Rhee Hyekyun, Belyea Michael, Mammen Jennifer
University of Rochester, School of Nursing, 601 Elmwood Avenue, Box SON, Rochester, NY 14642 USA.
Arizona State University, College of Nursing and Health Innovation, 500 N. 3rd Street, Phoenix, AZ 85004 USA.
Allergy Asthma Clin Immunol. 2017 Apr 28;13:24. doi: 10.1186/s13223-017-0196-7. eCollection 2017.
Success in asthma management hinges on patients' competency to detect and respond to ever-changing symptom severity. Thus, it is crucial to have reliable, simple, and sustainable methods of symptom monitoring that can be readily incorporated into daily life. Although visual analogue scale (VAS) has been considered as a simple symptom assessment method, its utility as a daily symptom monitoring tool in adolescents is unknown. This study was to determine the concurrent validity of VAS in capturing diurnal changes in symptoms and to examine the relationships between VAS and asthma control and pulmonary function.
Forty-two adolescents (12-17 years old) with asthma completed daily assessment of symptoms twice per day, morning and bedtime, for a week using VAS and 6-item symptom diary concurrently. Asthma control was measured at enrollment and 6 month later, and spirometry was conducted at enrollment. Pearson correlations, multilevel modeling and regression were conducted to assess the relationships between VAS and symptom diary, asthma control and FEV1.
Morning and evening VAS was positively associated with symptom diary items of each corresponding time frame of the day (r = 0.41-0.58, p < 0.0001). Morning VAS was significantly predicted by morning diary data reflecting nocturnal wakening (β = 2.13, p = 0.033) and morning symptoms (β = 4.09, p = 0.002), accounting for 57% of the total variance of morning VAS. Similarly, changes in four evening diary items, particularly shortness of breath (β = 2.60, p = 0.028), significantly predicted changes in evening VAS, accounting for 55% of the total variance. Average VAS scores correlated with asthma control (r = 0.65, p < 0.001) and FEV1 (r = -0.38, p = 0.029), and were predictive of asthma control 6 months later (β = 0.085, p = 0.006).
VAS is a valid tool capturing diurnal changes in symptoms reflected in a multi-item symptom diary. Moreover, VAS is a valid measure predicting concurrent and future asthma control. The findings suggest VAS can be a simple alternative to daily dairies for daily symptom monitoring, which can provide invaluable information about current and future asthma control without substantially increasing self-monitoring burdens for adolescent patients. NCT01696357. Registered 18 September 2012.
哮喘管理的成功取决于患者察觉并应对不断变化的症状严重程度的能力。因此，拥有可靠、简单且可持续的症状监测方法至关重要，这些方法应能轻松融入日常生活。尽管视觉模拟评分法（VAS）被视为一种简单的症状评估方法，但其作为青少年日常症状监测工具的效用尚不清楚。本研究旨在确定VAS在捕捉症状日间变化方面的同时效度，并探讨VAS与哮喘控制及肺功能之间的关系。
42名年龄在12至17岁的哮喘青少年患者，每天早晚两次使用VAS和6项症状日记，同时对症状进行为期一周的数据收集。在入组时和6个月后测量哮喘控制情况，并在入组时进行肺功能测定。采用Pearson相关性分析、多水平建模和回归分析来评估VAS与症状日记、哮喘控制及第一秒用力呼气容积（FEV1）之间的关系。
早晚的VAS与当天相应时间框架的症状日记项目呈正相关（r = 0.41 - 0.58，p < 0.0001）。反映夜间觉醒的早晨日记数据（β = 2.13，p = 0.033）和早晨症状（β = 4.09，p = 0.002）对早晨VAS有显著预测作用，占早晨VAS总方差的57%。同样，四项晚上日记项目的变化，尤其是呼吸急促（β = 2.60，p = 0.028），对晚上VAS的变化有显著预测作用，占总方差的55%。VAS平均得分与哮喘控制情况（r = 0.65，p < 0.001）和FEV1（r = -0.38，p = 0.029）相关，并且可预测6个月后的哮喘控制情况（β = 0.085，p = 0.006）。
VAS是一种有效的工具，能够捕捉多项目症状日记中所反映的症状日间变化。此外，VAS是预测当前和未来哮喘控制情况的有效指标。研究结果表明，VAS可作为日常症状监测中替代日常日记的简单方法，它能在不显著增加青少年患者自我监测负担的情况下，提供有关当前和未来哮喘控制的宝贵信息。 临床试验注册号：NCT０1696357。于2012年9月18日注册。
