measures of asthma and COPD severity. RESULTS 147 subjects with ACO were recruited. There were floor effects on non-respiratory components of the CAT, and ceiling effects on emotion domains of the AQLQ. Both questionnaires were significantly correlated with ACQ-5 score but were not correlated with FEV1% predicted or FVC% predicted. The AQLQ and CAT were strongly correlated with SGRQ score (r = -0.657 and r = 0.623, respectively). Multivariable linear regression analysis showed that the AQLQ (standardized β-coefficient = -0.449, p < .001) had a stronger association with SGRQ score compared with CAT (standardized β-coefficient = 0.211, p = .023). DISCUSSION The AQLQ and CAT were both valid for assessing the health-related quality of life in subjects with ACO, but the AQLQ performed better than CAT.
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Affiliation(s)
- Meishan Liu
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xuwen Yang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ying Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yong Lu
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lirong Liang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Hong Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Kewu Huang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
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Easton S, Ainsworth B, Thomas M, Latter S, Knibb R, Cook A, Wilding S, Bahrami‐Hessari M, Kennington E, Gibson D, Wilkins H, Yardley L, Roberts G. Planning a digital intervention for adolescents with asthma (BREATHE4T): A theory-, evidence- and Person-Based Approach to identify key behavioural issues. Pediatr Pulmonol 2022; 57:2589-2602. [PMID: 35932183 PMCID: PMC9826240 DOI: 10.1002/ppul.26099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/05/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To describe a transparent approach to planning a digital intervention for adolescents to self-manage their asthma using breathing retraining (BRT), based on an existing, effective adult intervention (BREATHE). METHODS A theory-, evidence-, and Person-Based Approach was used to maximise the effectiveness and persuasiveness of the intervention. A scoping review and semistructured interviews with target intervention users (N = 18, adolescents aged 12-17 years with asthma and parents) were carried out to explore user perspectives, barriers, and facilitators towards the intended behaviours and potential intervention features. The combined evidence was used alongside and to inform theory-based activities and enabled iterative planning of the intervention. RESULTS The scoping review identified themes relating to user-specific self-management issues, content, education, training needs, and features for a digital intervention. Interviews elicited potential barriers to intended behaviours such as the anticipated embarrassment of using BRT and concerns around remaining calm. Facilitators included BRT delivered by adolescents who share experiences of asthma and information for performing exercises discreetly. Relevant theoretical frameworks ensured that appropriate psychological constructs were targeted. A behavioural analysis identified six intervention functions and thirty behaviour change techniques. Logic modelling mapped the programme theory and mechanisms, which aims to improve adolescent asthma-related quality of life. CONCLUSIONS This study gives a transparent insight into the approach followed to plan a self-guided BRT intervention for adolescents and has led to identification of key behavioural issues, enabling relevant intervention content to be chosen. Insight has been given into adolescent perceptions of BRT, which facilitated development of the prototype intervention.
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Affiliation(s)
- Stephanie Easton
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Ben Ainsworth
- Department of Psychology, Faculty of Humanities and Social SciencesUniversity of BathBathUK
| | - Mike Thomas
- Primary Care and Population Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Sue Latter
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Rebecca Knibb
- School of Psychology, College of Health and Life SciencesUniversity of AstonBirminghamUK
| | - Amber Cook
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Sam Wilding
- Clinical Trials Unit, University Hospital SouthamptonSouthamptonUK
| | - Michael Bahrami‐Hessari
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | | | - Denise Gibson
- Physiotherapy DepartmentUniversity Hospital SouthamptonSouthamptonUK
| | - Hannah Wilkins
- Physiotherapy DepartmentUniversity Hospital SouthamptonSouthamptonUK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
| | - Graham Roberts
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
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Nabors LA, Adabla S, Merianos AL. Predictors of family resilience, emotional, behavioral, and developmental concerns and emergency room visits for children with asthma. Fam Syst Health 2022; 40:171-181. [PMID: 34914488 DOI: 10.1037/fsh0000665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The current study fills a gap in the literature by examining relations among physical health and resilience factors, family functioning, emergency visits, and mental health problems for youth with asthma. The study purpose was to assess associations among four predictors-asthma severity, body mass index (BMI), having an adult mentor, and ability to make and keep friends-and 3 three outcomes-family resilience, emotional, behavioral and developmental concerns, and emergency room (ER) visits among youth with asthma. METHOD The sample included 2,589 youth with asthma between 10 and 17 years old from the 2017-2018 National Survey of Children's Health. Multivariable logistic regressions examined associations between asthma severity, BMI, having an adult mentor, ability to make and keep friends and two outcomes: family resilience, and emotional behavioral and developmental concerns. A multinomial logistic regression examined the relationship between predictor variables and number of ER visits. RESULTS Findings indicated having a mentor, being able to make/keep friends, and being underweight, average, or overweight compared to being obese were related to having family resilience. Making/keeping friends was a protective factor for emotional behavioral and developmental concerns. Having a mentor was related to higher levels of emotional behavioral and developmental concerns than not having a mentor. Youth who had mentors and friendship skills were less likely to have ER visits than youth with no mentors and difficulty with friendships. Youth with mild asthma severity and who were not obese had lower levels of ER visits than those with moderate/severe asthma or obesity. DISCUSSION Child level protective factors were related to higher levels of family resilience and fewer ER visits for children with asthma. Further research to identify risk and protective factors is needed to develop interventions for youth with asthma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age and there is limited information about the effect of the COVID-19 pandemic on quality of life (QoL) in adolescents with asthma. In the present study, it was aimed to assess the attitudes of adolescents with asthma toward the COVID-19 pandemic and determine the effects of the pandemic on their QoL. METHODS In total, 125 adolescents with asthma and 98 healthy adolescents participated in the present study. The questionnaire form consisted of three parts. In the first part, all the participants were asked whether they complied with the protective measures against COVID-19. The second part included questions for measuring the participants' level of concern about COVID-19, while the third part consisted of EUROHIS-QOL 8. RESULTS The patient and control groups were similar in terms of the female/male ratio (55/70 and 48/50, respectively) and mean participant age (14.6 ± 2 and 15.1 ± 1.65 years, respectively) (P = 0.459 and P = 0.062, respectively). The prevalence of COVID-19 in the patients (n = 2, 1.6%) was lower than that in the controls (n = 6, 6.1%); however, the difference was not statistically significant (P = 0.142). The total EUROHIS-QOL score was significantly lower in the patients (31.2 ± 6.7) than in the controls (33.7 ± 4.4) (P < 0.001). The total QoL scores of asthmatic adolescents without other allergic disease (31.4 ± 6.7) was also lower than those of the controls (33.7 ± 4.4) (P = 0.009). Treatment disruption was significantly more common in patients who received subcutaneous immunotherapy (n = 20, 48.8%) than in those who did not (n = 8, 9.5%) (P < 0.001). Moreover, the patients had lower EUROHIS-QOL scores in the overall QoL, general health, finance, and home domains. CONCLUSION Our results indicate that the mean QoL score of asthmatic adolescents during COVID-19 pandemic is lower than in the healthy population. Disruption in their treatment was most common in patients with asthma who were receiving subcutaneous immunotherapy.
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Affiliation(s)
- Sukru Cekic
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zuhal Karali
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Fatih Cicek
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Yakup Canitez
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey.
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Rhee H, Love T, Wicks MN, Tumiel-Berhalter L, Sloand E, Harrington D, Walters L. Long-term Effectiveness of a Peer-Led Asthma Self-management Program on Asthma Outcomes in Adolescents Living in Urban Areas: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2137492. [PMID: 34874404 PMCID: PMC8652603 DOI: 10.1001/jamanetworkopen.2021.37492] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE Long-term effectiveness of a peer-led asthma self-management program in improving asthma outcomes in adolescents living in urban areas has not been established. OBJECTIVE To determine the long-term effects of a peer-led program on asthma control, quality of life, and asthma management among predominantly racial and ethnic minority adolescents living in urban areas. DESIGN, SETTING, AND PARTICIPANTS A parallel-group, randomized clinical trial was conducted in 2015 to 2019 in 3 metropolitan cities in the US: Buffalo, New York; Baltimore, Maryland; and Memphis, Tennessee. Adolescents aged 12 to 17 years old with persistent asthma were recruited mainly through clinical practices and schools. Participants were followed-up for 15 months after the intervention. Double-blinding was achieved for baseline. Data analysis was performed from June 2019 to June 2020. INTERVENTIONS The intervention group received a peer-led asthma self-management program; the control group received the identical program led by adult health care professionals. Peer leaders made follow-up contacts every other month for 12 months. MAIN OUTCOMES AND MEASURES The primary outcome was quality of life measured by the Pediatric Asthma Quality of Life Questionnaire, which consists of 3 subscales that measure symptoms (10 items), activity limitations (5 items), and emotional functioning (8 items) in the past 2 weeks. Each item was measured on a 7-point scale, with higher mean scores indicating better quality of life. Secondary measures included the Asthma Control Questionnaire and an asthma self-management index capturing steps to prevent and manage symptoms, self-efficacy, and lung function. RESULTS Of 395 eligible adolescents, 35 refused, 38 did not show or were lost to contact, and 2 withdrew before randomization; 320 adolescents participated (mean [SD] age, 14.3 [1.71] years), including 168 boys (52.5%), 251 Black or African American adolescents (78.4%), and 232 adolescents (72.5%) with public health insurance. Of 320 enrolled, 303 were included in the longitudinal analysis. Response rates were 80% or higher at all time points. The peer-led group had greater improvement in outcomes than the adult-led group, with adjusted mean differences (AMDs) between baseline and 15 months of 0.75 vs 0.37 for quality of life (between-group AMD, 0.38; 95% CI, 0.07 to 0.63) and -0.59 vs -0.31 for asthma control (between-group AMD, -0.28; 95% CI, -0.51 to -0.01). Outcomes were not affected by bimonthly contact doses. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, a peer-led asthma self-management education was more effective than an adult-led program in improving asthma outcomes, with the improvements sustained for up to 15 months. These findings suggest that a peer-led asthma self-management program should be considered in addressing the disproportionate asthma burden in racial and ethnic minority adolescents living in urban communities. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02293499.
