Linking numeracy and asthma-related quality of life.
OBJECTIVE
To examine the correlation of numerical skills used in patients' self-management of asthma with asthma-related quality of life (AQOL).


METHODS
Adults with moderate-severe asthma completed the Asthma Numeracy Questionnaire (ANQ), assessments of reading comprehension and self-efficacy, and the mini-Asthma Quality of Life Questionnaire (miniAQLQ). The numeracy-AQOL relationship was evaluated in the context of potential confounders (demographic variables) and mediators (e.g. income and self-efficacy), using tests of correlation then multivariable models to assess for confounders and mediators.


RESULTS
80 adults with moderate or severe asthma were evaluated. Mean ANQ score was 2.3+/-1.2 (range 0-4). ANQ was correlated with miniAQLQ (rho=0.24, p=0.03). This association was sustained (rho=0.27, p=0.02) when controlling for potential confounders significantly associated with AQOL (age, Latino ethnicity). The ANQ-miniAQLQ association was mediated by household income; the correlation was reduced by 81% when adjusting for income (rho=0.05, p=0.65). In contrast, self-efficacy less strongly mediated this association; the correlation was reduced by 26% when controlled for self-efficacy (rho=0.20, p=0.08).


CONCLUSIONS
Numerical skills needed for asthma self-management influence AQOL primarily through their impact on income and, to a lesser extent, on self-efficacy.


CONCLUSIONS
Adults with asthma will benefit from self-management instructions employing the simplest mathematical constructs whose understanding is confirmed by clinicians.
Apter
Andrea J
AJ
Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. apter@mail.med.upenn.edu
Wang
Xingmei
X
Bogen
Daniel
D
Bennett
Ian M
IM
Jennings
Rebecca M
RM
Garcia
Laura
L
Sharpe
Tamie
T
Frazier
Carmen
C
Ten Have
Thomas
T
D001249:Asthma; D004522:Educational Status; D005260:Female; D005541:Forced Expiratory Volume; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D011788:Quality of Life; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014797:Vital Capacity