Validation of the asthma impact survey,a brief asthma-specific quality of life tool

Background The Asthma Impact Survey (AIS-6) is a new six question asthma outcome tool for which information on validity has not been published. Objective To provide validation for the AIS-6 as a brief asthma-specific quality of life tool. Methods Surveys were sent to a random sample of members of a large managed care organization who were at least 35 years of age and in the two-year period preceding the survey had either (1) at least one documented asthma-related medical encounter, or (2) at least a 6 months supply of asthma medication dispensed. In addition to the AIS-6, the survey included a validated quality of life tool [the mini-Asthma Quality of Life Questionnaire (AQLQ)]; a validated asthma control questionnaire [the Asthma Therapy Assessment Questionnaire^TM (ATAQ)]; a validated symptom severity scale (AOMS); and information regarding demographics, co-morbidities, asthma severity, and asthma management. The results of the AIS-6 were compared to the results of the other tools by means of correlation and factor analysis. Independent predictors of AIS-6 and AQLQ scores were determined by multiple stepwise linear regression analyses. Results AIS-6 scores were significantly related to female sex, educational level, income, smoking, body mass index (BMI), COPD, steroid use, and hospitalization history in bivariate analyses. The AIS-6 score significantly correlated (r = − 0.84, p < 0.0001) with the AQLQ total score and loaded on the three factors (activity, symptoms, and concern/bother) reflected by the survey information and on which the AQLQ also loaded. Significant but somewhat smaller correlations were found between the AIS-6 and the ATAQ (r = 0.70, p < 0.0001) and the AOMS (r = 0.55, p < 0.0001). Independent predictors were the same for the AIS-6 and AQLQ and included oral steroid use, COPD history, BMI, female sex, educational level, and hospitalization in the past year. Conclusion These data support the validity of the short six-question AIS-6 as an asthma-specific quality of life tool.     

健康呼吸中心对支气管哮喘患者管理和生活质量的影响

目的 评价健康呼吸中心管理与系统教育模式对哮喘防治及哮喘患者生活质量的影响.方法 对2005年9月至今就诊"健康呼吸中心",参加过"哮喘之家"活动的642名接受规范化治疗疗程3年以上的慢性持续哮喘患者,随机分为严格管理(依从性好)和松懈管理(依从性不好)两组,由哮喘专科门诊医生以面对面问卷方式调查门诊成年哮喘患者对疾病...     

Health-related quality of life in asthma: A comparison between the St George's respiratory questionnaire and the asthma quality of life questionnaire

The aim of the study is to compare the performance of the Juniper Asthma Quality of Life Questionnaire (AQLQ) and the St George's Respiratory Questionnaire (SGRQ) in a sample of asthmatic patients, representative of a broad spectrum of asthma severity. We studied 116 patients with a mean age (SD) of 42.6 (18.3) year. Patients were assessed twice, at recruitment and after 2 months, to determine the reliability, validity and responsiveness of the AQLQ and the SGRQ. Both questionnaires showed good reliability coefficients (0.70) which reached the standards for comparison at individual level (0.90) in the case of activity, impacts and overall SGRQ scores as well as symptoms, activities and overall AQLQ scores. Both AQLQ and SGRQ were able to discriminate among groups of patients based on asthma severity and control and showed, except for the symptoms domain of the SGRQ, large (standardized response means >0.8) and significant changes in the group of patients that improved at follow-up. We conclude that the AQLQ and SGRQ have shown high reliability and validity and, with the exception of the SGRQ symptoms, a high level of responsiveness. In overall terms, not one of these instruments seems to behave better than the other.     

母乳喂养与被动吸烟对儿童哮喘及哮喘样症状的交互作用

目的 探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响.方法 采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园,共25所小学和50所幼儿园,对所选学校所有在此居住满2年的31 049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集.采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状(持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎)的影响.结果 在调查的31 049名儿童中,年龄为(8.32±2.75)岁,母乳喂养的儿童有23 987名,母乳喂养率为77.26％;被动吸烟的儿童有11 820名,被动吸烟率为38.07％.母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6.22％(1491/23 987)、4.67％(1120/23 987),非母乳喂养的儿童分别为7.70％(544/7062)、5.48％(387/7062).母乳喂养儿童发生哮喘(OR=0.79,95％ CI:0.72～0.88)、过敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的风险较低.父亲吸烟的儿童喘鸣现患阳性率为7.89％(929/11 770),父亲未吸烟的儿童为5.37％(1036/19 279),父亲吸烟的儿童发生喘鸣现患(OR=1.51,95％CI:1.38 ～1.65)的风险较高.母亲吸烟的儿童持续咳嗽阳性率为18.96％(51/269),母亲未吸烟的儿童为9.51％(2926/30 780),母亲吸烟的儿童发生持续咳嗽(OR =2.23,95％ CI:1.64～3.03)的风险较高.家中其他任何人吸烟的儿童持续咳痰阳性率为5.69％(871/15 316),家中无人吸烟的儿童为3.50％(550/15 733),家中其他任何人吸烟的儿童发生持续咳痰(OR=1.67,95％CI:1.49～ 1.86)的风险较高.Glimmix回归模型分析显示,母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响:在父亲吸烟暴露下,母乳喂养的儿童发生哮喘的风险低于非母乳喂养儿童;在母亲吸烟暴露下,母乳喂养的儿童发生过敏性鼻炎的风险低于非母乳喂养儿童;在家中其他任何人吸烟暴露下,母乳喂养的儿童发生哮喘、过敏性鼻炎的风险低于非母乳喂养儿童(P值均＜0.05).结论 母乳喂养使被动吸烟的儿童发生哮喘及哮喘样症状的风险降低.     

六个国家室内空气污染和吸烟对≥50岁人群哮喘的交互作用研究

目的 探讨室内空气污染和吸烟之间的交互作用对≥50岁人群哮喘的影响,为哮喘的防控提供科学依据。方法 随机抽取中国、加纳、印度、墨西哥、俄罗斯和南非6个中低收入国家的居民家庭户进行家庭问卷调查和对所有≥50岁的成员进行个人问卷调查。运用logistic回归模型分别分析室内空气污染（做饭燃料、烟囱设施）和吸烟（是否吸烟、吸烟频率、烟龄）与人群哮喘患病的关系,利用乘法模型和加法模型评价空气污染和吸烟对人群哮喘的交互作用影响。结果 共有33 327名调查对象纳入分析,≥50岁人群哮喘的总患病率为3.89%（1 296/33 327）。调整国家、年龄、性别、婚姻状况、居住地、教育程度、体力活动、家庭收入等混杂因素后,吸烟人群相对于从不吸烟人群患哮喘风险增加（OR=1.18,95% CI：1.01~1.45）;在不同吸烟频率的人群中,偶尔吸烟人群患哮喘的风险最高（OR=1.75,95% CI：1.33~2.30）。交互作用分析结果显示,除烟龄和做饭燃料外,室内空气污染和吸烟之间对≥50岁人群哮喘存在相加交互作用;是否吸烟（交互项OR=1.60,95% CI：1.26~2.02）、吸烟频率（交互项OR=1.61,95% CI：1.28~2.04）、吸烟烟龄（交互项OR=1.69,95% CI：1.39~2.21）均与做饭燃料之间在≥50岁人群哮喘患病风险中存在相乘交互作用。当2种危险因素同时存在时,患哮喘的风险最高。吸烟和做饭燃料为柴/煤/炭人群患哮喘的风险是不吸烟和燃料为电/燃气的1.43倍（95% CI：1.17~1.75）。结论 室内空气污染和吸烟均与≥50岁人群哮喘患病有关,并对≥50岁人群哮喘患病存在交互作用。     

规范化管理及治疗对哮喘患者病情控制水平和生命质量的影响

目的 探讨规范化管理及治疗对哮喘患者病情控制水平及生命质量的影响.方法 门诊和病房收治的100例哮喘患者,按照人组顺序分为管理组和对照组,每组50例,对照组给予常规治疗,管理组在常规治疗的基础上纳入规范化管理,给予6个月的健康教育;比较治疗前后两组哮喘患者生命质量评分的变化及治疗后两组患者的哮喘控制率,应用统计学软件SPSS 17.0进行数据分析,计量数据以-x±s表示,组间比较采用t检验,率的比较用x2检验,P＜0.05为差异有统计学意义.结果 管理及治疗后6个月,管理组哮喘良好控制率为56％,对照组为22％,管理组哮喘控制率高于对照组（x2=12.15,P＜0.05）;管理及治疗6个月后,管理组活动受限、哮喘症状、心理状况、对刺激源反应、对自身健康关心各维度的得分和生命质量总分分别为（47.4±5.8）、（35.3±6.2）、（28.2±4.3）、（22.7±3.5）、（17.6±3.9）、（151.2±14.7）,对照组分别为（38.2±4.5）、（27.1±4.8）、（23.1±5.7）、（18.3±4.3）、（13.7±4.2）、（121.4±12.6）,管理组各项评分及生命质量总分均高于对照组（t=6.17,4.42,4.98,5.76,5.43,6.35,均P＜0.05）.结论 规范化管理及治疗能够高哮喘控制率,改善哮喘患者不良情绪状态,提高哮喘患者的生命质量.     

北京市崇文区医务人员控烟效果评价

目的了解健康教育前后北京市崇文区医务人员吸烟状况及其控烟态度和行为的改变情况，并对干预效果进行评价。方法在北京市崇文区疾病预防控制中心辖区医院中，选择4家医院作为干预组，进行为期1年的控烟健康教育，另外选择4家医院作为对照组，通过问卷调查了解干预组与对照组干预前后吸烟状况、控烟知识、态度和行为情况，对干预效果进行评价。结果干预前共调查3093人，干预后共调查3172人。干预后，干预组在知识、态度和行为方面具有明显改善，且优于对照组，差异有统计学意义（P〈0．05）。干预后，干预组对吸烟导致肺癌、气管炎和冠心病的知晓率达到了85％以上，大部分控烟知识点的知晓率能够达到50％以上；态度上，97．8％的干预组调查对象认为“医生应主动宣讲吸烟的危害及戒烟知识”，行为上，接受过戒烟培训的比例由31．8％升高到77．1％；吸烟率由18．9％下降到10．9％。结论健康教育可以改变医务人员的吸烟行为、控烟理念及态度，降低医务人员吸烟率，从而推进全社会的控烟工作。     

Prevalence and characteristics of smoking in primary healthcare workers in Iquique, Chile

OBJECTIVE: To determine the prevalence and characteristics of the smoking habits of primary healthcare workers in Iquique, Chile. Study design: Cross-sectional study through a survey of all personnel working in primary health care in Iquique, Chile. METHODS: The following variables were investigated: biodemographical characteristics and aspects of smoking, knowledge of the adverse effects of smoking, and some lifestyle factors. RESULTS: Among the study population, a high prevalence of smokers was found (37%) and a further 26% were ex-smokers. The smokers were predominantly practical nurses, female, aged 25-45 years and married. The only significant relationship was between age and smoking habit (P=0.02), with smoking prevalence among younger groups being very high (56%). There was a high level of awareness about the adverse effects of smoking and its addictiveness (99 and 93%, respectively). Forty-three percent of participants had been smoking for more than 15 years, and the main reasons for smoking were 'social consumption' and 'stress' (36 and 29%, respectively). Thirty-two percent of the ex-smokers ceased smoking for discomfort or health reasons. There were no differences between smokers and ex-smokers with respect to participation in sports or working shifts. Fifty-two percent of those surveyed reported they they were annoyed when others smoked near them. CONCLUSION: This study revealed a high prevalence of smoking, particularly among practical nurses. Regarding attitudes to health, a dichotomy between knowledge and behaviour was found in this group. In pursuing the commitment to smoking cessation in healthcare personnel, a deeper review of cultural issues and motivation should be considered.     