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Affiliation(s)
- Hyekyun Rhee
- School of Nursing, University of Rochester, Rochester, New York
- Now with School of Nursing, University of Texas at Austin, Austin
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Mona N. Wicks
- College of Nursing, University of Tennessee Health Science Center, Memphis
| | - Laurene Tumiel-Berhalter
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo
| | - Elizabeth Sloand
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Leanne Walters
- Department of Social Work, Roberts Wesleyan College, Rochester, New York
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Turi ER, Reigada LC, Liu J, Leonard SI, Bruzzese JM. Associations among anxiety, self-efficacy, and self-care in rural adolescents with poorly controlled asthma. Ann Allergy Asthma Immunol 2021; 127:661-666.e1. [PMID: 34547441 PMCID: PMC8627490 DOI: 10.1016/j.anai.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/17/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rural adolescents are vulnerable to asthma; good self-care can reduce morbidity. The subtypes of anxiety (eg, asthma-related, generalized) may have differential associations with asthma self-care. Low self-efficacy, a determinant of behavior, is associated with increased anxiety. Little is known regarding these relationships in rural adolescents. OBJECTIVE To evaluate whether anxiety symptoms are associated with asthma symptom prevention and management among rural adolescents and whether self-efficacy mediates these relationships. METHODS We used baseline data from 197 rural adolescents (mean age = 16 years; 69% girls; 62% Black) who were part of a trial that tested the effectiveness of a school-based asthma intervention. Adolescents completed the Youth Asthma-Related Anxiety Scale, Screen for Child Anxiety and Emotional Disorders, Asthma Management Self-efficacy Index, and Asthma Prevention and Management Indices. Linear regression was performed to test whether: (1) asthma-related and generalized anxiety had curvilinear relationships with self-care; (2) social and separation anxiety had linear relationships with self-care; and (3) self-efficacy mediated relationships. RESULTS Asthma-related anxiety had a significant curvilinear relationship with prevention (P = 0.001) and a linear association with management (P = .01). Generalized anxiety had a significant curvilinear association with management (P = .03), whereas social anxiety had a significant linear relationship with prevention (P = .04). Self-efficacy partially or fully mediated these relationships. CONCLUSION Anxiety symptoms were associated with asthma self-care among this sample of rural adolescents, with differing roles for prevention and management. Self-efficacy may be a mechanism to improve asthma self-care among rural adolescents with anxiety. With a lack of self-efficacy, asthma-related, generalized, or social anxiety may motivate adolescents to take steps to care for their asthma.
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Affiliation(s)
- Eleanor R Turi
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Laura C Reigada
- Department of Psychology, Brooklyn College and The Graduate Center, The City University of New York, New York, New York
| | - Jianfang Liu
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Sarah I Leonard
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Jean-Marie Bruzzese
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York.
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Monteiro KS, Santino TA, Pakhale S, Balfour L, Pereira Pinto de Mendonça KM. Translation, cross-cultural adaptation and psychometric evaluation of the Brazilian version of the Cystic Fibrosis Knowledge Scale (CFKS). PLoS One 2021; 16:e0259232. [PMID: 34784376 PMCID: PMC8594816 DOI: 10.1371/journal.pone.0259232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Information on the level of knowledge about cystic fibrosis (CF) among affected people and their families is still scarce. OBJECTIVE This study aimed to translate, cross-culturally adapt and analyze the psychometric properties of the Brazilian version of Cystic Fibrosis Knowledge Scale (CFKS). MATERIALS AND METHODS The translation and cross-cultural adaptation involved the stages of translation, synthesis of translations, reverse translation, synthesis of reverse translations, review by a multi-professional committee of experts and pre-testing. The reliability, viability, construct, predictive, concurrent and discriminant validity were investigated. RESULTS The sample consisted of 40 individuals with cystic CF, 47 individuals with asthma, 242 healthcare workers and 81 students from the health area. The Brazilian version of the CFKS presented high internal consistency (α = 0.91), moderate floor and ceiling effects, without differences in the test-retest scores. An analysis of factorial exploration identified three dimensions. Confirmatory factor analysis led to an acceptable data-model fit. There was good predictive validity, with a difference in the scores among all the evaluated groups (p <0.001), as well as good discriminant validity since individuals with asthma had greater knowledge of asthma compared to CF (r = 0.401, p = 0.005; r2 = 0.162). However, there was no difference between the diagnosis time and knowledge about CF (r = -0.25, p = 0.11; r2 = 0.06), either between treatment adherence and knowledge about CF (r = -0.04, p = 0.77; r2 = 0.002). CONCLUSION The Brazilian version of the CFKS indicated that the scale is able to provide valid, reliable and reproducible measures for evaluating the knowledge about CF.
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Affiliation(s)
- Karolinne Souza Monteiro
- Faculty of Health Science of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
- * E-mail:
| | - Thayla Amorim Santino
- Graduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Smita Pakhale
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
| | - Louise Balfour
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
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Elward KS. Asthma Management Guidelines: Focused Updates for 2020. Am Fam Physician 2021; 104:446-447. [PMID: 34783488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Guo L, Wang L, Wang Z, Wei L, Ding L, Kong Y, Liu Z, Tian Y, Yang F, Sun L. Evaluation of the effectiveness and safety of cupping therapy in the treatment of asthma: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27518. [PMID: 34731141 PMCID: PMC8519211 DOI: 10.1097/md.0000000000027518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Asthma is one of the most common chronic airway diseases and is characterized by wheezing, dyspnea, chest tightness, and coughing. These symptoms reduce the patient's quality of life and limit physical activity in daily life. However, there is no systematic review of the efficacy of cupping therapy in the treatment of asthma. To evaluate the efficacy and safety of cupping in the treatment of asthma, we conducted a systematic review and meta-analysis of published randomized clinical trials of cupping in the treatment of asthma. METHODS We will search the following Chinese and English databases: China National Knowledge Infrastructure, China Science and Periodical Database, Wanfang Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library. All of the above electronic databases will be searched from inception to August 22, 2021. In addition, we will manually search for conference papers, ongoing experiments, and internal reports to supplement the studies retrieved via electronic search. We will use the Review Manager 5.4 provided by Cochrane Collaboration Network for statistical analysis. RESULTS The study will prove the effectiveness and safety of cupping in the treatment of asthma. CONCLUSION We plan to submit this systematic review to a peer-reviewed journal. INPLASY REGISTRATION NUMBER INPLASY202180104.
