开发和验证新的哮喘问卷,帮助学龄儿童和青少年实现高度控制

IF 6.2 2区 医学 Q1 ALLERGY Allergology International Pub Date : 2023-12-07 DOI:10.1016/j.alit.2023.11.001
Mayumi Matsunaga , Yasunori Sato , Mizuho Nagao , Masanori Ikeda , Chikako Motomura , Makoto Kameda , Yukinori Yoshida , Akihiko Terada , Isao Miyairi , Takao Fujisawa , the LePAT investigators
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引用次数: 0

摘要

背景保持良好的哮喘控制可将病情加重和肺功能下降的风险降至最低,是哮喘管理的首要目标。日本儿科哮喘指南(JPGL)采用了与其他指南不同的控制状态分类标准,强调更高水平的控制。在 JPGL 的基础上,我们之前开发了一份由护理人员填写的问卷,用于评估学龄前儿童哮喘控制情况并使其达到最佳控制水平。本研究的目的是为学龄儿童和青少年开发一份问卷。方法:我们向 362 名 6-15 岁的哮喘患者及其护理人员发放了一份工作问卷,其中包括 14 个针对患者的项目和 34 个针对护理人员的项目。另外,医生也填写了一份调查问卷,以确定 JPGL-defined 控制情况。利用从随机抽取的三分之二受试者填写的问卷中获得的数据,进行了逻辑回归分析,以构建预测控制水平的模型。结果 选出了一组 7 个问题,包括就诊时和过去一个月的自我评估控制状况,患者的夜间/清晨哮喘症状,以及护理人员的哮喘症状、呼吸困难、抢救性β-激动剂使用和哮喘住院的频率,7 个项目的模型显示出良好的统计拟合效果,AIC 为 110.5。该模型被命名为学龄儿童和青少年最佳哮喘控制测试(Best ACT-S)。最佳哮喘控制测试得分在不同JPGL定义的控制水平、升级/降级治疗决定以及上一年是否出现哮喘加重的组别间存在显著的假设性差异。
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Development and validation of a new asthma questionnaire to help achieve a high level of control in school-age children and adolescents

Background

Maintaining good asthma control minimizes the risk of exacerbations and lung function decline and is a primary goal of asthma management. The Japanese Pediatric Asthma Guidelines (JPGL) employs different classification criteria for control status from other guidelines, stressing a higher level of control. Based on JPGL, we previously developed a caregiver-completed questionnaire for assessing and achieving best asthma control in preschoolers. In this study, we aimed to develop a questionnaire for school-age children and adolescents.

Methods

A working questionnaire comprising 14 items for patients and 34 items for caregivers was administered to 362 asthma patients aged 6–15 years and their caregivers. Separately, physicians filled out a questionnaire to determine JPGL-defined control. Logistic regression analysis was performed to construct a model to predict control levels using data from a randomly selected set of completed questionnaires from two-thirds of the subjects. Validation was performed using the remaining questionnaires.

Results

A set of 7 questions, encompassing self-assessed control status at the time of the visit and in the past month, and nocturnal/early morning asthma symptoms for patients and frequency of asthma symptoms, dyspnea, rescue beta-agonist use, and asthma hospitalization for caregivers, were selected and the 7-item model showed a good statistical fit with AIC of 110.5. The model has been named the Best Asthma Control Test for School Children and Adolescents (Best ACT-S). Best ACT-S scores differed significantly in the hypothetical direction among the groups of different JPGL-defined control levels, step-up/down treatment decisions, and presence/non-presence of exacerbations in the previous year.

Conclusions

The Best ACT-S is a valid questionnaire for children/adolescents aiming for best asthma control.

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来源期刊
Allergology International
Allergology International ALLERGY-IMMUNOLOGY
CiteScore
12.60
自引率
5.90%
发文量
96
审稿时长
29 weeks
期刊介绍: Allergology International is the official journal of the Japanese Society of Allergology and publishes original papers dealing with the etiology, diagnosis and treatment of allergic and related diseases. Papers may include the study of methods of controlling allergic reactions, human and animal models of hypersensitivity and other aspects of basic and applied clinical allergy in its broadest sense. The Journal aims to encourage the international exchange of results and encourages authors from all countries to submit papers in the following three categories: Original Articles, Review Articles, and Letters to the Editor.
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