Rhee H, Belyea MJ, Elward KS. J Asthma. 2008;45(7):600–606
PURPOSE OF THE STUDY. To identify and to describe the patterns of asthma control perception in relation to actual symptom reports in adolescents and to compare the group with accurate control perception with the group with inaccurate perception.
STUDY POPULATION. A group of 126 adolescents with asthma, 13 to 20 years of age, were interviewed prospectively.
METHODS. Patterns of control perception were constructed on the basis of participants’ ratings of their perceptions of asthma control and self-reported asthma symptoms by using latent class analysis. Analyses of variance and multinomial logistic regressions were computed for group comparisons.
RESULTS. Participants were classified into 4 groups according to the patterns of control perception. Accurate groups included those whose asthma was well controlled (62%) or poorly controlled (7%), and inaccurate groups included those with nighttime symptoms (25%) or daytime symptoms (6%). Minority participants (P < .001) and those with low socioeconomic status (P < .001) were more likely to be represented in the inaccurate group than were their counterparts. The well-controlled accurate group consistently reported higher levels of asthma-related knowledge (P = .02), more-positive attitudes toward asthma (P < .001), fewer barriers to self-management (P = .04), and higher quality of life (P < .001) than did the inaccurate group.
CONCLUSIONS. This study demonstrated that accuracy of asthma control perception could be classified into 4 categories on the basis of patterns of various asthma symptoms. Adolescents’ tendency toward underperception was evident. The inaccurate groups are at greater risk for psychosocial impairments. This study underscores the importance of an intervention that improves the accuracy of asthma control perception in adolescents while promoting psychosocial well-being among adolescents with inaccurate perception.
REVIEWER COMMENTS. Asthma perception can be one of the most significant barriers to compliance with controller medication and response to acute episodes. In particular, adolescents have multiple barriers to adequate treatment of chronic diseases such as asthma. Physicians need to be sensitive to this issue in this group. Understanding and building interventions to improve symptom perception in this population are key to improving control and avoiding adverse events.
- Copyright © 2009 by the American Academy of Pediatrics