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Affiliation(s)
- Lei Guo
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
| | - Lie Wang
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
| | - Zhongtian Wang
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
| | - Lina Wei
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
| | - Lizhong Ding
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
| | - Yibu Kong
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
| | - Zhimei Liu
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
| | - Ye Tian
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
| | - Fushuang Yang
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
| | - Liping Sun
- Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun City, Jilin Province, China
- Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Road, Changchun City, Jilin Province, China
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Resztak JA, Farrell AK, Mair-Meijers H, Alazizi A, Wen X, Wildman DE, Zilioli S, Slatcher RB, Pique-Regi R, Luca F. Psychosocial experiences modulate asthma-associated genes through gene-environment interactions. eLife 2021; 10:e63852. [PMID: 34142656 PMCID: PMC8282343 DOI: 10.7554/elife.63852] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/16/2021] [Indexed: 01/04/2023] Open
Abstract
Social interactions and the overall psychosocial environment have a demonstrated impact on health, particularly for people living in disadvantaged urban areas. Here, we investigated the effect of psychosocial experiences on gene expression in peripheral blood immune cells of children with asthma in Metro Detroit. Using RNA-sequencing and a new machine learning approach, we identified transcriptional signatures of 19 variables including psychosocial factors, blood cell composition, and asthma symptoms. Importantly, we found 169 genes associated with asthma or allergic disease that are regulated by psychosocial factors and 344 significant gene-environment interactions for gene expression levels. These results demonstrate that immune gene expression mediates the link between negative psychosocial experiences and asthma risk.
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Affiliation(s)
- Justyna A Resztak
- Center for Molecular Medicine and Genetics, Wayne State UniversityDetroitUnited States
| | | | | | - Adnan Alazizi
- Center for Molecular Medicine and Genetics, Wayne State UniversityDetroitUnited States
| | - Xiaoquan Wen
- Department of Biostatistics, University of MichiganAnn ArborUnited States
| | - Derek E Wildman
- College of Public Health, University of South FloridaTampaUnited States
| | - Samuele Zilioli
- Department of Psychology, Wayne State UniversityDetroitUnited States
- Department of Family Medicine and Public Health Sciences, Wayne State UniversityDetroitUnited States
| | | | - Roger Pique-Regi
- Center for Molecular Medicine and Genetics, Wayne State UniversityDetroitUnited States
- Department of Obstetrics and Gynecology, Wayne State UniversityDetroitUnited States
| | - Francesca Luca
- Center for Molecular Medicine and Genetics, Wayne State UniversityDetroitUnited States
- Department of Obstetrics and Gynecology, Wayne State UniversityDetroitUnited States
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Ferraro VA, Zamunaro A, Spaggiari S, Di Riso D, Zanconato S, Carraro S. Pediatric asthma control during the COVID-19 pandemic. Immun Inflamm Dis 2021; 9:561-568. [PMID: 33657264 PMCID: PMC8014816 DOI: 10.1002/iid3.418] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The lockdown imposed by the COVID-19 pandemic resulted in a completely different style of life with possible effects on the attitude toward their disease in patients with chronic lung disease, such as asthma. The aim of our study was to investigate in asthmatic children the level of asthma control and the maintenance therapy used during the lockdown. METHODS Among asthmatic children attending our clinic, we identified those who had been prescribed the same therapy in March-April 2019 and March-April 2020. The level of asthma control (GINA-score) and the maintenance therapy used during the lockdown (March-April 2020) were compared with those of March-April 2019. We separately analyzed a small group of children with severe asthma treated with Omalizumab during the lockdown. RESULTS We enrolled 92 asthmatic children (67 males). Compared to 2019, in 2020 a higher proportion of children modified their maintenance therapy (38% vs. 15.2%, p < .001), with a significant increase in both the proportion of children who increased (p = .033) and in that of children who decreased their therapy (p = .026). The level of control resulted as significantly higher in 2020 (March p = .023; April p = .007). Also, the 13 children treated with Omalizumab showed a good level of control in 2020. CONCLUSIONS In asthmatic children, the COVID-19 pandemic lockdown had a significant impact on their asthma control and on their attitude toward maintenance therapy.
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Affiliation(s)
| | - Andrea Zamunaro
- Department of Womenʼs and Childrenʼs HealthUniversity of PadovaPadovaItaly
| | - Silvia Spaggiari
- Department of Developmental Psychology and SocializationUniversity of PadovaPadovaItaly
| | - Daniela Di Riso
- Department of Developmental Psychology and SocializationUniversity of PadovaPadovaItaly
| | - Stefania Zanconato
- Department of Womenʼs and Childrenʼs HealthUniversity of PadovaPadovaItaly
| | - Silvia Carraro
- Department of Womenʼs and Childrenʼs HealthUniversity of PadovaPadovaItaly
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de Albornoz SC, Chen G. Relationship between health-related quality of life and subjective wellbeing in asthma. J Psychosom Res 2021; 142:110356. [PMID: 33454566 DOI: 10.1016/j.jpsychores.2021.110356] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 12/17/2020] [Accepted: 01/02/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Poor health-related quality of life (HRQoL) is associated with a high risk of acute exacerbations in patients with asthma. The use of health state utility instruments to measure HRQoL is common, but it has been criticised for failing to adequately capture the impact of the condition from the patient perspective. We aimed to assess the ability of subjective wellbeing and health state utility instruments to capture important HRQoL dimensions for asthma patients. METHODS Regression analyses were conducted using data (n = 856 asthma patients) from a large multi-national cross-sectional survey to explore the relationship between subjective wellbeing (ONS4, PWI, SWLS), health state utility (15D, AQoL-8D, EQ-5D-5L, HUI3, SF-6D, SF-6Dv2), and an asthma-specific instrument (AQLQ-S). The latent structure of different instruments was investigated using an exploratory factor analysis. RESULTS All instruments could distinguish the impact of asthma on HRQoL. Among health utility instruments, 15D, SF-6D and AQoL-8D were more sensitive based on the average standardised regression coefficients. AQOL-8D had the strongest correlation with subjective wellbeing. Nevertheless, the exploratory factor analysis showed a complementary relationship between subjective wellbeing and HRQoL instruments. The most important subjective wellbeing domains were standard of living, achieving in life, and personal relationships; although contributions of these domains to overall life satisfaction differed among asthma patients identified by a latent class analysis. CONCLUSION The use of subjective wellbeing alongside AQLQ-S and health state utility instruments provides a comprehensive approach to assess the impact of asthma on the patient's life. Further research is needed to incorporate these measures in health care evaluation.
