Perceived triggers of asthma: evaluation of a German version of the Asthma Trigger Inventory.
OBJECTIVE
Patients' perception of asthma triggers has been explored in a largely unstructured fashion in the past. Therefore, we developed the Asthma Trigger Inventory (ATI), a questionnaire that allows for a psychometrically valid measurement of patients' perceived asthma triggers. Here we evaluate a German language version of the ATI and studied the relationship of subscales with self-reported health status, health care use, psychopathology, and results of allergy skin testing.


METHODS
Data were obtained from 370 asthma patients recruited from the community, primary care, and in-patient asthma treatment and education.


RESULTS
Analysis revealed a five-factor structure that largely confirmed results with the English original. Reliability was good to satisfactory (Cronbach's alpha=0.77-0.89) for allergy, exercise, air pollution/irritants, infection, and psychological trigger subscales. In hierarchical regression analysis adjusting for demographics and asthma severity, asthma patients with stronger non-allergic triggers showed less physical and mental well-being and more asthma-related health care use. Psychological triggers showed unique associations with anxious and depressed mood. Pollen and animal allergen scores of the ATI were significantly related to skin test results for relevant allergens. Non-allergic but not allergic triggers showed substantial associations with asthma control.


CONCLUSIONS
The German version of the ATI reliably measures asthma patients' trigger perceptions. Non-specific asthma triggers exert a greater burden on patients' well-being and primary health care use.
Department of Psychology, Southern Methodist University, 6424 Hilltop Lane, Dallas, TX 75205, USA. tritz@smu.edu
Thomas
T
Ritz
Antje
A
Kullowatz
Frank
F
Kanniess
Bernhard
B
Dahme
Helgo
H
Magnussen
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000209:etiology / Q000523:psychology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011594:Psychometrics; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires