The impact of alexithymia on asthma patient management and communication with health care providers: a pilot study.
OBJECTIVE
Alexithymia is a personality trait associated with difficulty identifying and verbalizing feelings. It has been associated with poorly controlled asthma and near-fatal asthma. The primary objectives were to (1) determine the prevalence of alexithymia in a group of moderate to severe asthmatics who attended an Outpatient Clinic; and (2) investigate the relationship between alexithymia and asthma control, management, and communication.


METHODS
Twenty-five moderate to severe asthma patients were recruited from the Royal Adelaide Hospital Outpatient Respiratory Clinic. Participants were either mailed the questionnaire pack or completed it after a clinic appointment. Existing validated questionnaires were used to collect data. The primary outcome measures were alexithymia, asthma control, adherence to medication; patient satisfaction with communication with health care providers and health-related quality of life. Data were analyzed using Pearson correlations, linear regression and analysis of variance (ANOVA) in SPSS. A p value <or= 0.05 was required for statistical significance.


RESULTS
A total of 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years +/- 11) participated. Alexithymia scores ranged between 23.0-76.0 (x = 48.3, SD = 13.2); 12% of participants reported high alexithymia scores, 32% reported borderline alexithymia scores, and 56% reported low alexithymia scores. Alexithymia mean scores were not statistically different across sociodemographic variables. A higher alexithymia score was associated with worse asthma control score (r = 0.57, p < 0.01) (where higher asthma control scores indicate worse asthma control); poor adherence (p = 0.03), and worse quality of life (r = - 0.65, p < 0.01). Alexithymia score was not correlated with satisfaction with communication (r = - 0.27, p = 0.2).), or the number of hospitalizations for asthma (p = 0.25).


CONCLUSIONS
This is the first study to investigate relationships between alexithymia, asthma control, asthma management and communication with health care professionals. The study reaffirms associations between alexithymia and asthma control, but a larger sample size is needed to determine the impact of alexithymia on self-management and provision of clinical care for asthma.
Chugg
Kelly
K
Discipline of General Practice, University of Adelaide. chug0007@flinders.edu.au
Barton
Christopher
C
Antic
Ral
R
Crockett
Alan
A
D000328:Adult; D000342:Affective Symptoms / Q000150:complications* / Q000453:epidemiology; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003142:Communication; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006282:Health Personnel; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011369:Professional-Patient Relations; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult; D016903:Drug Monitoring