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Affiliation(s)
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia.
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Joseph CLM, Mahajan P, Buzzelli-Stokes S, Jacobsen G, Johnson DA, Duffy E, Williams R, Havstad S, Zoratti E, Ownby DR, Johnson CC, Lu M. Participant-level characteristics differ by recruitment setting when evaluating a behavioral intervention targeting adolescents with asthma. J Asthma 2021; 58:370-377. [PMID: 31702415 PMCID: PMC10726210 DOI: 10.1080/02770903.2019.1690661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/03/2019] [Accepted: 11/05/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The recruitment setting plays a key role in the evaluation of behavioral interventions. We evaluated a behavioral intervention for urban adolescents with asthma in three randomized trials conducted separately in three different settings over the course of 8 years. We hypothesized that characteristics of trial participants recruited from the ED and clinic settings would be significantly different from that of youth participating in the school-based trials. The intervention evaluated was Puff City, a web-based program that uses tailoring to improve asthma management behaviors. METHODS The present analysis includes youth aged 13-19 years who reported a physician diagnosis of asthma and symptoms at trial baseline. In the three trials, all participants were randomized post-baseline to a web-based, tailored intervention (treatment) or generic web-based asthma education (control). RESULTS Compared to school-based trial participants, ED participants had significantly more acute-care visits for asthma (p < 0.001) and more caregiver depression (p < 0.001). Clinic-based participants were more likely to have computer/ internet access than participants from the school-based trial (p < 0.001). Both ED and clinic participants were more likely to report controller medication (p's < 0.001) and higher teen emotional support (p's < 0.01) when compared to the schools, but were less likely to report Medicaid (p's < 0.014) and exposure to environmental tobacco smoke (p < 0.001). CONCLUSION Compared to participants in the school-based trials, participants recruited from ED and clinic settings differed significantly in terms of healthcare use, as well as psychosocial and sociodemographic factors. These factors can inform intervention content, and may impact external validity of behavioral interventions for asthma.
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Affiliation(s)
| | - Prashant Mahajan
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Gordon Jacobsen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA
| | - Elizabeth Duffy
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Renee Williams
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Edward Zoratti
- Division of Allergy and Immunology, Henry Ford Health System, Detroit, MI, USA
| | - Dennis R. Ownby
- Department of Pediatrics, Augusta University, Augusta, GA, USA
| | | | - Mei Lu
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
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Hiles SA, Urroz PD, Gibson PG, Bogdanovs A, McDonald VM. A feasibility randomised controlled trial of Novel Activity Management in severe ASthma-Tailored Exercise (NAMASTE): yoga and mindfulness. BMC Pulm Med 2021; 21:71. [PMID: 33639922 PMCID: PMC7913205 DOI: 10.1186/s12890-021-01436-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Physical inactivity is common in severe asthma and associated with poor health outcomes. New approaches are needed to address physical inactivity in this group. OBJECTIVE To examine whether yoga and mindfulness improves health-related quality of life (HRQoL) compared with a minimal active control group and collect feasibility data to inform future studies. METHODS Over 12-weeks, adults with severe asthma were recruited. Participants were randomised 2:1 to parallel yoga or control groups. All participants received an activity tracker. The yoga group received tailored group classes twice a week for 16-weeks with a qualified yoga instructor. The control group set activity goals with a research officer and received eight progress calls. Outcomes were assessed at 16-weeks. Primary outcome was St George's Respiratory Questionnaire (SGRQ). Secondary outcomes included asthma control, physical activity, breathlessness, and inflammation. Face-to-face qualitative interviews were conducted to determine acceptability. RESULTS There were 15 participants randomised to yoga (mean 67 years; 60% female) and 9 to control (68 years; 56% female). Planned comparisons indicated the yoga group had greater SGRQ improvement than the control group. There was little change in secondary outcomes. Moderate-vigorous activity increased substantially in the control group. Participants found the intervention acceptable; key barriers and facilitators were social connection, the setting, addressing breathing and asthma symptoms, changing their mindset, and the intersection of different elements. CONCLUSION A yoga and mindfulness intervention was feasible, acceptable to patients and improved HRQoL. The findings will inform design of much needed future research into physical activity interventions for severe asthma. World Health Organization International Clinical Trials Registry Platform The study was registered under the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 26th of November 2018, Trial ID ACTRN12618001914257.
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Affiliation(s)
- Sarah A Hiles
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Paola D Urroz
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Peter G Gibson
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | | | - Vanessa M McDonald
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.
