Academic literature on the topic 'Asthma knowledge questionnaire'

OBJECTIVE: To develop and validate an asthma knowledge questionnaire for use in adult asthma patients in Brazil. METHODS: A 34-item self-report questionnaire was constructed and administered to adult asthma patients and adult controls. The maximum total score was 34. RESULTS: The questionnaire was shown to be discriminatory, with good reliability and reproducibility. The mean score for asthma patients and controls was, respectively, 21.47 ± 4.11 (range: 9-31) and 17.27 ± 5.11 (range: 7-28; p < 0.001). The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.53, and the Bartlett's test of sphericity demonstrated a satisfactory suitability of the data to factor analysis (p < 0.001). There was no significant difference between the total scores obtained in the first and in the second application of the questionnaire within a two-week interval (p = 0.43). The internal consistency reliability (KR-20 coefficient) was 0.69. CONCLUSIONS: This study has validated an asthma knowledge questionnaire for use in Brazil.

Background: Asthma has been considered as one of the most common chronic diseases worldwide. Asthma due to its effects on bronchial passage compromises the respiration and intern impairs the quality of life. Aim was to evaluate the knowledge of asthma among patients attending our tertiary care hospital.Methods: The patients were subjected to chest X-ray and spirometry followed by the knowledge on asthma questionnaire which consisted of 28 questions.Results: Out of 75 patients, aged between 18-80 years, majority were males. Out of 75 patients, 60 (80%) patients had obtained a total score below 10 out of the total of 28 score. The causative factors for asthma, 60 (80%) patients believed that asthma was due to allergy. Only 2-3 patients (3-4%) had knowledge of the underlying pathologic process during an asthma attack. Fifty nine (79%) patients were aware of the symptoms of asthma. However, only 10 (13%) patients knew about the early signs of worsening of asthma and only 14 (19%) patients could judge the severity of asthma. Only 5 (7%) patients knew which drug was for regular use and which was to be used if breathlessness occurred. Merely around 4-10 (5 to 13%) patients knew that asthma could be prevented by avoiding trigger factors and by taking medication regularly.Conclusions: A good level of knowledge about asthma and better practices are rigorously important to prevent asthma exacerbations. More comprehensive, regular and patient centred counselling programs will be beneficial in improving awareness of asthma.

Background: Asthma is a serious public health problem, affecting people of all ages. When uncontrolled it can cause significant morbidity and mortality. Poor implementation of the guidelines is considered one of several barriers for achieving asthma control. Objectives: To determine the asthma knowledge, attitude and prescribing behavior of primary health care physicians in the Kingdom of Bahrain. Methods: A cross–sectional survey was carried out from March 2012 to March 2013 among primary health care physicians (PHC) attending asthma workshops as part of a continuing medical education program. During the study period 5 workshops were conducted which were attended by PHC physicians. A self-administered questionnaire was designed to achieve the research objective. The questionnaire was based primarily on a previous study carried out by the Chicago Asthma Surveillance Initiative (CASI) in the USA; a similar questionnaire was used in a study conducted in 2004, and permission was taken from the investigators to use it in our study. Questionnaires were distributed to the study groups at the beginning of each workshop and 192 of the 240 attending doctors completed the questionnaire, an 80% response rate. Results: The responders were mainly family physicians (66.7%), of whom 73.4% were following asthma guidelines. The study showed that slightly more than half of PHC physicians (56.8%) were able to assess the level of asthma control appropriately and the majority of them reported scheduling regular follow-ups for their patients. However, only 39.1% of PHC physicians were aware of the appropriate medication recommended for step 1 and only 37.3% of them reported that they provided written plans for their patients. Conclusion: Various aspects of GINA guidelines appear to have been integrated into clinical practice by primary care physicians in the Kingdom of Bahrain, whereas other recommendations do not seem to have been readily implemented.

Mothers’ knowledge about childhood asthma influences management practices and disease control, but validating knowledge/practice questionnaires is difficult due to the lack of a gold standard. We hypothesized that Latent Class Analysis (LCA) could help identify underlying mother profiles with similar knowledge/practices. A total of 438 mothers of asthmatic children answered a knowledge/practice questionnaire. Using answers to the knowledge/practice questionnaire as manifest variables, LCA identified two classes: Class 1, “poor knowledge” (33%); Class 2, “good knowledge” (67%). Classification accuracy was 0.96. Mothers in Class 2 were more likely to be aware of asthma-worsening factors and indicators of attacks. Mothers in Class 1 were more likely to prevent exposure to tobacco smoke (91.1% vs. 78.8%, p = 0.005). For attacks, mothers in Class 2 were more likely to go to the emergency department and follow the asthma action plan. Mothers in Class 2 more frequently had a high education level (79.5% vs. 65.2%, p = 0.004). Children in Class 2 more frequently had fully controlled asthma (36.7% vs. 25.9%, p = 0.015) and hospitalizations for attacks in the previous 12 months (24.2% vs. 10.7%, p = 0.003). LCA can help discover underlying mother profiles and plan targeted educational interventions.

Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.

Doctor of Philosophy
Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.

Introduction: It is accepted that a greater degree of general health literacy and also, specifically, about bronchial asthma leads to better results in relation to disease control. However, validated questionnaires for adequately studying knowledge about asthma are scant. Thus, the primary objective of the present study was to develop and validate an asthma self-knowledge questionnaire, based on international recommendations on the disease. The secondary objectives were to compare knowledge about asthma between asthmatic patients and non-asthmatic individuals; assessing whether or not asthma affects the level of self-knowledge of the disease and what factors may be associated with poorer self-knowledge of the disease. Methods: The Bronchial Asthma Self-Knowledge Questionnaire was developed and validation studies were performed: logical or apparent validity, content validity, construct validity; internal consistency (Cronbach's alpha test), test-retest or reproducibility, in a face-to-face interview with 73 asthmatic patients and 76 non-asthmatic individuals (with a pilot study in 10 patients and 10 healthy controls). Other questionnaires were also applied: Mini Mental State Examination (in individuals over 65 years of age), Depression Scales (CES-D for individuals under 65 and GDS for individuals over 65 years of age), Demographic Questionnaire, BSI, EHLS and the Characterization Questionnaire for bronchial asthma. Results were then analysed using the Software Package for Social Sciences, version 25.0. Results: Regarding development of the questionnaire, content validity, determined using I-CVI allowed reducing the questionnaire to 21 items. The test proved to have a reasonable value of internal consistency by the Cronbach's alpha coefficient; the data were considered as normally distributed; the test had a good temporal stability, by test-retest, although Spearman rho values were significantly stronger in the asthmatic group. Finally, confirmatory factorial analysis yielded acceptable values for PCFI and PGFI, as well as a satisfactory value for RMSEA (0,087). In terms of the application of the questionnaire, both groups under study (asthmatics and non-asthmatics) showed statistically significant differences in replies of self-knowledge questionnaire items. Finally, factors such as health literacy and the presence of emotional disturbances do not seem to significantly influence self-knowledge of bronchial asthma. Conclusions: The developed and validated questionnaire showed adequate psychometric robustness. In terms of construct validity, by known-group (bronchial asthma) validity, the test was able to discriminate between patients with asthma and volunteers without asthma, regarding self-knowledge of the disease.
Introdução: Aceita-se que um maior grau de alfabetização em saúde geral e também, especificamente, sobre asma brônquica leva a melhores resultados em relação ao controlo da doença. No entanto, questionários validados para o estudo adequado do conhecimento sobre a asma são escassos. Assim, o objetivo primário do presente estudo foi desenvolver e validar um questionário de autoconhecimento da asma, baseado em recomendações internacionais sobre a doença. Os objetivos secundários foram comparar o conhecimento sobre asma entre pacientes asmáticos e indivíduos não asmáticos; avaliar se a asma afeta ou não o nível de autoconhecimento da doença e quais fatores podem estar associados ao pior autoconhecimento da doença. Métodos: O Questionário de Autoconhecimento da Asma Brônquica foi desenvolvido e os estudos de validação foram realizados: validade lógica ou aparente, validade de conteúdo (I-Validity Index / I-CVI), validade de construto; consistência interna (teste alfa de Cronbach), teste-reteste ou reprodutibilidade, em entrevista presencial com 73 pacientes asmáticos e 76 não asmáticos (estudo piloto em 10 pacientes e 10 controlos saudáveis). Outros questionários também foram aplicados: Mini Mental State Examination (em indivíduos com mais de 65 anos), Escalas de Depressão (CES-D para indivíduos com menos de 65 anos e GDS para indivíduos com idade superior a 65 anos), Questionário Demográfico, BSI, EHLS e o Questionário de caracterização da asma brônquica. Os resultados foram então analisados usando o Software Package for Social Sciences®, versão 25.0. Resultados: No desenvolvimento do questionário, a validade de conteúdo, determinada pelo I-CVI permitiu reduzir o questionário para 21 itens. O teste demonstrou ter um valor razoável de consistência interna pelo coeficiente de Cronbach; os dados foram considerados como normalmente distribuídos; o teste teve uma boa reprodutibilidade temporal, por teste-reteste, embora os valores de rho de Spearman tenham sido significativamente mais fortes no grupo asmático. Finalmente, na análise fatorial confirmatória obtiveram-se valores aceitáveis de PCFI e de PGFI e um valor satisfatório de RMSEA (0,087). No que concerne à aplicação do questionário, os dois grupos em estudo, de asmáticos e não asmáticos mostraram diferenças estatisticamente significativas nas respostas aos itens do questionário de autoconhecimento. Finalmente, fatores como a literacia em saúde e presença de distúrbios emocionais não parecem influenciar significativamente no autoconhecimento da asma brônquica. Conclusões: O questionário desenvolvido e validado demonstrou ter robustez psicométrica adequada. Em termos de validade de construto, por estudo de grupo conhecido com doença (asma brônquica), observou-se capacidade de discriminar entre doentes com asma e voluntários sem asma, quanto ao autoconhecimento da doença.