Measuring quality of life in children with asthma

The Paediatric Asthma Quality of Life Questionnaire contains 23 items that children with asthma have identified as troublesome in their daily lives. The aim was to evaluate the measurement properties of the questionnaire. The study design consisted of a 9 week single cohort study with assessments at 1, 5 and 9 weeks. Patients participating in the study were fifty-two children, 7–17 years of age, with a wide range of asthma severity. At each clinic visit, a trained interviewer administered the Paediatric Asthma Quality of Life Questionnaire, the Feeling Thermometer, a clinical asthma control questionnaire and measured spirometry. For 1 week before each clinic visit, patients recorded morning peak flow rates, medication use and symptoms in a diary. The Paediatric Asthma Quality of Life Questionnaire was able to detect quality of life changes in those patients who altered their health status either as a result of treatemnt or natural fluctuations in their asthma (p<0.001) and to differentiate these patients from those who remained stable (p<0.0001). It was reproducible in patients who were stable (ICC=0.95), which also indicates the instrument's strength to discriminate between subjects of different impairment levels. The questionnaire showed good levels of both longitudinal and cross-sectional correlations with the conventional asthma indices and with general quality of life. The results were consistent across individual domains and different age strata. The Paediatric Asthma Quality of Life Questionnaire has good measurement properties and is valid both as an evaluative and a discriminative instrument. It captures aspects of asthma most important to the patient and adds additional information to conventional clinical outcomes.Supported through a grant from Fisons Canada     

Health-related quality of life in Australian children with asthma: lessons for the cross-cultural use of quality of life instruments

The development of Australian forms of the Childhood Asthma Questionnaires (CAQs) is reported. Focus group methods and psychometric analyses were used to establish the conceptual, semantic and technical equivalence of these forms with the UK versions. Both versions also provide for data collection from non-asthmatic youngsters. The internal consistency was found to be acceptable (Cronbach's 0.52–0.90) and the health-related quality of life (HRQoL) scores were found to vary with asthma severity (p<0.05). Comparison with the UK data revealed that the non-asthmatic scores were higher for Australian than British children (p<0.001) but that the scores for children with asthma did not differ between the two countries. It was only in the Australian sample that the group with asthma reported impaired HRQoL when compared to their healthy peers. These findings were interpreted in the context of cultural expectations of life quality and conclusions are presented regarding the importance of the gap between experience and expectations. The difficulties raised by the developmental and cultural issues inherent in paediatric HRQoL research were discussed.     

Psychological distress and depressed mood in employees with asthma, chronic bronchitis or emphysema: A population-based observational study on prevalence and the relationship with smoking cigarettes

OBJECTIVES: To evaluate if employees with asthma, chronic bronchitis or emphysema can be characterized as a population of patients with a high prevalence of psychological distress and/or depressed mood. Above all, we wanted to examine the influence of smoking status on the relationship between chronic disease and psychological distress/depressed mood. METHODS: A postal survey was conducted among 12,103 employees participating in the Maastricht Cohort Study. RESULTS: Smoking employees, who reported having asthma, chronic bronchitis or emphysema were more likely to report suffering from depressed mood compared to smokers with no long-lasting disease (prevalence rate, PR: 29.3 and 9.0%, respectively; OR for depressed mood = 4.04; 95% CI: 2.56-6.39) and when compared to smoking employees with a history of heart disease, hypertension or myocardial infarction (PR: 18.1%; OR: 1.99; 95% CI: 1.07-3.68), or rheumatoid arthritis (PR: 20.1%; OR: 1.73; 95% CI: 0.96-3.11). CONCLUSION: These findings provide health care professionals with additional evidence regarding the importance for including the assessment of psychological distress and depressed mood in the routine evaluation of the patient with asthma, chronic bronchitis or emphysema, especially with regard to smoking cessation.     

Investigating indicators and determinants of asthma in young adults

Background: In epidemiological studies on asthma determinants an extreme variability in results exists, probably due to different criteria utilised for defining of an asthma ‘case’ and for measuring determinants. We aimed to assess multiple indicators and multiple determinants of asthma in young adults by applying latent variable mixture models (LVMMs), a novel statistical modelling with hidden (or latent) variables. Methods: We consider the pooled data of 1103 subjects (aged 20–44 years) from the three Italian centres of the European Community Respiratory Health Survey (ECRHS 1), a standardised database. Underlying multiple asthma indicators (clinicians’ diagnosis, self-report symptoms, respiratory trials) both a latent two-class of asthma syndrome, and three continuous latent variables (severity of diagnosed asthma, severity of asthma symptoms, and severity of respiratory function) were investigated. Results: Family history was the more relevant predictor of the two-class of asthma syndrome with a risk increase of about 60% per 1 relative with early life events (OR = 1.60, 95% CI: 1.30–1.97). Smoking, active and passive, are predictive for the indicators of severity of asthma symptoms. On average the risk increase of about 10% (OR = 1.10, 95%CI: 1.01–1.20) either per 1 source point of environmental tobacco smoke (ETS) or per 1 packet a day per 10 years. While, the risk of the indicators of both severity of asthma symptoms (OR = 1.59, 95%CI: 1.23–2.06) and severity of respiratory function (OR = 1.37, 95%CI: 1.03–1.82) increase in women compared to men, the risk of the indicators of severity of diagnosed asthma (OR = 0.57, 95%CI: 0.35–0.91) decreases. Conclusions: Considering latent modelling perspective for formulating plausible hypotheses in asthma research, this study highlighted that the host (genetic) component measured as number of relatives with life-events of asthma and/or allergies seems to be the primary determinants of overall observed asthma indicators summarised by hidden two-class of asthma syndrome. Furthermore, a secondary (or trigger) role of smoking on the continuous latent variable of severity of asthma symptoms, and a gender reversal effect were suggested.Mario Grassi developed the idea of the study, was responsible for statistical modelling, and paper writing.Massimiliano Bugiani was responsible of the recruitment of data from Torino centre, and collaborate in paper writing.Roberto de Marco is the national coordinator of Italian ECRHS group, was responsible of recruitment of data from Verona centre, and collaborate in paper writing.     

Perceived neighborhood problems and quality of life, physical functioning, and depressive symptoms among adults with asthma

OBJECTIVES: We investigated associations between perceived neighborhood problems and quality of life (QOL), physical functioning, and depressive symptoms among adults with asthma. METHODS: Using cross-sectional data from adults with asthma in northern California (n=435), we examined associations between 5 types of perceived neighborhood problems (traffic, noise, trash, smells, and fires) and asthma-specific QOL (Marks instrument), physical functioning (Short Form-12 physical component summary), and depressive symptoms (Center for Epidemiological Studies-Depression). We used multivariate regression analysis. RESULTS: When asthma severity and sociodemographics were taken into account, people reporting a score of 8 or higher on a scale of 0 to 25 for serious problems (the top quartile of seriousness) in their neighborhoods had significantly poorer QOL scores (mean difference=5.91; standard error [SE]=1.63), poorer physical functioning (mean difference=-3.04; SE=1.27), and almost a fivefold increase in depressive symptoms (odds ratio=4.79; 95% confidence interval=2.41, 9.52). CONCLUSIONS: A high level of perceived neighborhood problems was associated with poorer QOL, poorer physical functioning, and increased depressive symptoms among people with asthma when disease severity and sociodemographic factors were taken into account.     

Association of income with symptoms, morbidities and healthcare usage among Japanese adults

Objectives

Socioeconomic inequalities in healthcare services are major public health and healthcare concerns. We have examined the association of income with symptoms, morbidities and healthcare usage in a national sample of the Japanese population.

Methods

For this study, data compiled on 21,929 men and 24,620 women from the Comprehensive Survey of the Living Conditions of People on Health and Welfare in 2007 were assessed. Among the survey respondents with symptoms, we compared the prevalences of symptoms and treatments and the number of respondents who received treatments for 16 groups of symptoms and disorders according to household income, from the highest to the lowest, using the relative index of inequalities (RII). The RIIs were computed by age groups [25–59 years (young group) and 60+ years (senior group)].

Results

People with lower incomes had higher prevalences of symptoms and treatments for most of the disorders examined. The RIIs of symptoms and treatments were 1.19 [95% confidence interval (CI) 1.09–1.31] and 1.04 (95% CI 0.93–1.16) for the young group and 1.69 (1.53–1.87) and 1.51 (1.36–1.67) for the senior group, respectively. In terms of treatment prevalence among those with symptoms, the RII was not significantly lower than 1.0 except for a few disorders in the young group.

Conclusions

Our results indicate that income inequalities can be related to the prevalences of various symptoms and morbidities in our Japanese sample population and that these inequalities were greater in the senior group than in the young group. Our results also suggest that lower income is not a substantial barrier to the use of healthcare services by older Japanese individuals, while it is related to lower healthcare usage by individuals of working age.     

三联干预措施对儿童哮喘症状改善的影响

目的探讨三联干预措施对儿童哮喘症状改善的影响。方法随机将80例哮喘患儿分为对照组和治疗组,各40例。对照组采用常规治疗;治疗组在对照组治疗的基础上,采取三联干预进行干预治疗。观察2组干预前后的哮喘控制情况、肺功能、治疗的依从性、哮喘发作次数、急诊就诊次数、静脉用药次数、住院治疗的次数。结果干预后的哮喘控制率对照组为62．5％（25／40）,治疗组为92．5％（37／40）,2组差异有统计学意义（x2=10．32,P〈0．01）。干预后的用力肺活量（FVC）、呼气峰流速（Pre-FEV1）、第1秒时间肺活量（Pre-FEF）对照组和治疗组均明显高于干预前（均P〈0．05）,2组干预后的FVC、Pre—FEV1、Pre—FEF指标水平差异有统计学意义（P〈0．05）。对照组干预后的医生治疗方案、定期复诊、规范用药较干预前无明显变化（P〉0．05）,但干预后的规避诱发因素较干预前差异显著（P〈0．05）;治疗组干预后的配合医生治疗方案、定期复诊、规范用药、规避诱发因素均明显高于干预前（P〈0．05）,2组干预后的配合医生治疗方案、定期复诊、规范用药、规避诱发因素差异有统计学意义（P〈0．05）。干预后的发作次数、急诊就诊次数、住院次数、静脉用药次数对照组和治疗组较干预前差异均有统计学意义（均P〈0．05）,干预后的发作次数、急诊就诊次数、住院次数、静脉用药次数治疗组均少于对照组（P〈0．05）。结论三联干预措施对儿童哮喘干预效果明显,可以改善患者的临床症状,提高患者的肺功能、哮喘控制情况、治疗的依从性,降低治疗及用药次数,值得在儿童哮喘的治疗中广泛应用。     

上海市大学生使用烟草和酒精等成瘾物质状况

目的 了解上海市大学生使用烟草、酒精等成瘾物质的现状。方法 采用整群随机抽样的方法抽取7所大学1765名学生，用中国疾病预防控制中心提供的《中国城市青少年健康危险行为监测问卷（大学）》进行无记名调查。结果 不同年级和性别学生使用烟草、酒精的差异有显著意义，目前吸烟与目前饮酒二变量呈正相‰logistic多因素分层分析显示，父亲高学历是保护因素，男性和高年级相对女性和低年级及赌博是危险因素。结论 上海市大学生使用烟草、酒精等成瘾物质报告率高于本地中学生，但低于其他国内外的有关报道。应把开展以学校为基础的生活技能训练作为主要预防干预措施。     

Measuring quality of life in the parents of children with asthma

Parents and primary caregivers of children with asthma are limited in normal daily activities and experience anxieties and fears due to the child's illness. We have developed the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) to measure these impairments. The objective of this study was to evaluate the measurement properties of the PACQLQ. A 9-week single cohort study was conducted with assessments at 1, 5 and 9 weeks. Participants in the study were primary caregivers of 52 children (age 7–17 years) with symptomatic asthma, recruited from notices in the local media and paediatric asthma clinics. Caregivers completed the PACQLQ, Impact-on-Family Scale and Global Rating of Change Questionnaires. Patients completed the Paediatric Asthma Quality of Life Questionnaire and an asthma control questionnaire. Spirornetry and -agonist use were recorded. The PACQLQ was able to detect quality of life changes in those caregivers who changed (p<0.001) and to differentiate these from the caregivers whose quality of life remained stable (p<0.0001). The PACQLQ is reproducible in subjects who are stable (ICC=0.84), and showed acceptable levels of longitudinal and cross-sectional correlations with the child's asthma status and health-related quality of life and with other measures of caregiver health-related quality of life. The PACQLQ functions well as both an evaluative and a discriminative instrument.     