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Snoswell CL, Rahja M, Lalor AF. A Systematic Review and Meta-Analysis of Change in Health-Related Quality of Life for Interactive Telehealth Interventions for Patients With Asthma. Value Health 2021; 24:291-302. [PMID: 33518036 DOI: 10.1016/j.jval.2020.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/23/2020] [Accepted: 09/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Asthma is one of the most common major noncommunicable diseases in the world and affects individuals of all ages. Medication is used to achieve and maintain quality of life (QOL) for people with asthma. Telehealth interventions offer optimized and personalized symptom monitoring with timely treatment adjustment and the potential to increase medication adherence for individuals with asthma. This study examines and synthesizes the available data on the change in the QOL for patients with asthma who use interactive telehealth interventions, and identifies the most effective telehealth modalities used for intervention in this area. METHODS Literature searches were conducted in 5 databases in November 2018 for studies measuring a change in QOL for patients with asthma. Study QOL outcomes, where possible, were pooled in a meta-analysis. RESULTS Seventeen publications (describing 16 studies) comprising 2015 patients were included. Based on a meta-analysis, interactive telehealth interventions can improve QOL outcomes for people living with asthma, although the improved effects may be small: web portals (0.51, 95% confidence interval [CI] -0.00 to 1.03), interactive smartphone apps (0.30, 95% CI -0.16 to 0.76) and remote monitoring (standardized mean difference 0.20, 95% CI -0.11 to 0.52). Intervention delivery modalities identified include interactive web portals, smartphone apps, and remote monitoring programs. CONCLUSIONS The findings provide a comprehensive overview of the available literature on interactive telehealth interventions, including interactive web portals, smartphone apps, and remote monitoring programs. These findings demonstrated that a positive change in QOL can be attributed to these interventions and provide evidence for the implementation of telehealth interventions for individuals with asthma.
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Affiliation(s)
- Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia; Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia.
| | - Miia Rahja
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Aislinn F Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia; Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
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Abstract
BACKGROUND Background: Growing evidence from observational studies indicates a high prevalence of anxiety in asthma. However, prevalence rates of coexisting anxiety symptoms and comorbid anxiety disorders vary widely across studies. We aimed to evaluate the associations between anxiety and asthma and provide more precise comorbidity estimates. METHODS We systematically reviewed the literature from case-controlled studies and conducted a meta-analysis to evaluate the pooled prevalence estimates and risks of anxiety symptoms and anxiety disorders in asthma individuals. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. A random-effects model was used to calculate pooled prevalence rates. Meta-analysis was conducted using Review Manager 5.3. Multiple databases including PubMed, ScienceDirect, PsychINFO, and PsycARTICLES were searched for publications before 1 December 2019. The review protocol was registered on PROSPERO (ref: CRD42020176028). RESULTS In total, 19 studies involving 106813 participants were included. The pooled prevalence of anxiety symptoms and anxiety disorders in individuals with asthma was 0.32 (95% CI 0.22-0.43) and 0.24 (95% CI 0.13-0.41), respectively. The risks of coexisting anxiety symptoms and comorbid anxiety disorders were significantly higher in asthma patients than in non-asthma controls indicated by OR 1.89 (95% CI 1.42-2.52; Z = 4.37; p < 0.001) and OR 2.08 (95% CI 1.70-2.56; Z = 6.97; p < 0.001), respectively. Anxiety symptoms and anxiety disorders occur at increased frequency among patients with asthma. CONCLUSIONS Our findings highlight the need for appropriate assessments for these comorbid conditions, which may help to identify a subgroup of patients who might benefit from interventions designed to reduce anxiety and enhance the quality of life.
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Affiliation(s)
- Gang Ye
- Suzhou Guangji Hospital, Suzhou, Jiangsu, China
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
- University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
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Abstract
PURPOSE OF REVIEW Telemedicine, defined as synchronous video visits between a provider and a child with asthma, often takes place in the school setting. This review examines the new electronic sensors for adherence monitoring and studies that used telemedicine in the school setting to improve asthma outcomes. RECENT FINDINGS School-based telemedicine provides an important service to families of school-aged children who have difficulty due to time and distance in planning and keeping in-person appointments with primary or specialty providers. Significant improvements in objective measures of asthma control are inconsistently observed although caregiver and parent quality of life and child self-management behaviors are improved and satisfaction is high. Assessment and outcomes related to adherence are mentioned in studies but results are not often reported. However, it appears that adherence interventions are beneficial while maintained but the effects are not sustained upon intervention discontinuation. SUMMARY The school setting provides a convenient and suitable environment to conduct telemedicine visits between school-aged children and their primary care or specialty provider. Electronic adherence sensors allow review of controller and rescue medication use through a cloud-based dashboard and provides an opportunity for real-time assessment and intervention by providers to improve asthma outcomes.
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Affiliation(s)
- Kathryn V Blake
- Biomedical Research Department, Center for Pharmacogenomics and Translational Research, Nemours Children's Specialty Care, Jacksonville, Florida, USA
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Borg C, Porritt K, Hotham E. Patient, parent/carer, and health care professional experience of medication adherence in children and adolescents with asthma: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:2714-2720. [PMID: 33009105 DOI: 10.11124/jbisrir-d-18-00026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This systematic review aims to identify and synthesize available qualitative evidence related to patient, parent/carer, and health care professional experiences of medication adherence in children and adolescents with asthma. INTRODUCTION Poor medication adherence is a common cause of treatment failure in children with asthma. Research into promoting treatment adherence has found that the most effective interventions are complex. In a child with asthma, the child, the parents/carers, and the health care professional all have important roles in adhering to medication regimens. This review aims to explore the experiences of the patient, parent/carer, and health care professional in managing a child's asthma. INCLUSION CRITERIA This review will consider children and adolescents between the ages of three and 19 years with asthma, as well as the parent/carer and health care professionals who care for a child with asthma. Qualitative studies exploring the experiences of adherence or nonadherence to asthma medication will be included. METHODS A three-stage search will be conducted and will include published and gray literature. Databases to be searched include CINAHL, Embase, PubMed, PyscINFO, Scopus, and Web of Science. Only studies published in English will be considered, with no date limitation. Identified studies will be screened for inclusion by two independent reviewers. Data will be extracted using a standardized tool, and reviewers will discuss any disagreement. Data synthesis will adhere to the meta-aggregative approach to categorize findings. The categories will be synthesized into a set of findings that can be applied as evidence-based practice.
