Burgess Leonie, McCaffery Kirsten, Powell Heather, Murphy Vanessa E, Gibson Peter G, Turner Robin M
a Sydney School of Public Health, University of Sydney , Sydney , NSW , Australia .
b Sax Institute , Sydney , NSW , Australia .
J Asthma. 2015;52(10):1013-9. doi: 10.3109/02770903.2015.1038833. Epub 2015 Aug 24.
To investigate the relationship between asthma control and psychosocial outcomes in pregnant women with asthma.
Secondary analysis (N = 221) of a randomized controlled trial of treatment adjustments, based on fractional exhaled nitric oxide versus clinical guideline-based algorithms. Psychosocial variables included generic and asthma-specific quality of life (SF12, AQLQ-M), illness perceptions (BIPQ), perceived control (PCAQ), perceived risk of side effects (PRSE) and anxiety (STAI-6). Asthma control was defined as controlled (Asthma Control Questionnaire (ACQ7) ≤1.5 at randomization and end of study), improved (ACQ7 > 1.5 at randomization and ≤1.5 at end of study) and unimproved (ACQ7 >1.5 at end of study). Regression models were fitted for each psychosocial measure at the end of the study, with adjustment for baseline values and smoking status, with predictor variable asthma control.
Women with unimproved asthma had poorer physical (SF12, p = 0.012) and asthma-specific quality of life across all domains (AQLQ-M, p ≤ 0.012) compared to women with controlled asthma. They believed that they had less control over their asthma (PCAQ total p = 0.014), had more symptoms and that their illness had a greater effect on their emotions and their lives in general (BIPQ identity, consequences, concern, emotional response p ≤ 0.015). Women with improved asthma control had significantly lower AQLQ-M breathlessness (p = 0.048) and lower total scores (p = 0.04) than women with controlled asthma.
Pregnant women who are not able to get control of their asthma symptoms may experience worse quality of life and are likely to have more negative perceptions about their condition.
探讨哮喘孕妇的哮喘控制与心理社会结局之间的关系。
对一项基于呼出一氧化氮分数与基于临床指南的算法进行治疗调整的随机对照试验进行二次分析（N = 221）。心理社会变量包括一般和哮喘特异性生活质量（SF12、AQLQ-M）、疾病认知（BIPQ）、感知控制（PCAQ）、感知副作用风险（PRSE）和焦虑（STAI-6）。哮喘控制定义为：控制良好（随机分组时和研究结束时哮喘控制问卷（ACQ7）≤1.5）、改善（随机分组时ACQ7 > 1.5且研究结束时≤1.5）和未改善（研究结束时ACQ7 > 1.5）。在研究结束时，针对每项心理社会指标拟合回归模型，对基线值和吸烟状况进行调整，并将哮喘控制作为预测变量。
与哮喘得到控制的女性相比，哮喘未改善的女性在身体方面（SF12，p = 0.012）以及所有领域的哮喘特异性生活质量（AQLQ-M，p≤0.012）较差。她们认为自己对哮喘的控制较少（PCAQ总分p = 0.014），有更多症状，并且她们的疾病对其情绪和整体生活有更大影响（BIPQ身份认同、后果、担忧、情绪反应p≤0.015）。哮喘控制得到改善的女性与哮喘得到控制的女性相比，AQLQ-M呼吸急促得分显著更低（p = 0.048），总分也更低（p = 0.04）。
无法控制哮喘症状的孕妇可能生活质量更差，并且可能对自己的病情有更多负面认知。
