Measurement of psychological distress in asthma and asthma management programmes.

The Asthma Bother Profile assesses one of the components of asthma experience: asthma distress. An initial questionnaire was constructed from the content of earlier asthma quality of life research and modified by comments of 32 asthmatics in focus groups. Psychometric analysis of responses of 131 asthmatics to the final questionnaire showed that the 15 ¿bother items' constitute a unidimensional measure of asthma distress with high internal consistency, and the seven ¿management items' assess the patient's confidence of asthma knowledge, perception of the quality of care and confidence in managing asthma attacks. Patients who had attended a self-management clinic reported more knowledge of asthma, more bother from treatment but not significantly less bother in other contexts. Knowledge about when to call the doctor but not knowledge about medicine or asthma was correlated with total bother. Self-management programmes that encourage problem-focused coping strategies may not reduce asthma distress unless distress reduction counselling is included within the education programme.