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Affiliation(s)
- Corey Borg
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Kylie Porritt
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Elizabeth Hotham
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
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Synnes O, Orøy AJ, Råheim M, Bachmann L, Ekra EMR, Gjengedal E, Høie M, Jørgensen E, Michaelsen RKA, Sundal H, Vatne S, Lykkeslet E. Finding ways to carry on: stories of vulnerability in chronic illness. Int J Qual Stud Health Well-being 2020; 15:1819635. [PMID: 32954979 PMCID: PMC7534264 DOI: 10.1080/17482631.2020.1819635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 10/31/2022] Open
Abstract
Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future.
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Affiliation(s)
- Oddgeir Synnes
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Aud Jorun Orøy
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Målfrid Råheim
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Liv Bachmann
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Else Mari Ruberg Ekra
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Eva Gjengedal
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Magnhild Høie
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Else Jørgensen
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | | | - Hildegunn Sundal
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Solfrid Vatne
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Else Lykkeslet
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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Liang NC, Visger TV, Devereaux A. Mindfulness for Those with COPD, Asthma, Lung Cancer, and Lung Transplantation. Am J Respir Crit Care Med 2020; 202:P11-P12. [PMID: 32795142 DOI: 10.1164/rccm.2024p11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Panek MG, Karbownik MS, Kuna PB. Comparative analysis of clinical, physiological, temperamental and personality characteristics of elderly subjects and young subjects with asthma. PLoS One 2020; 15:e0241750. [PMID: 33156872 PMCID: PMC7647458 DOI: 10.1371/journal.pone.0241750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/21/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Asthma is a heterogeneous disease of a complex etiology in which genetic, environmental and personality variables are important factors determining the development of complicated strategies related to coping with stress and temperament traits. Our thesis is that coping styles in asthmatic patients are modified by the environment (chronic inflammation and stress) which affects individual temperament traits in the course of time. Thus, patient age is one of factors which determine the clinical image of asthma and its natural history. AIM The aim of the study was to evaluate the variables describing stress coping styles and temperament in young (18 to 35 years old) and elderly asthmatics (aged ≥60 years). MATERIAL AND METHODS A total of 200 patients, 104 elderly and 96 young asthmatics were enrolled in the study. Apart from medical examination, the following tests were performed in all subjects: the Formal Characteristics of Behavior- Temperament Inventory (FCB-TI), Coping Inventory for Stressful Situations (CISS), Beck Depression Inventory, State-Trait Anxiety Inventory, and Borg Rating of Perceived Exertion (RPE) Scale. RESULTS Elderly patients with asthma exhibited higher intensity of anxiety as a trait, a higher level of depression and experienced dyspnea, as well as higher levels of stress coping strategies such as Avoidance-Oriented Coping (AOC), Distraction Seeking (DS) and Social Diversion (SD) compared to young asthmatics. In elderly patients, Perseverance and Sensory Sensitivity traits have been observed to decline with the duration and development of asthma at later life stages as opposed to young asthmatics, in whom these temperament characteristics are elevated. CONCLUSIONS Asthma is a heterogeneous disease of a complex etiopathogenesis that has a complex interplay with mental health. The present study confirms a relationship between age and stress coping strategies as well as temperament traits.
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Affiliation(s)
- Michał G. Panek
- Medical University of Lodz, Department of Internal Medicine, Asthma and Allergy of the Medical University of Lodz, Lodz, Poland
- * E-mail:
| | - Michał S. Karbownik
- Medical University of Lodz, Department of Pharmacology and Toxicology of the Medical University of Lodz, Lodz, Poland
| | - Piotr B. Kuna
- Medical University of Lodz, Department of Internal Medicine, Asthma and Allergy of the Medical University of Lodz, Lodz, Poland
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Jo HS, Jeong S, Kim WJ, Park S, Yu SA. Development of a Transitional Care Model Program for Patients with Pneumonia, Asthma, and Chronic Obstructive Pulmonary Disease: In-depth Interviews with Readmitted Patients. J Korean Med Sci 2020; 35:e352. [PMID: 33140589 PMCID: PMC7606884 DOI: 10.3346/jkms.2020.35.e352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/20/2020] [Indexed: 11/20/2022] Open
Abstract
Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.
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Affiliation(s)
- Heui Sug Jo
- Department of Public Health Services, Kangwon National University Hospital, Chuncheon, Korea
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seungmin Jeong
- Department of Public Health Services, Kangwon National University Hospital, Chuncheon, Korea.
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seolhyang Park
- Department of Public Health Services, Kangwon National University Hospital, Chuncheon, Korea
| | - Seol Ae Yu
- Department of Public Health Services, Kangwon National University Hospital, Chuncheon, Korea
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Brite J, Friedman S, de la Hoz RE, Reibman J, Cone J. Mental health, long-term medication adherence, and the control of asthma symptoms among persons exposed to the WTC 9/11 disaster. J Asthma 2020; 57:1253-1262. [PMID: 31550944 PMCID: PMC7594532 DOI: 10.1080/02770903.2019.1672722] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/03/2019] [Accepted: 09/22/2019] [Indexed: 12/18/2022]
Abstract
Objective: A positive association between mental health conditions and poor asthma control has been documented in the World Trade Center-exposed population. Whether factors such as medication adherence mediate this association is unknown.Methods: The study population was drawn from adult participants of the World Trade Center Health Registry Cohort who self-reported as asthmatic after the disaster and who were currently prescribed a long-term control medication (LTCM). Multivariable linear regression was used to estimate the associations between mental health condition (PTSD, depression, or anxiety) and continuous adherence and Asthma Control Test (ACT) scores.Results: In the study sample of 1,293, 49% were not adherent to their LTCM and two thirds reported poorly or very poorly controlled asthma. Presence of any mental health condition was associated with a 2-point decline in ACT and half a point decrease in adherence scores. However, in the multivariable model, better adherence was statistically significantly associated with slightly worse control.Conclusions: The total effect of mental health on asthma control was opposite in sign from the product of the paths between mental health and adherence and adherence and asthma control; we therefore found no evidence to support the hypothesis that adherence mediated the negative association between poor mental health and adequate asthma control. More research is needed to understand the complex causal mechanisms that underlie the association between mental and respiratory health.
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Affiliation(s)
- Jennifer Brite
- World Trade Center Health Registry, New York City
Department of Health and Mental Hygiene, Queens, NY, USA
| | - Stephen Friedman
- World Trade Center Health Registry, New York City
Department of Health and Mental Hygiene, Queens, NY, USA
| | - Rafael E. de la Hoz
- Division of Occupational Medicine, Icahn School of Medicine
at Mount Sinai, New York, NY, USA
| | - Joan Reibman
- Division of Pulmonary, Critical Care, and Sleep Medicine,
Department of Medicine, New York University School of Medicine, New York, NY,
USA
| | - James Cone
- World Trade Center Health Registry, New York City
Department of Health and Mental Hygiene, Queens, NY, USA
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Paoletti G, Keber E, Heffler E, Malipiero G, Baiardini I, Canonica GW, Giua C. Effect of an educational intervention delivered by pharmacists on adherence to treatment, disease control and lung function in patients with asthma. Respir Med 2020; 174:106199. [PMID: 33120195 DOI: 10.1016/j.rmed.2020.106199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/03/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Lack of therapeutic adherence is a relevant problem in clinical practice and it can be assessed via validated tools such as the Test of Adherence to Inhalers (TAI). Education on the correct use of inhaler devices has been associated with improvement in adherence. Many studies highlighted the pivotal role of pharmacists in promoting therapeutic adherence in the management of respiratory diseases. OBJECTIVE To evaluate the effectiveness on adherence and clinical parameters of an educational intervention administered by clinical pharmacists (CPs) to patients with asthma on long-term inhalation therapy. METHODS A prospective comparative study involving 34 community pharmacies in Italy (23 intervention, 11 control). Enrolled subjects were evaluated for adherence to inhalation therapy by TAI, asthma control by "Asthma Control Test" (ACT), and lung function at baseline and after 2 months. The educational intervention at baseline was based on TAI results and administered by specifically trained pharmacists. RESULTS A total of 242 consecutive subjects (167 intervention, 75 control) were enrolled. There was a significant improvement in TAI score, ACT and lung function parameters (p-value<0.001) in the intervention group between baseline and the follow-up visit. Patients with baseline ACT≥20 maintained disease control more frequently in the intervention group compared to the control arm (95% vs 79.5%, p = 0.004). Conclusions through administration of TAI-driven educational interventions addressing both technical and psychological issues, trained CPs can help improve adherence to treatment and asthma control.
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Affiliation(s)
- Giovanni Paoletti
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Enrico Keber
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
| | - Giacomo Malipiero
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy
| | - Ilaria Baiardini
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Corrado Giua
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy
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Salandi J, Icks A, Gholami J, Hummel S, Schultz K, Apfelbacher C, Sheikh A, Loerbroks A. Impact of pulmonary rehabilitation on patients' health care needs and asthma control: a quasi-experimental study. BMC Pulm Med 2020; 20:267. [PMID: 33059650 PMCID: PMC7559596 DOI: 10.1186/s12890-020-01301-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary rehabilitation offers potential benefits to people with asthma. It is however unknown if rehabilitation favourably affects patients' health care needs. We therefore examined if rehabilitation reduced needs and, in addition, if it improved asthma control. METHODS One hundred fifty patients with asthma were surveyed in three rehabilitation clinics at admission and at discharge. Additionally, we surveyed 78 participants with asthma twice 4 weeks apart. The latter sample (i.e. the control group) was recruited through other pathways than rehabilitation clinics. The Patient Needs in Asthma Treatment (NEAT) questionnaire and the Asthma Control Test (ACT) were completed at baseline and follow-up. Differences between baseline and follow-up and between rehabilitation and control group were examined by t-tests and chi-squared-tests. Univariate ANCOVAS were used to examine if NEAT and ACT follow-up scores differed significantly between groups. Within the rehabilitation group, linear regressions were used to examine if self-reported utilization of more interventions that addressed needs were associated with NEAT scores at follow-up. RESULTS At baseline, there were no differences between the rehabilitation and the control group regarding needs and asthma control. At follow-up, the rehabilitation group showed reduced needs (t(149) = 10.33, p < 0.01) and increased asthma control (t(130) = -6.67, p < 0.01), whereas members of the control group exhibited no changes. Univariate ANCOVAS showed that unmet follow-up needs (F(1, 212) = 36.46, p < 0.001) and follow-up asthma control (F(1, 195) = 6.97, p = 0.009) differed significantly between groups. In the rehabilitation group, self-reported utilization of more interventions was associated with reduced needs (β = 0.21; p = 0.03). CONCLUSIONS This study provides preliminary evidence suggestion that pulmonary rehabilitation in adults with asthma may reduce asthma-related needs and confirms previous findings that rehabilitation may improve asthma control.
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- Institute of Health Services Research and Health Economics, German Diabetes Center, Medical Faculty, University of Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland, Bubertstraße 4, 26757, Borkum, Germany
| | - Stefan Hummel
- MEDIAN Klinik Heiligendamm, Kinderstrand 1, 18209, Bad Doberan, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd, Salzburger Str. 8-11, 83435, Bad Reichenhall, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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