Pogge Gabrielle, Waters Erika A, Webster Gregory D, Prabhakaran Sreekala, Hunleth Jean M, Fedele David A, Shepperd James A
University of Florida, Department of Psychology, Gainesville, FL, 32603, USA.
Washington University School of Medicine, Department of Surgery - Public Health Sciences, Saint Louis, MO, USA.
J Asthma Allergy. 2022 Dec 20;15:1795-1804. doi: 10.2147/JAA.S385891. eCollection 2022.
Although several indicators suggest that pediatric asthma control in the United States improved early in the pandemic, other indicators suggest not. Missing are reports from caregivers of the experiences of their children with asthma early in the pandemic.
Using the PP-ACT and other measures that we specifically constructed for our research, we conducted a cross-sectional national survey of US caregivers of children with asthma (N=595) to examine perceived change in their child's asthma control and changes in reports of ED visits and use of emergency relief medicine and controller medicine pre-pandemic (January to March 2020) versus early-pandemic (June to September 2020).
Caregivers fell into three groups: most caregivers perceived that their child's asthma control was improved (50.3%) or unchanged (41.2%), and few reported worse control (8.5%). Surprisingly, all three groups of caregivers reported similar frequencies of early-pandemic and pre-pandemic ED visits and use of emergency relief medicine. Also surprising, caregivers who perceived their child's asthma as more controlled (compared with the other two groups) reported more frequent ED visits and use of emergency relief medicine, yet also more use of controller medicine at both early-pandemic and pre-pandemic.
The mismatch between caregivers' perceptions of their child's early-pandemic asthma control and their reports of ED visits and use of emergency relief medicine suggests that caregivers may rely on a gist (a global evaluation that can include nonbiomedical evidence) when estimating their child's asthma control. Caregivers and their families could benefit from help from clinicians in understanding the discrepancy between subjective asthma control and asthma control indicators and in understanding what well-controlled asthma looks and feels like.
尽管有多项指标表明美国儿童哮喘控制在疫情早期有所改善，但其他指标却显示并非如此。目前缺少照顾者关于其子女在疫情早期哮喘经历的报告。
我们使用PP - ACT以及专门为研究构建的其他指标，对美国哮喘患儿的照顾者（N = 595）进行了一项全国性横断面调查，以研究他们对孩子哮喘控制的感知变化，以及疫情前（2020年1月至3月）与疫情早期（2020年6月至9月）急诊就诊报告和急救药物及控制药物使用情况的变化。
照顾者分为三组：大多数照顾者认为其孩子的哮喘控制得到改善（50.3%）或没有变化（41.2%），很少有人报告控制变差（8.5%）。令人惊讶的是，三组照顾者报告的疫情早期和疫情前急诊就诊频率以及急救药物使用情况相似。同样令人惊讶的是，那些认为孩子哮喘控制更好的照顾者（与其他两组相比）报告的急诊就诊和急救药物使用频率更高，但在疫情早期和疫情前使用控制药物的频率也更高。
照顾者对孩子疫情早期哮喘控制的认知与其急诊就诊报告及急救药物使用情况之间的不匹配表明，照顾者在评估孩子的哮喘控制时可能依赖于一种要点（一种可包括非生物医学证据的总体评估）。照顾者及其家人可能会从临床医生的帮助中受益，以理解主观哮喘控制与哮喘控制指标之间的差异，以及理解哮喘控制良好时的表现和感受。