中山市居室装修对儿童哮喘样症状的影响

目的 探究中山市居室装修对儿童哮喘及哮喘样症状的影响。方法 于2016年3-7月在中山市城区采用随机整群抽样方法,抽取小学和初中各5所共11 611名儿童,采用国际统一的标准问卷ATS调查表调查所选学生的哮喘及哮喘样症状及家庭装修等情况,分析居室装修对儿童哮喘和哮喘样症状的影响。结果 学生年龄介于5~17岁,平均年龄是（11.49±2.66)岁,持续咳嗽、持续咳痰、喘鸣、哮喘和哮喘现患的患病率分别是2.85%、1.20%、6.93%、5.70%和1.46%。单因素分析显示,家庭2年内住房装修,装修材料中的油漆和墙壁涂料壁纸和新家具均是儿童哮喘和哮喘样症状危险因素(P＜0.05);多因素二分类非条件Logistic回归分析结果显示,油漆是儿童持续咳嗽和哮喘现患的危险因素(OR:1.38-1.51,P＜0.05),墙涂料壁纸是儿童喘鸣和哮喘的危险因素(OR:1.24-1.29,P＜0.01)。结论 中山市居室装修是儿童患有哮喘及哮喘样症状的危险因素,不同的装修材料危害不一,应注意装修材料的使用。     

Modifying effect of suicidal ideation on the relationship between asthma and cigarette use behaviors among Korean adolescents

Objectives

Although cigarette smoking is known to be related to the exacerbation of asthma symptoms, several studies have indicated that the prevalence of cigarette smoking among asthmatic adolescents is similar to or even higher than that among non-asthmatic adolescents. The aim of this study was to evaluate the relationship between asthma and cigarette use behaviors and whether or not the presence of suicidal ideation modifies this relationship among Korean adolescents.

Methods

We analyzed data from the 2008 Korea Youth Risk Behavior Web-based Survey, which included a nationally representative sample of middle and high school students. Multiple logistic regression models were used to calculate odd ratios and 95% confidence intervals of cigarette use behaviors among current asthmatics, former asthmatics, and non-asthmatics, after adjusting for gender, grade, school records, socioeconomic status, current alcohol use, and suicidal ideation.

Results

Of 75 238 study participants, 3.5% were current asthmatics and 4.5% were former asthmatics. Compared with non-asthmatics, asthmatics were more likely to report current cigarette use, frequent and heavy cigarette use, and cigarette use before 13 years of age. There were statistically significant interactions between asthma and suicidal ideation in cigarette use behaviors.

Conclusions

This study demonstrated that asthmatic adolescents are more likely than non-asthmatic adolescents to engage in cigarette use behaviors and the presence of suicidal ideation is an effect modifier of the relationship between asthma and cigarette use behaviors. Particular attention should be paid to the awareness of health risks of cigarette smoking and mental health problems among asthmatic adolescents.     

Quality of life of adults with workplace exacerbation of asthma

Objective A cross-sectional study collecting demographic, work history, disease, and quality-of-life (QOL) data from adults with asthma was explored for a relationship between workplace exacerbation of asthma (WEA) and QOL. Study design and setting The study population of adults with asthma was drawn from adults affiliated with Fallon Community Health Plan, a health maintenance organization serving Massachusetts. Results The sample consisted of 598 adults with asthma. Based on univariate analyses, study participants with WEA had a statistically significant higher Total QOL score, indicating a worse quality of life, than participants whose asthma was not work-related (2.43 vs. 1.74, P ≤ 0.001), and also higher scores on the instrument’s four subscales for Breathlessness, Mood Disturbance, Social Disruptions, and Health Concerns. After controlling for covariates using multiple linear regression, the relationship between WEA and the Total QOL score was statistically significant (P = 0.0004) with a coefficient of 0.54. The coefficient for WEA was also statistically significant based on regression models for all the subscales with the exception of the Breathlessness score (P = 0.08). Conclusion In summary, WEA was associated with a worse QOL. Ideally, employees and employers would work together to minimize the conditions at work that contribute to WEA, which should decrease the frequency of WEA and related degradation of QOL. The U.S. Government's right to retain a non-exclusive, royalty-free license in and to any copyright is acknowledged.