Quality of life in asthmatic adolescents: an overall evaluation of disease control.
OBJECTIVE
to evaluate the relative impact of reported symptoms, school absenteeism, hospital admission, medical visits, and the presence of emotional and behavioral disorders on the health-related quality of life (HRQL) of low income asthmatic adolescents.


METHODS
Asthmatic adolescents were randomly selected among public schools in Belo Horizonte/MG, Brazil. Asthma severity was rated according to the Global Initiative for Asthma (GINA) classification. Emotional and behavior disorders (EBDs) were evaluated through the Strengths and Difficulties Questionnaire. HRQL was assessed through the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). PAQLQ score was analyzed for each intervening variable. Multivariate regression analysis was conducted.


RESULTS
One hundred and forty-six adolescents participated in the present study, 45% being male and age ranging from 14 to 16 years old. Mean PAQLQ score was 5.7 +/- 1.3 SD, with no significant difference regarding sociodemographic characteristics, except for gender (p = 0.001). The regression equation of the final model for the multivariate analysis was as follows: Mean PAQLQ score = 1.88 (Constant) - 0.42 gender + 1.14 nighttime symptoms + 0.69 medical visits in the past 12 months + 0.95 EBDs. Therefore, if the other variables remained constant, PAQLQ score: reduced in 0.42 points for females (p = 0.01); increased in 1.14 when there were no nighttime symptoms (p < 0.01); increased in 0.69 when there was no medical visit for respiratory problems within the past 12 months (p < 0.01); and increased in 0.95 when no EBDs were present (p < 0.01). This model was able to explain approximately half of the variation found in PAQLQ score (R-Sq = 49.4%).


CONCLUSIONS
HRQL of asthmatic adolescents is influenced by the complex interaction among several factors: the severity of clinical symptoms, morbidity, gender, and the psychological resources available so as to deal with such difficulties. A careful evaluation of HRQL is essential in order to capture feelings and subjective perceptions, which are not investigated by the conventional evaluation of asthma control.
Alvim
Cristina Gonçalves
CG
Pediatric, Federal University of Minas Gerais, Belo Horizonte, Brazil. cgalvim@terra.com.br
Picinin
Isabela Mendonça
IM
Camargos
Paulo Moreira
PM
Colosimo
Enrico
E
Lasmar
Laura Belizário
LB
Ibiapina
Cássio Cunha
CC
Fontes
Maria Jussara
MJ
Andrade
Cláudia Ribeiro
CR
D000041:Absenteeism; D000293:Adolescent; D000342:Affective Symptoms / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D001938:Brazil; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011788:Quality of Life; D012574:Schools / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors