Ethnic differences in methacholine responsiveness and word descriptors in African Americans, Hispanic-Mexican Americans, Asian-Pacific Islanders, and Whites with mild asthma.
OBJECTIVE
There is little asthma research that compares ethnic differences in airway responsiveness and word descriptors among African Americans, Hispanic-Mexican Americans, Asian-Pacific Islanders, and Whites. Thus, identifying ethnic differences in symptom descriptors and airway responsiveness may improve health outcomes by educating health professionals about treatment decisions that are culturally and ethnically sensitive.


METHODS
Specific Inclusion criteria-forced expiratory volume in one second (FEV(1)) >or= 70% predicted normal; provocative concentration causing a 30% fall in FEV(1) (PC(30)) <or= 8 mg/ml for methacholine (MCh), using only a beta(2)- inhaler, and self-reported ethnicity of African American, Hispanic-Mexican American, Asian-Pacific Islander, or White. Serial pulmonary function test (PFT) and Borg, Visual Analogue Scale (VAS), and Ethnic Word Descriptors (EWDs) were collected.


RESULTS
One hundred eighteen consented, 106 completed procedures, and 90 had a positive PC(30) and were enrolled. Asian-Pacific Islanders had significantly greater airway responsiveness (p <.02). Baseline FEV(1), MCh dose, and PC(30) correlated with race (p <.001); baseline FEV(1) and ethnicity predicted airway responsiveness (p <.001). EWDs differed significantly by ethnicity. Upper airway EWDs for Asian-Pacific Islanders: itchy throat (p < .04), itchy (p <.02), itchy back throat (p <.04), voice tight, tight throat (p <.001), and cough (p <.04). Upper airway EWDs for African Americans: add itchy throat (p <.002), itchy neck (p <.001), tight throat (p <.003), voice tight (p <.02), and cough (p <.04). Hispanic-Mexican Americans used both upper and lower airway EWDs; Whites used only lower airway EWDs.


CONCLUSIONS
This study provides new insights about ethnic differences in airway responsiveness and EWDs. Asian-Pacific Islanders required a significantly smaller dose of MCh to achieve a PC(30) compared to the other three ethnic groups. The upper airway EWDs used by African Americans, Asian-Pacific Islanders, and Hispanic-Mexican Americans indicate a shared language of symptoms. A new language of breathlessness that incorporates both cultural and ethnic differences is needed to address the present disparity in the management of asthma symptoms.
San Francisco State University, School of Nursing, San Francisco, California 94132, USA. ghardie@sfsu.edu
Grace
G
Hardie
Rebecca
R
Liu
Jennifer
J
Darden
Warren M
WM
Gold
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000208:ethnology* / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D044469:Racial Groups; D012129:Respiratory Function Tests; D055815:Young Adult
D016210:Methacholine Chloride